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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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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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Reginatto P, Agostinetto GDJ, Fuentefria RDN, Marinho DR, Pizzol MD, Fuentefria AM. Eye fungal infections: a mini review. Arch Microbiol 2023; 205:236. [PMID: 37183227 PMCID: PMC10183313 DOI: 10.1007/s00203-023-03536-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023]
Abstract
Ocular fungal infections annually affect more than one million individuals worldwide. The management of these infections is problematic, mainly due to the limited availability of effective antifungal agents. Thus, ocular infections are increasingly recognized as important causes of morbidity and blindness, especially keratitis and endophthalmitis. Thus, this review aims to demonstrate the importance of fungal eye infections through the description of the main related aspects, with emphasis on the treatment of these infections. For this purpose, a search for scientific articles was conducted in databases, such as Medline, published from 2000 onwards, addressing important aspects involving fungal eye infections. In addition, this work highlighted the limited therapeutic arsenal available and the severity associated with these infections. Thus, highlighting the importance of constantly updating knowledge about these pathologies, as it contributes to agility in choosing the available and most appropriate therapeutic alternatives, aiming at positive and minimally harmful results for that particular patient.
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Affiliation(s)
- Paula Reginatto
- Laboratório de Pesquisa em Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Giovanna de Jesus Agostinetto
- Laboratório de Pesquisa em Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Melissa Dal Pizzol
- Serviço de Oftalmologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Alexandre Meneghello Fuentefria
- Laboratório de Pesquisa em Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Yeow YY, Tan XT, Low LL. Mucosal Sporotrichosis from Zoonotic Transmission: Descriptions of Four Case Reports. Infect Dis Rep 2023; 15:102-111. [PMID: 36826351 PMCID: PMC9956378 DOI: 10.3390/idr15010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sporotrichosis is a subacute or chronic mycosis caused by a dimorphic fungus of the genus Sporothrix. Zoonotic-transmitted sporotrichosis has become a major public health concern and is characterised by a different clinical pattern from the traditional epidemiology of sporotrichosis. CASE PRESENTATION We present the details of four patients with mucosal sporotrichosis with regional lymphadenopathy (three cases of granulomatous conjunctivitis and one case of nasal sporotrichosis). The patients' age range was between 23 to 46 years old and their gender was three female and one male patient. All four patients shared the same ethnicity, Malay, and they had a common history of owning domestic cats as pets. Sporothrix schenckii were isolated from all the culture samples and its antifungal susceptibility patterns were compared in the mycelial and yeast phases. All four patients recovered with oral itraconazole treatment, but the treatment duration was variable among patients. CONCLUSIONS People who have a history of contact with domestic cats should be aware of the possibility of sporotrichosis infection. It can present in cutaneous, lymphocutaneous, disseminated, or systemic forms. Early treatment and the prevention of disease progression are more beneficial to patients. The published data concludes that antifungal treatment is highly efficacious, although the reported treatment duration is variable.
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Affiliation(s)
- Yong Yaw Yeow
- Infectious Diseases Unit, Department of Medicine, Hospital Sultanah Bahiyah, Alor Setar 05460, Malaysia
- Correspondence:
| | - Xue Ting Tan
- Infectious Diseases Research Center, Institute for Medical Research, National Institutes of Health, Kuala Lumpur 50588, Malaysia
| | - Lee Lee Low
- Infectious Diseases Unit, Department of Medicine, Hospital Sultanah Bahiyah, Alor Setar 05460, Malaysia
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Arinelli A, Aleixo ALQC, Freitas DFS, do Valle ACF, Almeida-Paes R, Nobre Guimarães AL, Oliveira RVC, Gutierrez-Galhardo MC, Curi ALL. Ocular Manifestations of Sporotrichosis in a Hyperendemic Region in Brazil: Description of a Series of 120 Cases. Ocul Immunol Inflamm 2023; 31:329-337. [PMID: 35080998 DOI: 10.1080/09273948.2022.2027465] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe 120 cases of ocular sporotrichosis. METHODS Review of medical records of patients with culture-proven (from eye specimen) ocular sporotrichosis, in Rio de Janeiro, from 2007 to 2017. RESULTS Women were more affected (61.7%) and median age was 24 years. The isolated ocular form was more frequent (75.8%). Fixed cutaneous sporotrichosis was the most commonly associated form (48.3%). Hypersensitivity reactions were observed in 10% of patients. Ocular involvement was unilateral in 98.3% of the cases, and the most frequent clinical presentation was granulomatous conjunctivitis (86.7%), followed by eyelid lesion (25%). Dacryocystitis represented 7.5% of the cases, predominantly in children (55.6%). Itraconazole was the first choice treatment (95.8%). Sequelae were observed in 23 patients (22.5%), and surgical treatment was required for most of them. CONCLUSION Ocular sporotrichosis can be considered a characteristic form of the zoonotic transmission, with high morbidity. Delay in initiating specific treatment is likely to increase the risk of progression to more severe forms of the disease, and development of ocular sequelae.
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Affiliation(s)
- Andrea Arinelli
- Laboratory of Clinical Research in Infectious Ophthalmology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Ana L Q C Aleixo
- Laboratory of Clinical Research in Infectious Ophthalmology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Dayvison F S Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Antonio C F do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Ana L Nobre Guimarães
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Raquel V C Oliveira
- Laboratory of Epidemiology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - André L L Curi
- Laboratory of Clinical Research in Infectious Ophthalmology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
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Vishwakarma P, Murthy SI, Joshi V, Mishra DK. Anterior segment optical coherence tomography and ultrasound biomicroscopy in the diagnosis of subconjunctival mycosis mimicking nodular scleritis. BMJ Case Rep 2023; 16:e253924. [PMID: 36653048 PMCID: PMC9853128 DOI: 10.1136/bcr-2022-253924] [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] [Indexed: 01/20/2023] Open
Abstract
A female patient in her 20s presented with a bulbar conjunctival mass lesion that was diagnosed as nodular scleritis. It was treated with topical and oral steroids in another hospital. Imaging was done using anterior segment optical coherence tomography and ultrasound biomicroscopy, which helped to rule out scleritis and subconjunctival cysticercosis. Histopathology of the excision biopsy specimen revealed fungal filaments. Topical antifungals were started, and the condition resolved without recurrence after therapy. Although rare, infections should be considered in the differential diagnosis of conjunctival mass lesions. Imaging can help to rule out other entities and guide towards appropriate management.
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Affiliation(s)
- Pratima Vishwakarma
- Shantilal Shangvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Somasheila I Murthy
- Shantilal Shangvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Vineet Joshi
- Shantilal Shangvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Dilip Kumar Mishra
- Ophthalmic Pathology Services, LV Prasad Eye Institute, Hyderabad, India
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Teixeira MM, Almeida-Paes R, Bernardes-Engemann AR, Nicola AM, de Macedo PM, Valle ACF, Gutierrez-Galhardo MC, Freitas DFS, Barker BM, Matute DR, Stajich JE, Zancopé-Oliveira RM. Single nucleotide polymorphisms and chromosomal copy number variation may impact the Sporothrix brasiliensis antifungal susceptibility and sporotrichosis clinical outcomes. Fungal Genet Biol 2022; 163:103743. [PMID: 36152775 DOI: 10.1016/j.fgb.2022.103743] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 02/05/2023]
Abstract
Feline-transmitted sporotrichosis has garnered attention due to the recent high incidence and the lack of efficient control in the epicenter of the epidemic, Rio de Janeiro, Brazil. Sporothrix brasiliensis is the major pathogen involved in feline-to-human sporotrichosis in Brazil and displays more virulent genotypes than the closely related species S. schenckii. Over the last two decades, several reports of antifungal-resistant strains have emerged. Sequencing and comparison analysis of the outbreak strains allowed us to observe that the azole non-wild-type S. brasiliensis strain CFP 1054 had significant chromosomal variations compared to wild-type strains. One of these variants includes a region of 231 Kb containing 75 duplicated genes, which were overrepresented for lipid and isoprenoid metabolism. We also identified an additional strain (CFP 1055) that was resistant to itraconazole and amphotericin B, which had a single nucleotide polymorphism in the tac1 gene. The patients infected with these two strains showed protracted clinical course and sequelae. Even though our sample size is modest, these results suggest the possibility of identifying specific point mutations and large chromosomal duplications potentially associated with antifungal resistance and clinical outcomes of sporotrichosis.
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Affiliation(s)
- Marcus M Teixeira
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA; Faculty of Medicine, University of Brasília-DF, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Andréa R Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Priscila M de Macedo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Antonio Carlos F Valle
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Dayvison F S Freitas
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Bridget M Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Daniel R Matute
- Biology Department, University of North Carolina, Chapel Hill, NC, USA
| | - Jason E Stajich
- Department of Microbiology & Plant Pathology and Institute for Integrative Genome Biology, University of California, Riverside, Riverside, CA, USA
| | - Rosely M Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
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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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Mohd Rasidin AH, Ang WJ, Raja Omar RN, Ahmad Tajudin LS. Ocular Sporotrichosis: Different Spectrums of Clinical Manifestations and a Review of the Literature. Cureus 2022; 14:e27186. [PMID: 36017280 PMCID: PMC9393341 DOI: 10.7759/cureus.27186] [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: 07/23/2022] [Indexed: 11/27/2022] Open
Abstract
We hereby describe two cases of patients with ocular sporotrichosis who presented with different spectrums of clinical manifestations. Both patients had an antecedent history of zoonotic and vegetative contact. The first patient presented with acute granulomatous anterior uveitis, and the second patient presented with granulomatous conjunctivitis. Patients received topical antibiotics, steroids, and cycloplegics. Systemic oral antifungals were added until full recovery was achieved. Both cases were treated without any episodes of relapse or recurrence.
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10
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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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Rabello VBS, Almeida MA, Bernardes-Engemann AR, Almeida-Paes R, de Macedo PM, Zancopé-Oliveira RM. The Historical Burden of Sporotrichosis in Brazil: a Systematic Review of Cases Reported from 1907 to 2020. Braz J Microbiol 2022; 53:231-244. [PMID: 34825345 PMCID: PMC8882507 DOI: 10.1007/s42770-021-00658-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/21/2021] [Indexed: 01/26/2023] Open
Abstract
Sporotrichosis is a cosmopolitan subcutaneous mycosis caused by Sporothrix species. Recently, this mycosis has gained notoriety due to the appearance of new endemic areas, recognition of new pathogenic species, changes in epidemiology, occurrence of outbreaks, and increasing numbers of cases. The purpose of this study is to analyze the peculiarities of sporotrichosis cases in Brazil since its first report in the country until 2020. In this work, ecological, epidemiological, clinical, and laboratorial characteristics were compiled. A systematic review of human sporotrichosis diagnosed in Brazil and published up to December 2020 was performed on PubMed/MEDLINE, SciELO, Web of Science, and LILACS databases. Furthermore, animal sporotrichosis and environmental isolation of Sporothrix spp. in Brazil were also evaluated. The study included 230 papers, resulting in 10,400 human patients. Their ages ranged from 5 months to 92 years old and 55.98% were female. The lymphocutaneous form was predominant (56.14%), but systemic involvement was also notably reported (14.34%), especially in the lungs. Besides, hypersensitivity manifestations (4.55%) were described. Most patients had the diagnosis confirmed by isolation of Sporothrix spp., mainly from skin samples. Sporothrix brasiliensis was the major agent identified. HIV infection, cardiovascular diseases, and diabetes were the most common comorbidities. Cure rate was 85.83%. Concerning animal sporotrichosis, 8538 cases were reported, mostly in cats (90.77%). Moreover, 13 Sporothrix spp. environmental strains were reported. This review highlights the burden of the emergent zoonotic sporotrichosis in Brazil, reinforcing the importance of "One Health" based actions to help controlling this disease.
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Affiliation(s)
- Vanessa Brito Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marcos Abreu Almeida
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Andrea Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Priscila Marques de Macedo
- Laboratório de Pesquisa Clínica Em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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Muhammed J, Ahmad-Fauzi S, Abd-Manan N, Yusof NS, Ibrahim M, Mohamad SA. Ocular sporotrichosis from a tertiary referral center in Malaysia and review of literature in Southeast Asia. Taiwan J Ophthalmol 2022; 12:237-241. [PMID: 35813792 PMCID: PMC9262025 DOI: 10.4103/tjo.tjo_93_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/21/2020] [Indexed: 12/02/2022] Open
Abstract
Ocular sporotrichosis is rare in Malaysia and Southeast Asia and is increasingly reported in endemic areas of Brazil and Peru. We describe six cases of ocular sporotrichosis involving the bulbar conjunctiva and lid with a literature review on ocular sporotrichosis in Southeast Asia. In these series, four patients presented with similar findings of granulomatous lesion at the palpebral conjunctiva within 1–3 weeks. There was one case mistakenly diagnosed as conjunctival concretion due to its multiple yellowish nodules on the palpebral conjunctiva and another case as chalazion due to swelling of the lower lid. All patients showed immunocompetence. Four patients had an immediate contact with sick cats, one patient had a history of skin scratched by a healthy cat, and another patient had a history of gardening without direct contact with cat. Culture from conjunctival biopsy obtained from five patients and from ruptured lower lid nodules of one patient yielded Sporothrix schenckii. The patients were successfully treated with oral itraconazole 200 mg twice daily. Two patients developed symblepharon after completing treatment, while four patients showed good results without any sequelae.
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13
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Mohamad SA, Muhammed J, Ibrahim M. Ocular sporotrichosis with limbal stem cell deficiency: An impostor with blinding sequelae. Middle East Afr J Ophthalmol 2022; 29:96-99. [PMID: 37123421 PMCID: PMC10138130 DOI: 10.4103/meajo.meajo_94_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/30/2022] [Accepted: 11/08/2022] [Indexed: 02/26/2023] Open
Abstract
Sporotrichosis is a chronic granulomatous fungal infection caused by Sporothrix schenckii. Inoculation of the fungus through breached skin or mucosa typically results in nodular ulceration of the cutaneous and subcutaneous tissue as well as its draining lymphatic nodules. However, reports on ocular involvement have recently increased. We describe a severe case of diffuse granulomatous conjunctivitis involving bulbar and palpebral conjunctiva, resulting in inevitable damage to the limbal stem cells. Isolation of S. schenckii from a conjunctival swab confirmed the diagnosis of sporotrichosis. A 6-month course of oral antifungal therapy was given through which the patient fully recovered. However, extensive corneal conjunctivalization secondary to total limbal stem cell deficiency has caused almost complete blindness in the affected eye. Clinical suspicion of this zoonotic disease is essential for early diagnosis and prompt treatment to prevent ocular surface complication and blindness.
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Ramírez-Soto MC, Tirado-Sánchez A, Bonifaz A. Ocular Sporotrichosis. J Fungi (Basel) 2021; 7:951. [PMID: 34829238 PMCID: PMC8621225 DOI: 10.3390/jof7110951] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/27/2022] Open
Abstract
Sporotrichosis is a subacute or chronic mycosis predominant in tropical and subtropical regions. It is an infection of subcutaneous tissue caused by Sporothrix fungus species, but occasionally resulting in an extracutaneous condition, including osteoarticular, pulmonary, nervous central system, and ocular disease. Cases of ocular sporotrichosis are rare, but reports have been increasing in recent decades. Ocular infections usually occur in hyperendemic areas of sporotrichosis. For its classification, anatomic criteria are used. The clinical presentation is the infection in the ocular adnexal and intraocular infection. Ocular adnexa infections include palpebral, conjunctivitis, and infections of the lacrimal sac. Intraocular infection includes exogenous or endogenous endophthalmitis. Most infections in the ocular adnexal have been reported in Brazil, China and Peru, and intraocular infections are limited to the USA and Brazil. Diagnosis is performed from Sporothrix isolation in the mycological examination from ocular or skin samples. Both sporotrichosis in the ocular adnexa and intraocular infection can mimic several infectious and non-infectious medical conditions. Ocular adnexa infections are treated with potassium iodide and itraconazole. The intraocular infection is treated with amphotericin B. This review describes the clinical findings and epidemiological, diagnosis, and treatment of ocular sporotrichosis.
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Affiliation(s)
- Max Carlos Ramírez-Soto
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
- Facultad de Ciencias de la Salud, Universidad Tecnológica del Perú, Lima 15046, Peru
| | - Andrés Tirado-Sánchez
- Internal Medicine Department, Hospital General de Zona 29, Instituto Mexicano del Seguro Social, Ciudad de México 07950, Mexico;
- Dermatology Service & Mycology Department, Hospital General de México, “Dr. Eduardo Liceaga”, Balmis 148, Colonia Doctores, Ciudad de México 06726, Mexico;
| | - Alexandro Bonifaz
- Dermatology Service & Mycology Department, Hospital General de México, “Dr. Eduardo Liceaga”, Balmis 148, Colonia Doctores, Ciudad de México 06726, Mexico;
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Spinelli TP, Bezerra LM, de Souza BOF, Rocha A, Neto JE, Sá FB. Primary conjunctival sporotrichosis in three cats from Northeastern Brazil. Vet Ophthalmol 2021; 24:209-215. [PMID: 33608958 DOI: 10.1111/vop.12865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 12/21/2022]
Abstract
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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Affiliation(s)
- Taciana P Spinelli
- Departamento de Medicina Veterinária, Universidade Federal Rural de Pernambuco, Recife, Brasil
| | - Leticia M Bezerra
- Departamento de Medicina Veterinária, Universidade Federal Rural de Pernambuco, Recife, Brasil
| | | | - Angelica Rocha
- Departamento de Medicina Veterinária, Universidade Federal Rural de Pernambuco, Recife, Brasil
| | - Joaquim E Neto
- Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Brasil
| | - Fabrício B Sá
- Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Brasil
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Rossow JA, Queiroz-Telles F, Caceres DH, Beer KD, Jackson BR, Pereira JG, Ferreira Gremião ID, Pereira SA. A One Health Approach to Combatting Sporothrix brasiliensis: Narrative Review of an Emerging Zoonotic Fungal Pathogen in South America. J Fungi (Basel) 2020; 6:E247. [PMID: 33114609 PMCID: PMC7712324 DOI: 10.3390/jof6040247] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/21/2022] Open
Abstract
Cat-transmitted sporotrichosis caused by Sporothrix brasiliensis has become a major public health concern and presents a distinct divergence from the traditional epidemiology of sporotrichosis. This emerging fungal pathogen spreads readily among cat populations, and human infections occur exclusively via zoonotic transmission. While sporotrichosis is an implantation mycosis that typically manifests as cutaneous lesions in humans and cats, severe extracutaneous manifestations are more common with S. brasiliensis than other Sporothrix species infections. Rapid diagnosis and appropriate treatment regimens are critical for successful clinical resolution of sporotrichosis in both cats and humans. Species-level identification of Sporothrix is possible with molecular diagnostics and necessary for tracking the geographic expansion of S. brasiliensis and better understanding its epidemiology. Combatting cat-transmitted sporotrichosis requires a One Health approach to successfully implement public health control measures.
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Affiliation(s)
- John A. Rossow
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Flavio Queiroz-Telles
- Department of Public Health, Hospital de Cíinicas, Federal University of Parana, Curitiba 82015-154, Brazil;
| | - Diego H. Caceres
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
- Center of Expertise in Mycology, Radboudumc/CWZ, 6532 SZ Nijmegen, The Netherlands
| | - Karlyn D. Beer
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
| | - Brendan R. Jackson
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
| | - Jose Guillermo Pereira
- Ministry of Public Health and Social Welfare, National Leprosy Control Program, National Directorate of Health Surveillance, Dermatology Specialty Center, San Lorenzo 2160, Paraguay;
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-360, Brazil; (I.D.F.G.); (S.A.P.)
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-360, Brazil; (I.D.F.G.); (S.A.P.)
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17
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Conjunctival sporotrichosis from cat to human: Case report. Am J Ophthalmol Case Rep 2020; 20:100898. [PMID: 32875165 PMCID: PMC7452082 DOI: 10.1016/j.ajoc.2020.100898] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/19/2020] [Accepted: 08/16/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To report a case of conjunctival plaque infected from Sporothrix schenckii, which was possible transmitted from a cat. Observations A case of Thai woman presented with chronic painless ulcerated conjunctiva with white plaque. The lesion was not healed for one month after excision. She became concerned of getting infection from her cat because it developed chronic and multiple skin lesions on its legs. Identification of Sporothrix schenckii by PCR method was confirmed in the tissues from her conjunctiva and cat's skin. Conclusion and Importance The diagnosis of Sporothrix infection should be suspected in atypical conjunctival lesion in patient who had closed contact with infected cat. This brought awareness to doctors and cat owners, even though it was uncommon.
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Dixon MK, Dayton CL, Anstead GM. Parinaud's Oculoglandular Syndrome: A Case in an Adult with Flea-Borne Typhus and a Review. Trop Med Infect Dis 2020; 5:E126. [PMID: 32751142 PMCID: PMC7558689 DOI: 10.3390/tropicalmed5030126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/13/2020] [Accepted: 07/24/2020] [Indexed: 11/16/2022] Open
Abstract
Parinaud's oculoglandular syndrome (POGS) is defined as unilateral granulomatous conjunctivitis and facial lymphadenopathy. The aims of the current study are to describe a case of POGS with uveitis due to flea-borne typhus (FBT) and to present a diagnostic and therapeutic approach to POGS. The patient, a 38-year old man, presented with persistent unilateral eye pain, fever, rash, preauricular and submandibular lymphadenopathy, and laboratory findings of FBT: hyponatremia, elevated transaminase and lactate dehydrogenase levels, thrombocytopenia, and hypoalbuminemia. His condition rapidly improved after starting doxycycline. Soon after hospitalization, he was diagnosed with uveitis, which responded to topical prednisolone. To derive a diagnostic and empiric therapeutic approach to POGS, we reviewed the cases of POGS from its various causes since 1976 to discern epidemiologic clues and determine successful diagnostic techniques and therapies; we found multiple cases due to cat scratch disease (CSD; due to Bartonella henselae) (twelve), tularemia (ten), sporotrichosis (three), Rickettsia conorii (three), R. typhi/felis (two), and herpes simplex virus (two) and single cases due to tuberculosis, paracoccidioidomycosis, Yersinia enterocolitica, Pasteurella multocida, Chlamydia trachomatis, Epstein-Barr virus, and Nocardia brasiliensis. Preauricular lymphadenopathy is a common clinical clue for POGS and is unusual in viral and bacterial conjunctivitis. For POGS, the major etiological consideration is B. henselae, which is usually diagnosed by the indirect immunofluorescence serologic technique. Although CSD POGS is usually self-limited, oral azithromycin may hasten resolution. However, other possible etiologies of POGS may also arise from cat or cat flea contact: sporotrichosis, tularemia, Pasteurella multocida, or FBT. If there is no cat contact, other epidemiologic and clinical findings should be sought, because several of these conditions, such as tularemia, paracoccidioidomycosis, and tuberculosis, may have grave systemic complications. Although there are usually no long-term ocular sequelae if POGS is properly diagnosed, it still may cause prolonged ocular discomfort and require multiple physician contacts.
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Affiliation(s)
- M. Kevin Dixon
- Baylor Scott & White Clinic, 800 Scott & White Drive, College Station, TX 77845, USA;
| | - Christopher L. Dayton
- Division of Critical Care, Department of Medicine, University of Texas Health, San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA;
| | - Gregory M. Anstead
- Medical Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA
- Division of Infectious Diseases, Department of Medicine, University of Texas Health, San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
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Rodrigues AM, Della Terra PP, Gremião ID, Pereira SA, Orofino-Costa R, de Camargo ZP. The threat of emerging and re-emerging pathogenic Sporothrix species. Mycopathologia 2020; 185:813-842. [PMID: 32052359 DOI: 10.1007/s11046-020-00425-0] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/09/2020] [Indexed: 01/19/2023]
Abstract
Sporotrichosis is a neglected subcutaneous mycosis of humans and animals acquired by traumatic inoculation of soil and plant material (classical route) contaminated with infectious propagules of the pathogen or being bitten/scratched by infected cats (alternative route). Within a genus composed of 53 species displaying an essentially environmental core, there are only a few members which have considerable impacts on human or animal health. Infections are typically caused by S. brasiliensis, S. schenckii or S. globosa. Rare mammal pathogens include members of the S. pallida and S. stenocereus complexes. To illustrate the tremendous impact of emerging zoonotic sporotrichosis on public health, we discuss the main features of the expanding epidemics driven by S. brasiliensis in cats and humans. The cat entry in the transmission chain of sporotrichosis, causing epizooties (cat-cat) or zoonosis (cat-human), has contributed to the definition of new paradigms in Sporothrix transmission, reaching epidemic levels, making the disease a serious public health problem. Indeed, S. brasiliensis infection in humans and animals is likely to become even more important in the future, with projections of its expansion in biogeographic domains and host range, as well as greater virulence in mammals. Therefore, lessons from a long-standing outbreak in the state of Rio de Janeiro about the source and distribution of the etiological agents among outbreak areas can be used to create better control and prevention plans and increase awareness of sporotrichosis as a serious emerging zoonotic disease.
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Affiliation(s)
- Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, 04023-062, Brazil.
| | - Paula Portella Della Terra
- Laboratory of Emerging Fungal Pathogens, Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, 04023-062, Brazil
| | - Isabella Dib Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rosane Orofino-Costa
- Dermatology Department, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro, RJ, Brazil
| | - Zoilo Pires de Camargo
- Laboratory of Emerging Fungal Pathogens, Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, 04023-062, Brazil
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M. F. Matos A, M. Moreira L, F. Barczewski B, X. de Matos L, B. V. de Oliveira J, F. Pimentel MI, Almeida-Paes R, G. Oliveira M, C. A. Pinto T, Lima N, de O. Matos M, de M. e Costa LG, Santos C, Marques Evangelista Oliveira M. Identification by MALDI-TOF MS of Sporothrix brasiliensis Isolated from a Subconjunctival Infiltrative Lesion in an Immunocompetent Patient. Microorganisms 2019; 8:microorganisms8010022. [PMID: 31877698 PMCID: PMC7023001 DOI: 10.3390/microorganisms8010022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/17/2019] [Accepted: 12/17/2019] [Indexed: 11/16/2022] Open
Abstract
Sporotrichosis is a globally distributed subcutaneous fungal infection caused by dimorphic fungi belonging to the Sporothrix species complex that affects the skin of limbs predominantly, but not exclusively. A rare case of ocular sporotrichosis in an immunocompetent Brazilian patient from the countryside of Rio de Janeiro State is reported. A 68-year-old woman presented with a subconjunctival infiltrative lesion in the right eye with pre-auricular lymphadenopathy of onset 4 months ago that evolved to suppurative nodular lesions on the eyelids. Conjunctival secretion was evaluated by histopathological examination and inoculated on Sabouraud Dextrose Agar (SDA). Histopathology showed oval bodies within giant cells and other mononucleated histiocytes. Fungus grown on SDA was identified as Sporothrix sp. by morphological observations. The isolated strain was finally identified by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) associated with an in-house database enriched with reference Sporothrix complex spectra. The strain presented a MALDI spectrum with the ion peaks of the molecular mass profile of S. brasiliensis. The patient was adequately treated with amphotericin B subsequently replaced by itraconazole. Due to scars left by the suppurative process, the patient presented poor final visual acuity. The present work presents an overview of ocular sporotrichosis and discusses the diagnostic difficulty that can lead to visual sequelae in these cases.
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Affiliation(s)
- Aline M. F. Matos
- Department of Ophthalmology, University Hospital of the Federal University of Juiz de Fora, Juiz de Fora 36038-330, Brazil; (A.M.F.M.); (B.F.B.); (L.X.d.M.); (J.B.V.d.O.)
| | - Lucas M. Moreira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (L.M.M.); (R.A.-P.)
| | - Bianca F. Barczewski
- Department of Ophthalmology, University Hospital of the Federal University of Juiz de Fora, Juiz de Fora 36038-330, Brazil; (A.M.F.M.); (B.F.B.); (L.X.d.M.); (J.B.V.d.O.)
| | - Lucas X. de Matos
- Department of Ophthalmology, University Hospital of the Federal University of Juiz de Fora, Juiz de Fora 36038-330, Brazil; (A.M.F.M.); (B.F.B.); (L.X.d.M.); (J.B.V.d.O.)
| | - Jordane B. V. de Oliveira
- Department of Ophthalmology, University Hospital of the Federal University of Juiz de Fora, Juiz de Fora 36038-330, Brazil; (A.M.F.M.); (B.F.B.); (L.X.d.M.); (J.B.V.d.O.)
| | - Maria Ines F. Pimentel
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil;
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (L.M.M.); (R.A.-P.)
| | - Murilo G. Oliveira
- Department of Pharmacy, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil;
| | - Tatiana C. A. Pinto
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Brazil;
| | - Nelson Lima
- CEB—Biological Engineering Centre, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal;
| | - Magnum de O. Matos
- Imaging Department of Instituto Oncológico, Hospital Nove de Julho, Juiz de Fora 36010-510, Brazil;
| | - Louise G. de M. e Costa
- Department of Pathology, Faculty of Medicine of Federal University of Juiz de Fora, Juiz de Fora 36038-330, Brazil;
| | - Cledir Santos
- Department of Chemical Science and Natural Resources, BIOREN-UFRO, Universidad de La Frontera, 4811-230 Temuco, Chile
- Correspondence: (C.S.); (M.M.E.O.)
| | - Manoel Marques Evangelista Oliveira
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil
- Laboratório de Taxonomia, Bioquímica e Bioprospecção de Fungos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil
- Correspondence: (C.S.); (M.M.E.O.)
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