# Adjuvant hyperbaric oxygen therapy reduces the duration of sporotrichosis treatment

## TL;DR

Adding hyperbaric oxygen therapy to standard antifungal treatment speeds up recovery from sporotrichosis, a fungal skin infection.

## Contribution

This study demonstrates that hyperbaric oxygen therapy significantly reduces healing time for sporotrichosis when used as an adjuvant.

## Key findings

- Patients receiving hyperbaric oxygen therapy healed in 57.54 days versus 208.53 days with antifungal alone.
- Hyperbaric oxygen therapy made patients 65 times more likely to heal faster.
- Each additional year of age reduced chances of rapid healing by 2%.

## Abstract

Sporotrichosis is a subcutaneous mycosis caused by Sporothrix spp., typically acquired through traumatic inoculation of fungal spores from soil, plants and infected cat scratches. The disease manifests in various clinical forms, including lymphocutaneous, ocular, bone, and disseminated infections. Standard treatment relies on prolonged administration of antifungals such as itraconazole, terbinafine, and potassium iodide, often requiring months for complete resolution. Moreover, treatment challenges include slow clinical response, recurrence, and potential drug toxicity. Hyperbaric oxygen therapy has been investigated as a potential adjuvant for invasive fungal infections due to its antimicrobial properties, enhanced tissue oxygenation, and immunomodulatory effects, which may contribute to improved healing and therapeutic outcomes.

Patients with a confirmed diagnosis of cutaneous/lymphocutaneous sporotrichosis were divided into two groups to receive either itraconazole or itraconazole plus hyperbaric oxygen therapy. The primary outcomes were time to cure and therapeutic response. The intervention group was assessed weekly through clinical parameters and photographic records, and the control group was assessed monthly.

Patients who received hyperbaric oxygen therapy experienced a much shorter healing time than those who did not. The average time until a cure was 208.53 days in the itraconazole group compared to 57.54 days in the itraconazole plus hyperbaric oxygen therapy group. Patients in the Hyperbaric oxygen therapy group received an average of 18.23 hyperbaric sessions and were 65 times more likely to achieve faster healing than those who did not. Notably, with each additional year of age, the chances of rapid healing decreased by 2%.

Our findings suggest that adjuvant hyperbaric oxygen therapy significantly accelerates the healing of fixed cutaneous/lymphocutaneous sporotrichosis. The results also highlight hyperbaric oxygen therapy´s potential to enhance treatment efficacy and reduce the burden of prolonged antifungal therapy. These results support further investigation of this valuable adjunctive treatment in the management of sporotrichosis.

Sporotrichosis is a skin infection caused by a fungus found in soil, plants and infected cats. People usually catch it through small cuts, scrapes and infected cat scratches. The most common type of this disease is lymphocutaneous, which can take several months or even a year to fully heal. Therefore, long-term treatment with antifungal medications like itraconazole may cause several side effects. In this study, we explored whether adding hyperbaric oxygen therapy (HBOT), a treatment where patients breathe pure oxygen in a pressurized chamber, could help patients recover faster. We compared two groups of patients — one group received only itraconazole, and the other group received itraconazole plus HBOT. The results showed that patients who received HBOT got better much faster — on average, in about 58 days — compared to those who only took itraconazole, who needed more than 200 days to heal. Interestingly, as people get older, their chances of healing quickly decrease by about 2% each year. Our findings suggest that HBOT could be a helpful addition to standard treatment, speeding up recovery and reducing the risks linked to long-term use of antifungal drugs.