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Almeida HLD, Scott da Rocha A, Müller L, Boff AL. Single-lesion sporotrichosis triggering Sweet's syndrome. An Bras Dermatol 2024; 99:788-790. [PMID: 38851895 PMCID: PMC11342989 DOI: 10.1016/j.abd.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 06/10/2024] Open
Affiliation(s)
- Hiram Larangeira de Almeida
- Postgraduation in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil; Department of Dermatology, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
| | - Augusto Scott da Rocha
- Postgraduation in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | | | - Ana Letícia Boff
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
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Camandaroba LM, Soares-Neto RF, de Oliveira FS, Saraiva MN, Tenório MDL, Oliveira PD, Dos Santos CA, Martins-Filho PR, Portugal FM. First Case of Sporotrichosis in a Child in a Nonendemic Region of Brazil. Pediatr Infect Dis J 2024; 43:e256-e257. [PMID: 38502900 DOI: 10.1097/inf.0000000000004333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Leonora Maria Camandaroba
- Residency Program in Dermatology, University Hospital, Federal University of Sergipe, Aracaju, SE, Brazil
| | | | | | - Mariana Nunes Saraiva
- Residency Program in Dermatology, University Hospital, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Martha Débora Lira Tenório
- Residency Program in Dermatology, University Hospital, Federal University of Sergipe, Aracaju, SE, Brazil
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
- Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Pedro Dantas Oliveira
- Residency Program in Dermatology, University Hospital, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Cliomar Alves Dos Santos
- Government of Sergipe State, Central Laboratory of Public Health, (LACEN/SE), Aracaju, SE, Brazil
| | - Paulo Ricardo Martins-Filho
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
- Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Fedro Menezes Portugal
- Residency Program in Dermatology, University Hospital, Federal University of Sergipe, Aracaju, SE, Brazil
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3
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Mesquita VA, Talhari S, Leturiondo AL, de Souza GC, de Brito EM, de Andrade SL, Fernandes DCDL, Frota MZM, Cruz RCDS, Guimarães JDAR, Miot HA, Talhari C, Pedrosa VL. Zoonotic Sporotrichosis outbreak: Emerging public health threat in the Amazon State, Brazil. PLoS Negl Trop Dis 2024; 18:e0012328. [PMID: 39038043 PMCID: PMC11293696 DOI: 10.1371/journal.pntd.0012328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 08/01/2024] [Accepted: 06/27/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Sporotrichosis is the most common subcutaneous mycosis caused by Sporothrix spp. Traditionally, it is transmitted through injuries involving plant debris. However, over the past few decades, there has been an epidemic increase in human cases resulting from contact with infected animals, particularly cats, in various regions of Brazil. In this report, we report a notable increase in both human and animal cases within the Brazilian Amazon state. METHODOLOGY/PRINCIPAL FINDINGS An ecological study was conducted by analyzing official records of human and animal sporotrichosis diagnosed in the state of Amazon from 2020 to 2023. Data including patient demographics, clinical manifestations, mycological examination results, and species identification through PCR confirmation were evaluated. During this period, a total of 950 human cases and 2,823 animal cases of sporotrichosis were reported at an exponential rate, since no human cases were registered in 2020. The spatial and temporal dispersion of human sporotrichosis followed that of animal cases, moving from downtown areas to the periphery. Contact with infected animals was reported in 77.7% of cases, with cats being the most commonly implicated (73.5%). Only 66.7% of individuals underwent mycological examination. Among the positive cultures for Sporothrix spp., 65.4% were identified as S. brasiliensis. All patients were treated with systemic antifungals. CONCLUSIONS/SIGNIFICANCE This study highlights a rising incidence of sporotrichosis among animals and humans in the Brazilian Amazon region over the past four years, with S. brasiliensis being the predominant agent. Collaborative efforts involving healthcare professionals, veterinarians, and public health authorities are crucial to implement effective control measures, educate populations at risk, and promote responsible guidance for pet guardians. These measures are essential to mitigate the burden of epidemic sporotrichosis in Brazil.
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Affiliation(s)
- Viviany Araujo Mesquita
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Sinesio Talhari
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Fundação Hospitalar Alfredo da Matta de Dermatologia, Manaus, Amazonas, Brazil
| | - André Luiz Leturiondo
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Fundação Hospitalar Alfredo da Matta de Dermatologia, Manaus, Amazonas, Brazil
| | - Guilherme Caldas de Souza
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Euzenio Moreira de Brito
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Suanni Lemos de Andrade
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Departament of Pathology—Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | | | - Rossilene Conceição da Silva Cruz
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Fundação Hospitalar Alfredo da Matta de Dermatologia, Manaus, Amazonas, Brazil
| | - Juliana de Andrade Rebouças Guimarães
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Departament of Internal Medicine—Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Helio Amante Miot
- Departamento de Dermatologia da FMB-UNESP, Botucatu, São Paulo, Brazil
| | - Carolina Talhari
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Departamento de Dermatologia da Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Valderiza Lourenço Pedrosa
- Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Fundação Hospitalar Alfredo da Matta de Dermatologia, Manaus, Amazonas, Brazil
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4
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Poester VR, Xavier MO, Munhoz LS, Basso RP, Zancopé-Oliveira RM, Freitas DFS, Pasqualotto AC. Sporothrix brasiliensis Causing Atypical Sporotrichosis in Brazil: A Systematic Review. J Fungi (Basel) 2024; 10:287. [PMID: 38667958 PMCID: PMC11051268 DOI: 10.3390/jof10040287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
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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Affiliation(s)
- Vanice Rodrigues Poester
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande (FURG), Rio Grande 96200-190, Rio Grande do Sul (RS), Brazil; (V.R.P.); (M.O.X.); (L.S.M.); (R.P.B.)
- Mycology Laboratory of FAMED-FURG, Rio Grande 96200-190, RS, Brazil
| | - Melissa Orzechowski Xavier
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande (FURG), Rio Grande 96200-190, Rio Grande do Sul (RS), Brazil; (V.R.P.); (M.O.X.); (L.S.M.); (R.P.B.)
- Mycology Laboratory of FAMED-FURG, Rio Grande 96200-190, RS, Brazil
| | - Lívia Silveira Munhoz
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande (FURG), Rio Grande 96200-190, Rio Grande do Sul (RS), Brazil; (V.R.P.); (M.O.X.); (L.S.M.); (R.P.B.)
- Mycology Laboratory of FAMED-FURG, Rio Grande 96200-190, RS, Brazil
| | - Rossana Patricia Basso
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande (FURG), Rio Grande 96200-190, Rio Grande do Sul (RS), Brazil; (V.R.P.); (M.O.X.); (L.S.M.); (R.P.B.)
- Mycology Laboratory of FAMED-FURG, Rio Grande 96200-190, RS, Brazil
- Hospital Universitário Dr. Miguel Riet Correa Jr., FURG/Empresa Brasileira de Serviços Hospitalares (EBSERH), Rio Grande 96200-190, RS, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Rio de Janeiro (RJ), Brazil; (R.M.Z.-O.); (D.F.S.F.)
| | - Dayvison Francis Saraiva Freitas
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Rio de Janeiro (RJ), Brazil; (R.M.Z.-O.); (D.F.S.F.)
| | - Alessandro Comarú Pasqualotto
- Molecular Biology Laboratory, Hospital Dom Vicente Scherer, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil
- Medicine Department, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90035-075, RS, Brazil
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Fonseca SNS. Overview of invasive fungal infections in children in South America - the threat of resistant Candida species and the role of climate change in the new geographic distribution of endemic systemic mycosis. Curr Opin Pediatr 2024; 36:136-143. [PMID: 38299979 DOI: 10.1097/mop.0000000000001327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Invasive fungal infection (IFI) in children is a growing problem with crescent morbidity and mortality, well recognized in developed countries, affecting mainly immunocompromised children, including neonates and children in intensive care units. The burden of IFI in South American children is less well comprehended. In addition, the current epidemiology of endemic systemic mycoses in children may have changed over time. RECENT FINDINGS Candida spp. infections are very prevalent in South America hospitalized children, especially in neonates, in a rate far superior compared to developed countries. C. auris, has already been responsible for outbreaks in neonates and children in Venezuela and Colombia. Sporotrichosis is well established as an urban zoonosis in impoverish families. Paracoccidioidomycosis and histoplasmosis are affecting new areas of Brazil, probably due to climate change, deforestation, and human migration. SUMMARY This review aims to unveil the real dimension of these infections in South American children. Hopefully, the awareness brought by this review will help healthcare professionals to recognize IFI more easily and it will provide support for getting more resources for IFI treatment and prevention.
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Affiliation(s)
- Silvia Nunes Szente Fonseca
- Department of Pediatrics and Pediatric Infectious Diseases, Escola de Medicina Estácio-Idomed, Ribeirão Preto, São Paulo State, Brazil
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Romiti R, Hirayama ALDS, Porro AM, Gonçalves HDS, Miot LDB, Durães SMB, Marques SA. Infections in the era of immunobiologicals. An Bras Dermatol 2024; 99:167-180. [PMID: 38238209 PMCID: PMC10943328 DOI: 10.1016/j.abd.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/15/2023] [Accepted: 08/27/2023] [Indexed: 03/11/2024] Open
Abstract
Immunobiologicals represent an innovative therapeutic option in dermatology. They are indicated in severe and refractory cases of different diseases when there is contraindication, intolerance, or failure of conventional systemic therapy and in cases with significant impairment of patient quality of life. The main immunobiologicals used in dermatology basically include inhibitors of tumor necrosis factor-alpha (anti-TNF), inhibitors of interleukin-12 and -23 (anti-IL12/23), inhibitors of interleukin-17 and its receptor (anti-IL17), inhibitors of interleukin-23 (anti-IL23), rituximab (anti-CD20 antibody), dupilumab (anti-IL4/IL13) and intravenous immunoglobulin. Their immunomodulatory action may be associated with an increase in the risk of infections in the short and long term, and each case must be assessed individually, according to the risk inherent to the drug, the patient general condition, and the need for precautions. This article will discuss the main risks of infection associated with the use of immunobiologicals, addressing the risk in immunocompetent and immunosuppressed patients, vaccination, fungal infections, tuberculosis, leprosy, and viral hepatitis, and how to manage the patient in the most diverse scenarios.
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Affiliation(s)
- Ricardo Romiti
- Department of Dermatology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Adriana Maria Porro
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Heitor de Sá Gonçalves
- State Health Secretariat of Ceará, Centro de Dermatologia Dona Libânia, Fortaleza, CE, Brazil
| | - Luciane Donida Bartoli Miot
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Sandra Maria Barbosa Durães
- Department of Internal Medicine, Dermatology Unit, Faculty of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Silvio Alencar Marques
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
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Almeida-Paes R, do Valle ACF, Freitas DFS, de Macedo PM, Zancopé-Oliveira RM, Gutierrez-Galhardo MC. The present and future research agenda of sporotrichosis on the silver anniversary of zoonotic sporotrichosis in Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2024; 119:e230208. [PMID: 38359307 PMCID: PMC10868377 DOI: 10.1590/0074-02760230208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Twenty-five years have passed since the initial observation of endemic zoonotic sporotrichosis in Rio de Janeiro, Brazil. Since then, this disease has spread throughout South America. Accompanying the emergence of this mycosis, some progress has been made, including the expansion of a research network in this field and higher visibility of sporotrichosis within government authorities and funding agencies. However, there are still some challenges to curbing the expansion of this disease in the coming years. These include the development of rapid and accurate diagnostic tests, new antifungal drugs, particularly for the treatment of extracutaneous manifestations of sporotrichosis, and more comprehensive care for cats with sporotrichosis. Including these actions in the sporotrichosis research agenda is required so as to change the development of this disease in the years to come.
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Affiliation(s)
- Rodrigo Almeida-Paes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
| | - Antonio Carlos Francesconi do Valle
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
| | - Dayvison Francis Saraiva Freitas
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
| | - Priscila Marques de Macedo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
| | - Rosely Maria Zancopé-Oliveira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
| | - Maria Clara Gutierrez-Galhardo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
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de Oliveira VF, Petrucci JF, Taborda M, Brener PZ, Kremer PGDBB, Randi BA, Magri ASGK, Magri MMC, Levin AS, Silva GD. Clinical characteristics, diagnosis, and treatment of central nervous system sporotrichosis: Systematic review and meta-analysis. Mycoses 2024; 67:e13697. [PMID: 38374494 DOI: 10.1111/myc.13697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND The clinical features of central nervous system (CNS) sporotrichosis are derived from case reports and a limited series of cases. Our objective was to carry out a systematic review and meta-analysis of CNS sporotrichosis. METHODS We searched PubMed/MEDLINE, Embase, Scopus, and LILACS on 9 September 2023. Our inclusion criteria were documentation of Sporothrix and demonstrated CNS involvement. A metaproportion or metamean analysis was performed to estimate a summary proportion with 95% confidence intervals. RESULTS We included 52 cases of CNS sporotrichosis published from 1966 to 2023. Forty-six patients were male (88%, 95% CI: 77-95), and the mean age was 39 years (95% CI: 36-43). Close contact with cats was reported in 55% of cases (95% CI: 37-72). Thirty-two (61.5%) patients were from Brazil, 18 patients from the United State of America (34.6%). Only two Sporothrix species were reported: S. schenckii (26/41, 63%), and S. brasiliensis (15/41, 37%). The most common neurological symptom was headache. Meningitis was chronic in approximately 80% of cases. A significant majority of the patients were immunocompromised. HIV infection was the primary cause of immunosuppression (85%, 95% CI: 61-95). Overall mortality was 56% (22/39). The comparison of Kaplan-Meier survival curve showed a higher mortality with a statistically significant difference in immunosuppressed patients (p = .019). CONCLUSION CNS sporotrichosis represents a notable cause of chronic meningitis, especially in individuals living in the Americas with HIV infection and concurrent skin lesions.
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Affiliation(s)
- Vítor Falcão de Oliveira
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Júlia Figueiredo Petrucci
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mariane Taborda
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Bruno Azevedo Randi
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Adriana Satie Gonçalves Kono Magri
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcello Mihailenko Chaves Magri
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Anna S Levin
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme Diogo Silva
- Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Reis EGD, Pereira SA, Miranda LHMD, Oliveira RDVCD, Quintana MDSB, Viana PG, Figueiredo ABF, Honorato CCDS, Pereira-Oliveira GR, Silva JN, Schubach TMP, Gremião IDF. A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis. J Fungi (Basel) 2024; 10:101. [PMID: 38392773 PMCID: PMC10889782 DOI: 10.3390/jof10020101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
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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Affiliation(s)
- Erica Guerino Dos Reis
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | | | | | - Marcel de Souza Borges Quintana
- Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-361, Brazil
| | - Paula Gonçalves Viana
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Anna Barreto Fernandes Figueiredo
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Cindy Caroline Dos Santos Honorato
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Gabriela Reis Pereira-Oliveira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Jéssica Nunes Silva
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Tânia Maria Pacheco Schubach
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
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Magalhães VCR, Colombo SA, Peres NTA, Moura AS, Lyon AC, Lyon S, Dutra MRT, Fereguetti TO, Andrade VA, Azevedo MI, Santos DA. Clinical factors associated with systemic sporotrichosis in Brazil. Mycoses 2024; 67:e13656. [PMID: 37743555 DOI: 10.1111/myc.13656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/07/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Systemic sporotrichosis occurs when organs, other than subcutaneous tissues and lymph nodes, are infected. Interestingly, systemic sporotrichosis in apparently immunocompetent individuals is increasing in Brazil, but data on clinical manifestations and risk factors are scarce. Most of the existing data on such condition relate to people living with HIV. We aimed to study the risk factors associated with systemic sporotrichosis among HIV-negative and HIV-positive patients. METHODS We performed a retrospective cross-sectional study with 80 patients from Brazil, diagnosed between 2014 and 2021. The association between disease classification, clinical presentation and risk factors were analysed by logistic regression. RESULTS Of the 80 patients, 29 (36.3%) presented with systemic sporotrichosis. All HIV-positive patients developed the systemic form, with increased mortality (p = .002). Alcohol ingestion (p = .009) and diabetes (p = .010) were associated with systemic disease. Alcohol ingestion seemed to favour pulmonary infection (p = .013) and, diabetes favoured osteoarticular (p = .009) and ocular involvement (p = .033). The occurrence of fever (p = .001) and weight loss (p = .006) were significantly associated with systemic sporotrichosis, while meningeal involvement (p = .001) increased mortality risk. Nine (11.3%) patients died from sporotrichosis. The presence of fungal structures in the mycological examination of the patients' lesions were associated with the systemic form (p = .017) and death (p = .002). CONCLUSION Our study points to the factors that drive systemic sporotrichosis other than HIV, such as alcohol ingestion and diabetes. Considering the high number of patients presenting severe sporotrichosis, the recognising these factors may contribute to timely diagnosis and proper treatment.
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Affiliation(s)
- Vanessa C R Magalhães
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
| | - Salene A Colombo
- Department of Preventive Veterinary Medicine, School of Veterinary, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Nalu T A Peres
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre S Moura
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
| | - Ana C Lyon
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
| | - Sandra Lyon
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
| | - Maria R T Dutra
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
| | - Tatiani O Fereguetti
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
| | - Virginia A Andrade
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
| | - Maria I Azevedo
- Department of Preventive Veterinary Medicine, School of Veterinary, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniel A Santos
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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11
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Reis NF, de Jesus MCS, de Souza LCDSV, Alcântara LM, Rodrigues JADC, Brito SCP, Penna PDA, Vieira CS, Silva JRS, Penna BDA, Machado RLD, Mora-Montes HM, Baptista ARDS. Sporothrix brasiliensis Infection Modulates Antimicrobial Peptides and Stress Management Gene Expression in the Invertebrate Biomodel Galleria mellonella. J Fungi (Basel) 2023; 9:1053. [PMID: 37998858 PMCID: PMC10672515 DOI: 10.3390/jof9111053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/25/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
Sporothrix brasiliensis is the most pathogenic species, responsible for the Brazilian cat-transmitted sporotrichosis hyperendemic. In this scenario, an investigation of the pathogen-host interaction can provide relevant information for future treatment strategies. To this end, the invertebrate Galleria mellonella has proven to be a suitable alternative for evaluating the virulence of pathogenic fungi, since the insect immune system is similar to the mammalian innate immune response. The aim of this work was to investigate phenotypic and molecular aspects of the immune response of G. mellonella throughout the S. brasiliensis infection. Hemocyte density and the evolution of the fungal load were evaluated. In parallel, RT-qPCR expression analysis of genes encoding antimicrobial peptides (Gallerimycin and Galiomycin) and stress management genes (C7 Contig 15362 and C8 Contig 19101) was conducted. The fungal load and hemocyte densities increased simultaneously and proportionally to the deleterious morphological events and larvae mortality. Gallerimycin, C7 Contig 15362 and C8 Contig 19101 genes were positively regulated (p < 0.05) at distinct moments of S. brasiliensis infection, characterizing a time-dependent and alternately modulated profile. Galiomycin gene expression remained unchanged. Our results contribute to the future proposal of potential alternative pathways for treating and consequently controlling S. brasiliensis zoonosis, a major public health issue in Latin America.
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Affiliation(s)
- Nathália Faria Reis
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Myrela Conceição Santos de Jesus
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Lais Cavalcanti dos Santos Velasco de Souza
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Lucas Martins Alcântara
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Julia Andrade de Castro Rodrigues
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Simone Cristina Pereira Brito
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Patrícia de Azambuja Penna
- Laboratory of Insect Biology, Federal Fluminense University, Niterói 24220-900, RJ, Brazil; (P.d.A.P.); (C.S.V.)
| | - Cecília Stahl Vieira
- Laboratory of Insect Biology, Federal Fluminense University, Niterói 24220-900, RJ, Brazil; (P.d.A.P.); (C.S.V.)
| | - José Rodrigo Santos Silva
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, São Cristóvão 49107-230, SE, Brazil;
| | - Bruno de Araújo Penna
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Fluminense Federal University, Niterói 24020-141, RJ, Brazil;
| | - Ricardo Luiz Dantas Machado
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Hector M. Mora-Montes
- Department of Biology, Division of Natural and Exact Sciences, Campus Guanajuato, University of Guanajuato, Guanajuato 36050, Mexico;
| | - Andréa Regina de Souza Baptista
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
- Rede Micologia RJ—Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro 21941-630, RJ, Brazil
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12
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Uemura EVG, Rossato L. Sporotrichosis co-infection with human immunodeficiency virus/acquired immunodeficiency syndrome. Mycoses 2023; 66:845-853. [PMID: 37376902 DOI: 10.1111/myc.13627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023]
Abstract
Sporotrichosis is a subcutaneous mycosis caused by a dimorphic fungus belonging to the genus Sporothrix. This fungal infection can affect both humans and domestic animals, and in recent years, an increase in the geographic spread and prevalence of sporotrichosis has been observed globally. This systematic review aimed to examine the clinical-epidemiological and therapeutic aspects related to sporotrichosis co-infection with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). An extensive electronic search was conducted on databases including PubMed, Web of Science, Lilacs, Medline, Embase, Scopus and SciELO was performed to identify clinical cases of people living with HIV (PLWH) with sporotrichosis published until May 2023. As a result, we found that most co-infected patients were male, representing 71.76% (94/131) of cases. The most prevalent age group was 41-50 years, with a mean age of 36.98 years. The countries with the highest number of cases were Brazil (75.57%, 99/131) and the United States (16.03%, 21/131). The most frequent clinical presentation was systemic dissemination, accounting for 69.47% (91/131) of the cases, followed by cutaneous dissemination with 13% (17/131). The mean CD4+ cell count was 154.07 cells/μL, and most patients used amphotericin B with at least one azole, which represented 47.33% (62/131) of cases, followed by azole monotherapy in 17.56% (23/131) of cases. As for the outcome, 51.15% (67/131) of the patients remained alive, and 37.4% (49/131) died. Therefore, it was concluded that sporotrichosis in PLWH is a disease with a high prevalence in Brazil and may be associated with systemic clinical manifestations requiring longer periods of systemic antifungal therapy.
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Affiliation(s)
| | - Luana Rossato
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Brazil
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13
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do Prado CM, Razzolini E, Santacruz G, Ojeda L, Geraldo MR, Segovia N, Pereira Brunelli J, Vicente VA, Svoboda WK, Queiroz-Telles F. First Cases of Feline Sporotrichosis Caused by Sporothrix brasiliensis in Paraguay. J Fungi (Basel) 2023; 9:972. [PMID: 37888228 PMCID: PMC10607289 DOI: 10.3390/jof9100972] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Sporothrix brasiliensis is an emerging fungal pathogen causing cat-transmitted sporotrichosis, an epi-zoonosis affecting humans, cats and dogs in Brazil and now spreading to neighboring South American countries. Here, we report the first two autochthonous cases of cat-transmitted sporotrichosis in Paraguay. The first case was a four-year-old male cat showing several ulcerative lesions, nasal deformity and respiratory symptoms. The second case was a one-year-old male cat showing a single ulcerated lesion, respiratory symptoms and nasal deformity. Both cases were admitted to a veterinary clinic in Ciudad del Este, Paraguay. Isolates were recovered from swabs of the two cases. Using molecular methods, the isolates were identified as S. brasiliensis.
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Affiliation(s)
- Carolina Melchior do Prado
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba 81531-980, Brazil; (C.M.d.P.); (M.R.G.); (V.A.V.)
| | - Emanuel Razzolini
- Postgraduate Program in Bioprocess and Biotechnology Engineering, Technology Sector, Department of Biotechnology, Federal University of Parana, Curitiba 81531-990, Brazil;
| | - Gabriela Santacruz
- Regional Epidemiological Laboratory, Faculty of Health Sciences, National University of the East, Minga Guazú 7420, Paraguay; (G.S.); (L.O.); (N.S.)
| | - Leticia Ojeda
- Regional Epidemiological Laboratory, Faculty of Health Sciences, National University of the East, Minga Guazú 7420, Paraguay; (G.S.); (L.O.); (N.S.)
| | - Marlon Roger Geraldo
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba 81531-980, Brazil; (C.M.d.P.); (M.R.G.); (V.A.V.)
| | - Nancy Segovia
- Regional Epidemiological Laboratory, Faculty of Health Sciences, National University of the East, Minga Guazú 7420, Paraguay; (G.S.); (L.O.); (N.S.)
| | | | - Vânia Aparecida Vicente
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba 81531-980, Brazil; (C.M.d.P.); (M.R.G.); (V.A.V.)
- Postgraduate Program in Bioprocess and Biotechnology Engineering, Technology Sector, Department of Biotechnology, Federal University of Parana, Curitiba 81531-990, Brazil;
| | - Walfrido Kühl Svoboda
- Department of Public Health, Federal University of Latin American Integration, Foz do Iguaçu 85870-650, Brazil;
| | - Flávio Queiroz-Telles
- Department of Public Health, Hospital de Clínicas, Federal University of Paraná, Curitiba 80060-900, Brazil
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14
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Cognialli RCR, Cáceres DH, Bastos FDAGD, Cavassin FB, Lustosa BPR, Vicente VA, Breda GL, Santos-Weiss I, Queiroz-Telles F. Rising Incidence of Sporothrix brasiliensis Infections, Curitiba, Brazil, 2011-2022. Emerg Infect Dis 2023; 29:1330-1339. [PMID: 37347527 PMCID: PMC10310366 DOI: 10.3201/eid2907.230155] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
Zoonotic outbreaks of sporotrichosis are increasing in Brazil. We examined and described the emergence of cat-transmitted sporotrichosis (CTS) caused by the fungal pathogen Sporothrix brasiliensis. We calculated incidence and mapped geographic distribution of cases in Curitiba, Brazil, by reviewing medical records from 216 sporotrichosis cases diagnosed during 2011-May 2022. Proven sporotrichosis was established in 84 (39%) patients and probable sporotrichosis in 132 (61%). Incidence increased from 0.3 cases/100,000 outpatient visit-years in 2011 to 21.4 cases/100,000 outpatient visit-years in 2021; of the 216 cases, 58% (n = 126) were diagnosed during 2019-2021. The main clinical form of sporotrichosis was lymphocutaneous (63%), followed by localized cutaneous (24%), ocular (10%), multisite infections (3%), and cutaneous disseminated (<0.5%). Since the first report of CTS in Curitiba in 2011, sporotrichosis has increased substantially, indicating continuous disease transmission. Clinician and public awareness of CTS and efforts to prevent transmission are needed.
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15
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García-Carnero LC, Martínez-Duncker I, Gómez-Gaviria M, Mora-Montes HM. Differential Recognition of Clinically Relevant Sporothrix Species by Human Mononuclear Cells. J Fungi (Basel) 2023; 9:448. [PMID: 37108903 PMCID: PMC10146672 DOI: 10.3390/jof9040448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/23/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Sporotrichosis is a human and animal fungal infection distributed worldwide that is caused by the thermodimorphic species of the Sporothrix pathogenic clade, which includes Sporothrix brasiliensis, Sporothrix schenckii, and Sporothrix globosa. The cell wall composition and the immune response against the Sporothrix species have been studied mainly in S. brasiliensis and S. schenckii, whilst little is known about the S. globosa cell wall and the immune response that its components trigger. Therefore, in this study, we aimed to analyze the cell wall composition of S. globosa in three morphologies (germlings, conidia, and yeast-like cells) and the differences in cytokine production when human peripheral blood mononuclear cells (PBMCs) interact with these morphotypes, using S. schenckii and S. brasiliensis as a comparison. We found that S. globosa conidia and yeast-like cells have a higher cell wall chitin content, while all three morphologies have a higher β-1,3-glucan content, which was found most exposed at the cell surface when compared to S. schenckii and S. brasiliensis. In addition, S. globosa has lower levels of mannose- and rhamnose-based glycoconjugates, as well as of N- and O-linked glycans, indicating that this fungal cell wall has species-specific proportions and organization of its components. When interacting with PBMCs, S. brasiliensis and S. globosa showed a similar cytokine stimulation profile, but with a higher stimulation of IL-10 by S. globosa. Additionally, when the inner cell wall components of S. globosa were exposed at the surface or N- and O-glycans were removed, the cytokine production profile of this species in its three morphotypes did not significantly change, contrasting with the S. schenckii and S. brasiliensis species that showed different cytokine profiles depending on the treatment applied to the walls. In addition, it was found that the anti-inflammatory response stimulated by S. globosa was dependent on the activation of dectin-1, mannose receptor, and TLR2, but not TLR4. All of these results indicate that the cell wall composition and structure of the three Sporothrix species in the three morphologies are different, affecting their interaction with human PBMCs and generating species-specific cytokine profiles.
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Affiliation(s)
- Laura C. García-Carnero
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, col. Noria Alta, C.P., Guanajuato 36050, Gto., Mexico; (L.C.G.-C.); (M.G.-G.)
| | - Iván Martínez-Duncker
- Laboratorio de Glicobiología Humana y Diagnóstico Molecular, Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Cuernavaca 62209, Mor., Mexico;
| | - Manuela Gómez-Gaviria
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, col. Noria Alta, C.P., Guanajuato 36050, Gto., Mexico; (L.C.G.-C.); (M.G.-G.)
| | - Héctor M. Mora-Montes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, col. Noria Alta, C.P., Guanajuato 36050, Gto., Mexico; (L.C.G.-C.); (M.G.-G.)
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16
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Bombassaro A, Spruijtenburg B, Medeiros F, Jacomel Favoreto de Souza Lima B, Ballardin LB, Farias MRD, Vicente VA, de Queiroz‐Telles F, Meis JF, de Groot T. Genotyping and antifungal susceptibility testing of
Sporothrix brasiliensis
isolates from Southern Brazil. Mycoses 2023. [DOI: 10.1111/myc.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
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17
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Magalhães VCR, Colombo SA, Freitas GJC, Moura AS, Vieira FCL, Lyon AC, Azevedo MI, Peres NTDA, Santos DA. Late Diagnosis of Disseminated Sporothrix brasiliensis Infection with Bone Marrow Involvement in an HIV-Negative Patient. Pathogens 2022; 11:pathogens11121516. [PMID: 36558850 PMCID: PMC9781367 DOI: 10.3390/pathogens11121516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Sporotrichosis is a fungal disease that causes symptoms similar to those of other infectious and non-infectious diseases, making diagnosis difficult and challenging. Here, we report a case of an HIV-negative patient presenting disseminated sporotrichosis with widespread cutaneous lesions mimicking pyoderma gangrenosum, with bone marrow infection, pancytopenia, and hemophagocytic syndrome. However, all the clinical manifestations and a bacterial coinfection delayed the request for a fungal diagnosis. Therefore, sporotrichosis should always be investigated in patients from endemic areas presenting with widespread cutaneous lesions associated with pancytopenia.
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Affiliation(s)
- Vanessa Caroline Randi Magalhães
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte 31270-901, Brazil
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), R. Dr. Cristiano Rezende, 2213, Belo Horizonte 30622-020, Brazil
| | - Salene Angelini Colombo
- Department of Preventive Veterinary Medicine, School of Veterinary, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte 31270-901, Brazil
| | - Gustavo José Cota Freitas
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte 31270-901, Brazil
| | - Alexandre Sampaio Moura
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), R. Dr. Cristiano Rezende, 2213, Belo Horizonte 30622-020, Brazil
| | - Flávia Cardoso Lopez Vieira
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), R. Dr. Cristiano Rezende, 2213, Belo Horizonte 30622-020, Brazil
| | - Ana Cláudia Lyon
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), R. Dr. Cristiano Rezende, 2213, Belo Horizonte 30622-020, Brazil
| | - Maria Isabel Azevedo
- Department of Preventive Veterinary Medicine, School of Veterinary, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte 31270-901, Brazil
| | - Nalu Teixeira de Aguiar Peres
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte 31270-901, Brazil
- Correspondence: (N.T.d.A.P.); (D.A.S.); Tel.: +55-31-3409-2760 (N.T.d.A.P.); +55-31-3409-2758 (D.A.S.); Fax: +55-31-3409-2733 (N.T.d.A.P.); +55-31-3409-2733 (D.A.S.)
| | - Daniel Assis Santos
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte 31270-901, Brazil
- Correspondence: (N.T.d.A.P.); (D.A.S.); Tel.: +55-31-3409-2760 (N.T.d.A.P.); +55-31-3409-2758 (D.A.S.); Fax: +55-31-3409-2733 (N.T.d.A.P.); +55-31-3409-2733 (D.A.S.)
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18
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Cognialli R, Bloss K, Weiss I, Caceres DH, Davis R, Queiroz-Telles F. A Lateral Flow Assay for the Immunodiagnosis of Human Cat-Transmitted Sporotrichosis. Mycoses 2022; 65:926-934. [PMID: 35943444 PMCID: PMC9546384 DOI: 10.1111/myc.13516] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/29/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cat-transmitted sporotrichosis (CTS) caused by Sporothrix brasiliensis has emerged as an important zoonosis in Brazil and neighboring countries. OBJECTIVES Evaluate the performance of a lateral flow assay (LFA) for the detection of anti-Sporothrix antibodies in human sera. METHODS A LFA for the detection of anti-Sporothrix antibodies (Anti-Sporo LFA) in human sera, developed by IMMY, was evaluated using 300 human sera collected prospectively at the Hospital de Clínicas, Federal University of Paraná (HC-UFPR), in Curitiba, Brazil. These specimens included 100 sera from patients with CTS. CTS cases were classified as: 59 lymphocutaneous, 27 fixed cutaneous,13 ocular, and one mixed form. One-hundred specimens from patients with other mycoses, including cryptococcosis (n=32), candidemia (n=27), paracoccidioidomycosis (n=14), aspergillosis (n=10), histoplasmosis (n=9), fusariosis (n=4), lobomycosis (n=1), chromoblastomycosis (n=1), mucormycosis (n=1), and trichosporonosis (n=1). And 100 specimens from apparently healthy volunteers (AHV). RESULTS The Anti-Sporo LFA showed a global sensitivity of 83% (95% confidence interval [CI] = 74%-90%), a global specificity of 82% (95% CI = 76%-87%), and accuracy of 82% (95% CI = 77%-86%). By clinical form sensitivity was as follows: Mixed form 100%, ocular 92%, lymphocutaneous 83%, and fixed cutaneous 78%. False-positive results were observed in 11 specimens from people with other mycoses and 26 specimens from AHV. CONCLUSION-DISCUSSION This study presents the results of the evaluation of the first lateral flow assay for the detection of anti-Sporothrix antibodies in human sera. The findings here show evidence that IMMY´s Anti-Sporo LFA is a promising tool for the rapid diagnosis of CTS.
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Affiliation(s)
- Regielly Cognialli
- Mycology Unit, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil.,Postgraduate Program in Internal Medicine and Health Science, Federal University of Paraná, Curitiba, Brazil
| | - Konner Bloss
- Immuno-Mycologics (IMMY), Norman, Oklahoma, United States of America
| | - Izabella Weiss
- Department of Clinical Analysis, Federal University of Paraná, Curitiba, Brazil
| | - Diego H Caceres
- Immuno-Mycologics (IMMY), Norman, Oklahoma, United States of America.,Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.,Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Rachelle Davis
- Immuno-Mycologics (IMMY), Norman, Oklahoma, United States of America
| | - Flavio Queiroz-Telles
- Department of Clinical Analysis, Federal University of Paraná, Curitiba, Brazil.,Department of Public Health, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
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Human sporotrichosis: recommendations from the Brazilian Society of Dermatology for the clinical, diagnostic and therapeutic management. An Bras Dermatol 2022; 97:757-777. [PMID: 36155712 PMCID: PMC9582924 DOI: 10.1016/j.abd.2022.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The increase in the zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis, which started in the late 1990s in Rio de Janeiro and is now found in almost all Brazilian states, has been equally advancing in neighboring countries of Brazil. Changes in the clinical-epidemiological profile, advances in the laboratory diagnosis of the disease, and therapeutic difficulties have been observed throughout these almost 25 years of the epidemic, although there is no national consensus. The last international guideline dates from 2007. OBJECTIVES Update the clinical classification, diagnostic methods and recommendations on the therapeutic management of patients with sporotrichosis. METHODS Twelve experts in human sporotrichosis were selected from different Brazilian regions, and divided into three work groups: clinical, diagnosis and treatment. The bibliographic research was carried out on the EBSCOHost platform. Meetings took place via electronic mail and remote/face-to-face and hybrid settings, resulting in a questionnaire which pointed out 13 divergences, resolved based on the opinion of the majority of the participants. RESULTS The clinical classification and laboratory diagnosis were updated. Therapeutic recommendations were made for the different clinical forms. CONCLUSION Publication of the first national recommendation, carried out by the Brazilian Society of Dermatology, aimed at the Brazilian scientific community, especially dermatologists, infectologists, pediatricians, family medicine personnel, and laboratory professionals who work in the management of human sporotrichosis.
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