Sporotrichosis in Himachal Pradesh (North India)

Abstract

Sporotrichosis is being increasingly reported from a particular area of Himachal Pradesh, a state in north-west India. A skin-test survey was conducted using sporotrichin and peptido-rhamnomannan antigen among the population in the villages where 2 or more cases of sporotrichosis had been reported and results were compared with those for villages of the same where no case of sporotrichosis had been reported. The study was helped by local doctors, leaders and patients who were cured of sporotrichosis. The delayed-hypersensitivity positivity rates were significantly higher in case villages (range 22.9-40.0%) compared to control area (range 6.5-7.6%). Analysis by age showed that positivity rate increased with increase in age for both sexes. Analysis by occupation showed higher skin-test positivity in populations engaged in horticulture, nursery work, gardening, woodwork (43.2%) and farming (33.9%). The case villages have lower temperature and higher rainfall than the control villages. During the 1-year study period (1996-97), 25 cases of sporotrichosis were diagnosed: 16 cases were referred by doctors from the local area and 9 were from cases suspected during the skin-test survey. This study identifies Kangra district and adjoining areas in Himachal Pradesh as an endemic region for sporotrichosis and highlights the need for evaluation of geo-climatically similar areas.

Epidemiology of sporotrichosis: A study of 304 cases in Brazil

“…Female patients are almost two times more affected than male patients and this is a result of the agricultural work done by female residents in these countries. 21,24,38,43 In our study, occupational hazard was 13 times more frequent in the male population compared with the female population. Apparently, the absence of the same distinctive distribution by age or sex across endemic areas may reflect the absence of a unique pattern of age-or sex-related activities leading to exposure to the fungus.…”

“…As mentioned in other studies, more research in this field should be directed toward evaluating the importance of other species in the epidemiology of sporotrichosis. 26,35,37 Adults represent the highest proportion of cases in most selected endemic areas 15,21,26,36,[38][39][40][41][42] except in Peru, where a striking predominance (60%) of individuals younger than 15 years has been described. 2 With regard to sex, there is no uniform prevalence of either male or female patients in endemic areas.…”

“…Lesions on the upper limbs were twice as common as the ones located on the lower limbs for both adults and children. All studies, with minor variations, found a strikingly higher proportion of upper extremity involvement in adults, 17,19,21,38,39,42,44 but have highlighted that the face is the most frequently affected site in children and adolescents, 2,21,62,63 mainly because this anatomic site has a thinner and more delicate skin. In our study, we verified a significantly higher predominance of facial involvement in children, although the upper limbs were also frequently affected in this age group.…”

A case series and review of sporotrichosis in Sikkim

“…To our knowledge, only one case has been reported so far from Sikkim and this patient was investigated and treated in the neighbouring state of West Bengal [14]. It has been suggested that a humid and moist climate favours the growth of S. schenckii [19]. Thus Sikkim remains a lesser known niche for sporotrichosis and the present cases document the autochthonous emergence of sporotrichosis in this geographical region.…”

Sporotrichosis : A Case Report

“…Currently, oral itraconazole has become the drug of choice for lymphocutaneous sporotrichosis. [8], [9] The recommended dosage is 100-200 mg daily, to be administered for 3-6 months. In our patient, the diagnosis of sporotrichosis was suspected clinically and started on tab.…”