Case series of sporotrichosis at a teaching hospital in Brazil

Abstract

Introduction: Sporotrichosis is a subcutaneous fungal infection with a worldwide distribution and higher incidence in tropical and subtropical areas, such as the Brazilian territory, where it has been standing out due to its frequent epidemics. Thus, the present study aimed to evaluate the prevalence of sporotrichosis and profile the affected patients at a university teaching hospital in the central region of Rio Grande do Sul, Brazil. Methods: This study was a case series of patients diagnosed with Sporothrix spp. from January 2006 to December 2015 by microscopic examination or fungal isolates. Medical records were reviewed for epidemiological data. Results: Forty-three cases of sporotrichosis were diagnosed through the period. The sample comprised predominantly young male adults and rural workers. The most common disease type was lymphocutaneous (51%), followed by fixed cutaneous form (32.5%). The predominant location was the upper limbs (70%), followed by the lower limbs (16%). A significant association was observed between the lymphocutaneous form and upper limb location and between the fixed cutaneous form and lower limb location (p = 0.019). Potassium iodine and itraconazole were the most common treatments. Conclusions: This study will help update the epidemiological situation of sporotrichosis in the central region of the state of Rio Grande do Sul, Brazil, over the last decade.

Epidemiology of Clinical Sporotrichosis in the Americas in the Last Ten Years

“…After analyzing the articles to carry out the classification according to the new taxonomy, we found that the most common reported etiological agent was Sporothrix spp. with 94.34% (11,922/12,636), followed by S. schenckii with 3.16% (400/12,636), S. brasiliensis with 1.21% (153/12,636), S. globosa plus S. schenckii with 0.72% (91/12,636), S. globosa with 0.51% (65/12,636), S. mexicana 0.03% (4/12,636), and S. pallida with 0.007% (1/12,636) [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 ,…”

“…A total of 68 publications with 11,050 cases of sporotrichosis were found in South America [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 …”

“…Of these, 4 reports were found in Argentina during the analyzed period with 38 cases, of which 9 were caused by S. schenckii sensu stricto (23.68%), 26 by S. brasiliensis (68.52%), 1 by S. globosa (2.6%), 1 by S. schenckii (2.6%), and 1 by S. schenckii complex (2.6%) [ 61 , 62 , 63 , 64 ]. Brazil reported 42 articles with 5546 analyzed cases [ 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 ], identifying Sporothrix spp. and S. schenckii complex as the causative agent in 4906 cases (88.46%), S. schenckii in 302 (5.45%), S. brasiliensis in 125 (2.25%), Sporothrix sensu lato in 110 (1.98%), S. globosa plus S. schenckii in 91 cases (1.64%) Sporothrix sensu stricto in 5 (0.09%), S. globosa in 4 (0.07%), and S. mexicana in 3 (0.05%) during the studied period.…”

“…In Brazil, the main pathogenic agent was Sporothrix spp. with 95.56%, S. brasiliensis 2.25%, S. globosa plus S. schenckii 1.64%, S. schenckii 0.41%, S. globosa 0.07%, and S. mexicana 0.05% [ 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 ]. In Colombia, S. schenckii 44.00%, Sporothrix spp.…”

“…The most frequent types of disease were lymphocutaneous with 3293 cases (29.47%), fixed cutaneous with 1947 (17.43%), disseminated cutaneous with 34 (0.30%), systemic form with 18 (0.16%), and others with 177 cases (1.60%). However, there were 5702 cases (51.04%) with undetermined types from all the cases diagnosed as sporotrichosis [ 56 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 ,…”