Sporothrix brasiliensis: Epidemiology, Therapy, and Recent Developments

Xavier, Melissa Orzechowski; Poester, Vanice Rodrigues; Trápaga, Mariana Rodrigues; Stevens, David A.

doi:10.3390/jof9090921

Cited by 11 publications

(6 citation statements)

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“…All the atypical cases of zoonotic sporotrichosis occurred in Brazil, which is considered the epicenter of the disease in the world [9], and the majority occurred in the state of Rio de Janeiro, where this mycosis has a hyperendemic status, in a scenario that began as an outbreak at the end of the 1990s [3,42]. Besides Rio de Janeiro, atypical zoonotic sporotrichosis cases were also reported in patients from ten additional Brazilian states.…”

Section: Discussionmentioning

confidence: 99%

“…Not restricted to Brazil anymore, nowadays S. brasiliensis is also an emergent pathogen in other South American countries, with autochthonous cases being described in Chile, Argentina, Paraguay, and Uruguay. Furthermore, cases of zoonotic sporotrichosis have been reported in recent years in other continents (North America and Europe) where patients were infected by cats imported from Brazil [4][5][6][7][8][9]. Domestic cats are the main victims of sporotrichosis caused by S. brasiliensis and the main source of the dissemination of this fungal species.…”

Section: Introductionmentioning

confidence: 99%

“…Considering the increase in the reports of these atypical manifestations in patients with zoonotic sporotrichosis, which can lead to a higher rate of hospitalization and a worse prognosis [3,9,23,38], we compiled data from all cases reported and/or series of cases published in the literature in a unique and combined approach, to better understand their impact. Therefore, here we perform a systematic review of the literature on zoonotic sporotrichosis involving HR and extracutaneous presentations.…”

Section: Introductionmentioning

confidence: 99%

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Sporothrix brasiliensis Causing Atypical Sporotrichosis in Brazil: A Systematic Review

Poester,

Xavier,

Munhoz

et al. 2024

JoF

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Zoonotic sporotrichosis, a subcutaneous mycosis caused by Sporothrix brasiliensis, has become hyperendemic and a serious public health issue in Brazil and an emerging disease throughout the world. Typical sporotrichosis is defined as fixed or lymphocutaneous lesion development, however, reports of atypical presentations have been described in hyperendemic areas, which may result in a worse prognosis. Thus, considering an increase in atypical cases and in more severe extracutaneous cases and hospitalizations reported in Brazil, we aimed to perform a systematic review to search for hypersensitivity reactions (HRs) and extracutaneous presentations associated with zoonotic sporotrichosis. A systematic review was performed, following the PRISMA guidelines to search for atypical/extracutaneous cases (mucosal, osteoarthritis, HRs, pulmonary, meningeal) of zoonotic sporotrichosis. A total of 791 published cases over 26 years (1998–2023) in eleven Brazilian states were reviewed. Most cases corresponded to a HR (47%; n = 370), followed by mucosal (32%; n = 256), multifocal (8%; n = 60), osteoarthritis (7%; n = 59), meningeal (4%; n = 32), and pulmonary (2%; n = 14) infections. When available (n = 607), the outcome was death in 7% (n = 43) of cases. Here, we show a frequent and worrisome scenario of zoonotic sporotrichosis in Brazil, with a high and dispersed incidence of atypical/extracutaneous cases throughout the Brazilian territory. Therefore, educational measures are necessary to make health professionals and the overall population aware of this fungal pathogen in Brazil as well as in other countries in the Americas.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sporothrix brasiliensis Causing Atypical Sporotrichosis in Brazil: A Systematic Review

Poester,

Xavier,

Munhoz

et al. 2024

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“…Cats are the most susceptible animal species to Sporothrix infection, often developing severe forms of the disease [2,26,27]. Clinical manifestations range from a single to multiple skin lesions, which can progress to disseminated systemic forms [28].…”

Section: Introductionmentioning

confidence: 99%

A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis

Reis,

Pereira,

Miranda

et al. 2024

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Feline sporotrichosis is an endemic disease with high occurrence in Brazil. Itraconazole (ITZ) remains the drug of choice for treating this disease in cats, despite the increasing reports of therapeutic failure. A controlled, randomized clinical trial was performed on 166 naive cats with sporotrichosis to assess the effectiveness and safety of the combination therapy with ITZ and potassium iodide (KI) compared with ITZ monotherapy. Cats were randomly allocated into two treatment groups: G1—ITZ 100 mg/cat/day—and G2—ITZ 100 mg/cat/day + KI 2.5–20 mg/kg/day. Cats treated in G2 presented 77% more risk of reaching a clinical cure (a positive effect) than those treated in G1, even when controlled by negative predictors. The survival curves of the two treatment protocols indicate that a clinical cure was achieved faster in G2. An increase in the KI dose was necessary in 28 cats due to the persistence of clinical signs. Adverse reactions were equally frequent in both groups and manageable with a temporary drug suspension and/or a hepatoprotective therapy. The combination therapy was associated with a higher cure rate and a shorter treatment time, suggesting that ITZ+KI arises as a better option for treating feline sporotrichosis and should be considered the first-line treatment, especially in the presence of negative predictors.

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“…Sporotrichosis caused by Sporothrix brasiliensis poses a severe public health challenge in Brazil and had spread to other countries (Paraguay, Chile, Argentina, the United Kingdom, and the United States) over the last decade, emerging as a global infectious disease ( Rabello et al, 2022 ; Gómez-Gaviria, Martínez-Álvarez & Mora-Montes, 2023 ; Xavier et al, 2023 ). Distinct genotypic profiles were shown to coexist in the major Brazilian hyperendemic areas, with S. brasiliensis isolates from Rio de Janeiro state (RJ) differing from those from Rio Grande do Sul state (RS) ( Rodrigues et al, 2013 ; Losada et al, 2023 ; Spruijtenburg et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Amlodipine and lufenuron as repurposing drugs against Sporothrix brasiliensis

Poester,

Hidalgo,

Jardim

et al. 2023

PeerJ

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Background Sporotrichosis caused by Sporothrix brasiliensis is a globally emerging infectious disease with limited therapeutic options. Thus, we aimed to evaluate the in vitro activity of amlodipine (AML) and lufenuron (LUF) alone and their interaction with itraconazole (ITZ), the first-choice drug against S. brasiliensis. Methods Twenty clinical isolates of S. brasiliensis from two hyperendemic regions were tested through a microdilution assay to evaluate the minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) of AML and LUF. Checkerboard assay was performed with 10 isolates for both drug interactions with ITZ. Results AML showed inhibitory and fungicidal activity against all isolates included, with MIC values ranging from 32 to 256 µg/mL, and MFC from 64 to 256 µg/mL. However, none of the S. brasiliensis isolates were inhibited by the highest soluble concentration of LUF (MIC >64 µg/mL for all strains). Synergic interaction of AML and LUF with ITZ occurred in 50% and 40% of the isolates tested, without any antagonistic effects. Conclusion Both repurposing drugs evaluated in our study showed a promising in vitro activity, especially in synergy with ITZ against S. brasiliensis, warranting future in vivo investigations regarding its activity.

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Sporothrix brasiliensis: Epidemiology, Therapy, and Recent Developments

Cited by 11 publications

References 100 publications

Sporothrix brasiliensis Causing Atypical Sporotrichosis in Brazil: A Systematic Review

Sporothrix brasiliensis Causing Atypical Sporotrichosis in Brazil: A Systematic Review

A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis

Amlodipine and lufenuron as repurposing drugs against Sporothrix brasiliensis

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