Epidemiological and Clinical Aspects of Sporotrichosis in Espírito Santo State, Southeast Brazil: A Study of Three Decades (1982–2012)

Abstract

This study discusses a historical patient series and is designed to describe clinical and epidemiological characteristics of human sporotrichosis in the state of Espírito Santo, Brazil. Data were derived from patients treated at the Infectious Diseases service of Cassiano Antônio Moraes University Hospital in Vitória, the state capital, from July 1982 to June 2012. A total of 171 patients were diagnosed with sporotrichosis, mostly men (80.7%) with a median age of 33 years and 5 months. We can presume an approximate average incidence rate of 4.9 cases per 100,000 inhabitants during the studied period. All the patients were involved in occupational or leisure activities with direct contact with soil or plants. Most cases were recorded in the mountainous region of the state during the hot and rainy periods. The average time elapsed from lesion progression to diagnosis was 3 months, with the lymphocutaneous form being the most common (70.2%), followed by the fixed cutaneous form (28.6%). Diagnosis was confirmed in 93.6% of the cases by culturing Sporothrix spp. in Sabouraud dextrose agar, and from the clinical features in the remaining cases. Aspiration of cutaneous nodule secretions was the best method for the collection of clinical specimens for disease diagnosis. A 25% saturated solution of potassium iodide (SSKI) was provided to almost all patients (98.8%), with therapeutic success. In conclusion, in this retrospective study in the state of Espírito Santo, we found that sporotrichosis affects primarily the ³ 10-year-old population, and the most common presentation is the lymphocutaneous form affecting the lower and upper limbs, and the infection appeared to be acquired predominantly through occupational activities. Treatment with SSKI was safe and effective.

Molecular‐based assessment of diversity and population structure of Sporothrix spp. clinical isolates from Espírito Santo‐Brazil

“…Also, until 2012 sporotrichosis was restricted to rural and mountainous areas in the state of Espírito Santo. Such regions have high altitude characteristics, having colder climate, and confirmed cases of this fungal infection were associated with occupational and leisure activities 18 . However, according to our results, there is a new scenario in which the disease has abruptly spread in urban areas in recent years.…”

“…According to our findings, the disease had a higher prevalence in the municipalities of Vila Velha and Cariacica, in the metropolitan region, surpassing more than 15 cases in both locations in three years. Restricting itself only to sporotrichosis cases treated at HUCAM, the number of cases in the last 3 years (n = 162) was remarkably close to the cases reported by Caus et al 18 in 30 years, which confirms the expansion of the disease in the state of Espírito Santo.…”

“…Caus et al 18 analysed the medical records of patients attending the Infectious Diseases Service Clinic at HUCAM from 1982 to 2012 and found that 171 patients were diagnosed with sporotrichosis. These cases were distributed in 38 municipalities in the state, with the highest occurrence in Domingos Martins and Afonso Cláudio, while the metropolitan region had only one case in each municipality.…”

“…Until now, there is no behavioural data for the idiomorphs of Sporothrix species in the state of Espírito Santo. Moreover, from 1982 to 2012, 171 cases of human sporotrichosis have been recorded in Espírito Santo state 18 . However, species distribution and molecular identification of fungal isolates involved in those sporotrichosis cases are still unclear.…”

The clinico‐epidemiological characteristics and therapeutic experience of 152 patients with cutaneous sporotrichosis: a 10‐year retrospective study from India

“…The lymphocutaneous form is more common and is seen in nearly 70%-80% of patients in most studies. 12,13,24 The Similar observations were also made by Song et al 25 in their study, noting 55% of 457 patients with fixed cutaneous form.…”