Zoonotic sporotrichosis with greater severity in Rio de Janeiro, Brazil: 118 hospitalizations and 11 deaths in the last 2 decades in a reference institution

Falcão, Eduardo Mastrangelo Marinho; Pires, Mariah Castro de Souza; Andrade, Hugo Boechat; Gonçalves, Marcelo Luiz Carvalho; Almeida‐Paes, Rodrigo; Valle, Antônio Carlos Francesconi do; Bastos, Francisco Inácio; Gutierrez-Galhardo, Maria Clara; Freitas, Dayvison Francis Saraiva

doi:10.1093/mmy/myz024

Cited by 25 publications

(33 citation statements)

References 9 publications

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“…The classical form of infection is through direct contact with contaminated material, normally by cutaneous inoculation 4 or, less frequently, by inhalation of conidia 5 . However, an alternative route of infection involves the zoonotic transmission of the agent mostly though bites and scratches from infected domestic cats 6,7 …”

Section: Introductionmentioning

confidence: 99%

Primary conjunctival sporotrichosis in three cats from Northeastern Brazil

Spinelli¹,

Bezerra²,

Souza

et al. 2021

Veterinary Ophthalmology

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Introduction Classically, sporotrichosis occurs as a chronic granulomatous lymphocutaneous infection. The extracutaneous form is uncommon and may affect the eye without cutaneous involvement. The most frequent form of ocular sporotrichosis reported in humans is a granulomatous conjunctivitis. There are no previous reports on primary ocular sporotrichosis in cats. Procedures Three mixed breed cats rescued from shelters were referred by the veterinarian for ophthalmic evaluation with a complaint of conjunctivitis nonresponsive to treatment with no evidence of skin disease or systemic disease. Complete ophthalmic examination, conjunctival cytology, and microbiological analysis were performed. Results Ophthalmic examinations revealed epiphora, purulent ocular discharge, conjunctival hyperemia, and a mass in the palpebral conjunctiva. Conjunctival cytology revealed segmented and degenerated neutrophils, conjunctival epithelial cells, and an abundant number of round and oval cells compatible with Sporothrix spp. Microbiological culture was performed and confirmed the presence of fungi from the Sporothrix schenckii complex. All animals were treated with oral itraconazole; two animals received topical itraconazole in association with oral treatment. Case 1 was refractory to treatment, and iodate potassium was combined with itraconazole therapy without resolution at the time of this publication. Cases 2 and 3 had complete resolution of conjunctival lesions with four months of oral and topical itraconazole therapy. Conclusion Conjunctival sporotrichosis should be considered as a differential diagnosis of conjunctivitis in cats from endemic regions. Conjunctival cytology is an important tool that can aid early diagnosis.

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Section: Introductionmentioning

confidence: 99%

Primary conjunctival sporotrichosis in three cats from Northeastern Brazil

Spinelli¹,

Bezerra²,

Souza

et al. 2021

Veterinary Ophthalmology

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“…In extracutaneous sporotrichosis, the lesions may be restricted to a single organ or may be disseminated. Disseminated sporotrichosis can affect, besides the skin, the osteoarticular system, mucous membranes, lungs, eye, and the central nervous system 1,3 . This form occurs by hematogenous dissemination of the fungus to any organ or tissue.…”

Section: Discussionmentioning

confidence: 99%

“…As expected, most cases present as a localized skin disease. However, an increase in cases of immunosuppressed hosts, such as co‐infection with the human immunodeficiency virus (HIV), has been observed, often with disseminated infection and fatal outcome 3,4 …”

Section: Introductionmentioning

confidence: 99%

Zoonotic sporotrichosis in renal transplant recipients from Rio de Janeiro, Brazil

Fichman

Macedo

Freitas

et al. 2020

Transplant Infectious Dis

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Sporotrichosis is the main subcutaneous mycosis in the world. In the last two decades, zoonotic sporotrichosis transmitted by cats has become hyperendemic in Rio de Janeiro, Brazil. Renal transplant recipients are subject to invasive fungal infection because of the effects of immunosuppressive therapy, but sporotrichosis is rarely reported. The authors conducted a retrospective study describing epidemiological, clinical, and therapeutic data related to adult renal‐transplant‐recipient patients diagnosed with sporotrichosis. The molecular identification of fungal isolates was performed. Minimal inhibitory concentration (MIC) of amphotericin B (AMB), itraconazole (ITZ), posaconazole (POS), isavuconazole, and terbinafine (TRB) against the strains was determined using the protocol described by the Clinical and Laboratory Standards Institute (CLSI). Six cases were identified from a cohort with 2429 sporotrichosis patients. They were five men and one woman, with a mean age of 44.2 years (range: 34‐54 years). Four of them had cutaneous limited forms, and two patients had disseminated forms. The mean time between transplant and the onset of sporotrichosis symptoms was 25.5 (range: 6‐36) months. Sporothrix brasiliensis was identified as the causative agent. The isolates were classified as wild type for all antifungal drugs tested. Treatment schemes included AMB (deoxycholate and liposomal), ITZ, and TRB. Five patients evolved to cure, and one died as a result of disseminated disease. Renal transplant recipients may be a vulnerable group for sporotrichosis in endemic countries. The authors highlight the importance of sporotrichosis prevention, early diagnosis, and treatment to prevent disseminated disease and poor prognosis.

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“…We report a case of primary pulmonary sporotrichosis due to S. brasiliensis in an area spanning a nearly 2,000 km of distance from the epicenter in Rio de Janeiro, showing the emerging characteristic of this species in other parts of Brazil. The number of atypical cases due to S. brasiliensis has been increasing [25] and its high virulence to mammals has been constantly reported [26][27], including more aggressive manifestations in humans [28]. On the other hand, the species included in the environmental clade, such as S. chilensis, S. mexicana and S. pallida [29][30], as well as to S. globosa, (clinical clade) are attenuated in virulence [31].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Fatal pulmonary sporotrichosis caused by Sporothrix brasiliensis in Northeast Brazil

et al. 2020

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Background A relevant case of pulmonary sporotrichosis due to Sporothrix brasiliensis is reported in a 50-year-old immunocompetent woman who had no history of skin trauma, but was in close contact with several stray cats at her nap time. The patient was hospitalized after 7 months of illness. The survey was conducted for pulmonary tuberculosis, an endemic disease in Brazil. She presented multiple central pulmonary nodules images, with central cavitation. Methodology/Principal findings The patient bronchoalveolar lavage was cultured and Sporothrix sp. growth was obtained. Then, the isolate (LMMM1097) was accurately identified to the species level by using species-specific polymerase chain reaction (PCR). Molecular diagnosis revealed that the emerging species Sporothrix brasiliensis was the agent of primary pulmonary sporotrichosis and the patient was treated with Amphotericin B lipid complex, but presented severe clinical symptoms and the fatal outcome was observed at day 25 after hospitalization. Conclusions/Significance Our report adds important contributions to the clinical-epidemiological features of sporotrichosis, showing the geographic expansion of the agent within different regions of Brazil and a rare clinical manifestation (primary pulmonary sporotrichosis) caused by the emerging agent S. brasiliensis in an immunocompetent female patient.

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Zoonotic sporotrichosis with greater severity in Rio de Janeiro, Brazil: 118 hospitalizations and 11 deaths in the last 2 decades in a reference institution

Cited by 25 publications

References 9 publications

Primary conjunctival sporotrichosis in three cats from Northeastern Brazil

Primary conjunctival sporotrichosis in three cats from Northeastern Brazil

Zoonotic sporotrichosis in renal transplant recipients from Rio de Janeiro, Brazil

Fatal pulmonary sporotrichosis caused by Sporothrix brasiliensis in Northeast Brazil

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