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Epidemiology of Clinical Sporotrichosis in the Americas in the Last Ten Years. J Fungi (Basel) 2022; 8:jof8060588. [PMID: 35736071 PMCID: PMC9224952 DOI: 10.3390/jof8060588] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sporotrichosis is a fungal infection caused by species of the Sporothrix genus. Presently, the prevalence of sporotrichosis in the Americas is unknown, so this study aims to analyze the cases reported in the past 10 years. METHODS An advanced search was conducted from 2012 to 2022 in English and Spanish in PUBMED, SciELO, and Cochrane, with the terms: "sporotrichosis", "lymphocutaneous sporotrichosis", "fixed sporotrichosis", "mycosis", "Sporothrix spp.", "Sporothrix complex", "S. schenckii sensu stricto", "S. schenckii sensu lato", "S. globose", "S. brasiliensis", "S. luriei". Sporotrichosis is a fungal infection caused by species of the Sporothrix genus associated with "pathogenicity" or "epidemiology". RESULTS A total of 124 articles were found in the Americas, corresponding to 12,568 patients. Of these, 87.38% of cases were reported in South America, 11.62% in North America, and 1.00% in Central America and the Caribbean. Brazil, Peru, and Mexico had the highest number of cases. The most prevalent etiological agents were S. schenckii complex/Sporothrix spp. (52.91%), S. schenckii (42.38%), others (4.68%), and Not Determined (ND) (0.03%). The most frequent form of the disease was lymphocutaneous infection; however, the infection type was not determined in 5639 cases. Among the diagnostic methods, culture was the most used. CONCLUSIONS There is a high occurrence of cases reported in the literature. South America is the region with the highest number of reports because of its environment (climate, inhalation of spores, etc.), zoonotic transmission (scratches and sneezes from contaminated animals), and possible traumatic inoculation due to outdoor activities (agriculture, gardening, and related occupations). Molecular diagnosis has not been sufficiently developed due to its high cost.
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Sporotrichosis in Children: Case series and Narrative Review. CURRENT FUNGAL INFECTION REPORTS 2022; 16:33-46. [PMID: 35284035 PMCID: PMC8902271 DOI: 10.1007/s12281-022-00429-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 11/23/2022]
Abstract
Purpose of Review Pediatric sporotrichosis has not been sufficiently studied; this review aims to evaluate the risk and prognostic factors related to the development of sporotrichosis associated to this age group. Also, we want to evaluate the causes of the increased number of cases of sporotrichosis in the pediatric population such as environmental changes in endemic areas, the biodiversity, and virulence among the pathogenic clade causing sporotrichosis in different areas of the globe, and especially the progression of the zoonotic transmission of infections caused by Sporothrix brasiliensis infections, associated to zoonotic transmission in Brazil and other endemic sporotrichosis countries. Recent Findings After evaluating a case series of 40 patients, we found that pediatric sporotrichosis in Mexico is mainly caused by Sporothrix schenckii which prevails in rural areas and is mainly sapronotically transmitted. In Brazil, the longest and largest pediatric sporotrichosis outbreak is caused by Sporothrix brasiliensis, etiologically related to sick cats, directly from lesions containing a high yeast cell burden. When affecting children S. schenckii and S. brasiliensis may cause distinct clinical manifestations especially in the onset of the disease and affected anatomical site. In Mexico, most of the patients are successfully treated with potassium iodide, whereas in Brazil, all patients respond to itraconazole. Summary Sporothrix schenckii is the major etiologic agent in Mexico, being sapronotically transmitted, while in Brazil, Sporothrix brasiliensis is only transmitted by cats. In Mexico, the disease prevails in male patients (60%) from rural areas; in Brazil, the disease is more frequent in females (60%) from an urban region. Due to the zoonotic sporotrichosis outbreak in Brazil, the time of evolution seems to be shorter in Brazilian patients than in Mexican patients. Most Brazilian patients presented with facial lesions, including ocular involvement, while in Mexico, most of the children presented upper limbs involvement. In Mexico, treatment with potassium iodide in children was observed to induce faster remission than itraconazole, but controlled studies are lacking to evaluate this versus itraconazole, due to the low number of cases. A comparative study should be designed to evaluate the best and safest antifungal therapy for pediatric sporotrichosis. Supplementary Information The online version contains supplementary material available at 10.1007/s12281-022-00429-x.
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Ma Y, Wang X, Li R. Cutaneous and subcutaneous fungal infections: recent developments on host-fungus interactions. Curr Opin Microbiol 2021; 62:93-102. [PMID: 34098513 DOI: 10.1016/j.mib.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/27/2021] [Accepted: 05/07/2021] [Indexed: 02/07/2023]
Abstract
The incidence of skin fungal infections is increasing at an alarming rate worldwide, presenting a major challenge to health professionals. Cutaneous and subcutaneous fungal infections are caused by pathogenic or opportunistic organisms varying from mold, yeasts, to dimorphic fungi. Recently, skin fungal have been increasingly reported and studied, giving rise to crucial breakthroughs in etiology and pathogenesis. This review aims to summarize recent insights into the clinical and etiological characteristics of common skin fungal infections according to different fungal species, as well as remarkable advances in the immune mechanisms. We hope it will be helpful to understand these diverse skin fungal infections, and bring about the latest developments that may facilitate novel diagnostic and therapeutic approaches to improve the outcomes in these patients.
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Affiliation(s)
- Yubo Ma
- Department of Dermatology and Venerology, Peking University First Hospital, China; Research Center for Medical Mycology, Peking University, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, China; National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China
| | - Xiaowen Wang
- Department of Dermatology and Venerology, Peking University First Hospital, China; Research Center for Medical Mycology, Peking University, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, China; National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China.
| | - Ruoyu Li
- Department of Dermatology and Venerology, Peking University First Hospital, China; Research Center for Medical Mycology, Peking University, China; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, China; National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China.
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Lecca LO, Paiva MT, de Oliveira CSF, Morais MHF, de Azevedo MI, Bastos CDVE, Keller KM, Ecco R, Alves MRS, Pais GCT, Salvato LA, Xaulim GDMD, Barbosa DS, Brandão ST, Soares DFDM. Associated factors and spatial patterns of the epidemic sporotrichosis in a high density human populated area: A cross-sectional study from 2016 to 2018. Prev Vet Med 2020; 176:104939. [PMID: 32143029 DOI: 10.1016/j.prevetmed.2020.104939] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/17/2020] [Accepted: 02/23/2020] [Indexed: 12/19/2022]
Abstract
An epidemiological characterization of human and feline sporotrichosis was carried out between 2016 and 2018, in a high density-populated area in Brazil. Professionals were trained to identify suspect cats and notify vets to interview the owners and collect swabs of the wounds from these animals. Mycological cultures were performed, and colonies identified as Sporothrix spp. Subsequently, data regarding the outcome from suspect animals were collected. Confirmed cases of human sporotrichosis (56) were also counted and analyzed for spatial distribution. 118 positive animals were observed. The prevalence of feline sporotrichosis was 8.36 ‰ (CI 95 %, 5.38-9.55 ‰). The odds for being positive in animals that lived only partially at home were 3.02 times greater than for those cats without access to the street (OR 3.02, CI 95 % 1,96-10,43). There was no statistically significant association between environmental variables and positive diagnosis, corroborating the hypothesis that direct transmission by infected cats plays a greater role in the occurrence and continuous outbreaks of sporotrichosis in Brazil. Among the positive animals, 61.90 % (CI 95 % 58.95-64.96) died, and they had an odds to die in the next six months 6.30 times greater than negative animals (p < 0.05, OR 6.30, CI 95 % 2,79-14,42). The case fatality rate was 55.08 % in cats (CI 95 % 49.20-51.15). The cause-specific death rate was 4.6 ‰ in cats (CI 95 % 3.4-6 ‰). Only 7.62 % (CI 95 % 7.12-8.16) positive cats were treated and cured. Among dead positive animals, 29.23 % were inappropriately discarded. In the study period 56 human cases were recorded in the Barreiro region. Regions with highest prevalence of feline sporotrichosis, had greater frequencies of both human and feline cases. This is the first report on the epidemic of sporotrichosis in Minas Gerais, Brazil. The free offer for treatment and veterinary care for these animals should be taken into consideration, as well as the collection and incineration of the dead ones, as measures of public health, followed by the guidance and care for the human patient.
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Affiliation(s)
- Lívian Otávio Lecca
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcelo Teixeira Paiva
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Camila Stefanie Fonseca de Oliveira
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Isabel de Azevedo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila de Valgas E Bastos
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Kelly Moura Keller
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Roselene Ecco
- Departamento de Clínica e Cirurgia Veterinária, Escola de Veterinária da Universidade Federal de Minas Gerais Belo Horizonte, Minas Gerais, Brazil
| | - Márcia Regina Silva Alves
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Graziella Coelho Tavares Pais
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Lauranne Alves Salvato
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gustavo de Morais Donancio Xaulim
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - David Soeiro Barbosa
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais Belo Horizonte, Minas Gerais, Brazil
| | - Silvana Tecles Brandão
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
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