Cutaneous Disseminated and Extracutaneous Sporotrichosis: Current Status of a Complex Disease

Abstract

Sporotrichosis is an implantation or inoculation mycosis caused by species of Sporothrix schenckii complex; its main manifestations are limited to skin; however, cutaneous-disseminated, disseminated (visceral) and extracutaneous variants of sporotrichosis can be associated with immunosuppression, including HIV-AIDS, chronic alcoholism or more virulent strains. The most common extracutaneous form of sporotrichosis includes pulmonary, osteoarticular and meningeal. The laboratory diagnosis requires observing yeast forms and isolating the fungus; the two main causative agents are Sporothrix schenckii (ss) and Sporothrix brasiliensis. Antibody levels and species recognition by Polimerase Chain Reaction using biological samples or cultures are also useful. The treatment of choice for most cases is amphotericin B and subsequent itraconazole for maintenance therapy.

Monitoring Fungal Burden and Viability of Sporothrix spp. in Skin Lesions of Cats for Predicting Antifungal Treatment Response

“…In fact, experimental models have shown that the efficiency of the immune response will affect the control of fungal burden [ 23 , 24 , 25 , 26 ]. Similarly, in humans and dogs, the occurrence of lesions with high fungal burdens is usually associated with immunosuppressive conditions, such as malnutrition, use of steroid, and the presence of underlying diseases, especially those that induce immunosuppression, such as AIDS [ 27 , 28 , 29 , 30 , 31 , 32 ]. In cats, Miranda et al [ 7 , 33 ] and Souza et al [ 13 ] have already observed that different immune response patterns determine the intensity of the fungal burden in skin lesions of feline sporotrichosis and that large numbers of fungal cells generally occur in lesions with a poorly organized inflammation.…”

Sporothrix brasiliensis induces a more severe disease associated with sustained Th17 and regulatory T cells responses than Sporothrix schenckii sensu stricto in mice

“…Sporotrichosis is the most reported and globally distributed subcutaneous mycosis (Bonifaz and Tirado-S anchez, 2017). Although considered endemic in tropical and subtropical countries, sporotrichosis has been increasingly observed in other regions and currently is regarded as an important and emergent disease.…”

The estimated burden of fungal disease in South Africa

“…While blastomycosis is endemic to SA, it is uncommon; [71][72][73][74] we estimated 10 cases per year. Sporotrichosis, an implantation mycosis that can also present with pulmonary and disseminated disease in HIV, [58,75] has been implicated in sporadic infections and outbreaks in SA, the latter primarily reported among mineworkers. [59,76,77] We estimated 40 cases of sporotrichosis per year.…”