A 55-year-old renal transplant recipient on immunosuppressive therapy develops multiple painful subcutaneous nodules along the lymphatics of the hand after a rose thorn prick. KOH of tissue shows cigar-shaped yeast cells. Which antifungal is the treatment of choice for lymphocutaneous disease?
- A Oral fluconazole
- B Intravenous amphotericin B
- C Oral itraconazole ✓
- D Oral terbinafine
Correct answer: C. Oral itraconazole
Explanation
The clinical picture describes lymphocutaneous sporotrichosis caused by Sporothrix schenckii. Itraconazole is the treatment of choice for lymphocutaneous and fixed cutaneous sporotrichosis according to IDSA guidelines. Potassium iodide (SSKI) is an alternative in resource-limited settings. IV amphotericin C is reserved for disseminated or pulmonary disease. Fluconazole is less effective.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.