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Ribeiro VT, Caligiorne RB, Martins AP, Gomes Neto AP, Christo PP. Meningeal sporotrichosis in an immunocompetent host: A case report. Med Mycol Case Rep 2024; 45:100665. [PMID: 39290785 PMCID: PMC11406475 DOI: 10.1016/j.mmcr.2024.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/14/2024] [Accepted: 08/23/2024] [Indexed: 09/19/2024] Open
Abstract
A 78-year-old woman presented to hospital with altered mental status. Hyponatremia was diagnosed and treated. She maintained mental confusion despite normal sodium. No headache, fever or focal signs were present. CSF analysis showed chronic meningitis; MRI demonstrated basilar enhancement. She was empirically treated for tuberculosis, with no improvement. PCR for Sporothrix in the CSF was positive. After treatment with Amphotericin followed by oral itraconazole, she completely recovered her cognitive abilities. Follow-up CSF was normal. This report illustrates the need to consider sporotrichosis in the differential diagnosis of chronic meningitis in immunocompetent, and the importance of PCR as a diagnostic tool.
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Affiliation(s)
- Victor Teatini Ribeiro
- Departament of Neurology, Santa Casa de Belo Horizonte Hospital, Belo Horizonte (MG), Brazil
| | | | - Aldrin Pedroza Martins
- Departament of Neurology, Santa Casa de Belo Horizonte Hospital, Belo Horizonte (MG), Brazil
| | | | - Paulo Pereira Christo
- Departament of Neurology, Santa Casa de Belo Horizonte Hospital, Belo Horizonte (MG), Brazil
- Faculdade Santa Casa BH, Programa de Pós-graduação Stricto Sensu, Belo Horizonte (MG), Brazil
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Oliveira MDA, de Almeida SR, Martins JO. Novel Insights into Sporotrichosis and Diabetes. J Fungi (Basel) 2024; 10:527. [PMID: 39194853 DOI: 10.3390/jof10080527] [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: 07/01/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/29/2024] Open
Abstract
Sporotrichosis is a type of zoonotic subcutaneous mycosis caused by different species of dimorphic fungus of the genus Sporothrix, and it is the most common form of subcutaneous mycosis in Latin America. Sporotrichosis is generally restricted to cutaneous and lymphatic tissue (i.e., localized forms), and involvement in the viscera (i.e., disseminated or disseminated cutaneous form) is uncommon, especially in the central nervous system. However, immunosuppression in individuals with diabetes mellitus can lead to the disseminated form of the disease due to a failure to eliminate the pathogen and poor infection treatment outcomes. Possible correlations between patients with diabetes and their greater susceptibility to disseminated cases of sporotrichosis include a decreased cytokine response after stimulation, increased oxidative stress, decreased chemotaxis, phagocytic activity, adhesion and rolling of neutrophils and monocytes/macrophages, and increased macrophage/monocyte and polymorphonuclear cell apoptosis. Therefore, this review highlights novel insights into diabetes and sporotrichosis by investigating how chronic inflammation affects and aggravates the infection, the possible causes of the greater susceptibility of Sporothrix sp. to hematogenous dissemination in immunocompromised patients, and the main alterations that this dissemination can cause.
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Affiliation(s)
- Mariana de Araujo Oliveira
- Laboratory of Immunoendocrinology, Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Sandro Rogério de Almeida
- Laboratory of Mycology, Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Joilson O Martins
- Laboratory of Immunoendocrinology, Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
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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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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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de Souza Rabello VB, de Melo Teixeira M, Meyer W, Irinyi L, Xavier MO, Poester VR, Pereira Brunelli JG, Almeida-Silva F, Bernardes-Engemann AR, Ferreira Gremião ID, Dos Santos Angelo DF, Clementino IJ, Almeida-Paes R, Zancopé-Oliveira RM. Multi-locus sequencing typing reveals geographically related intraspecies variability of Sporothrix brasiliensis. Fungal Genet Biol 2024; 170:103845. [PMID: 38040325 DOI: 10.1016/j.fgb.2023.103845] [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: 09/28/2023] [Revised: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023]
Abstract
Sporotrichosis is a subcutaneous mycosis caused by pathogenic Sporothrix species. Among them, Sporothrix brasiliensis is the main species associated with endemic regions in South America, especially Brazil. It is highly virulent and can be spread through zoonotic transmission. Molecular epidemiological surveys are needed to determine the extent of genetic variation, to investigate outbreaks, and to identify genotypes associated with antifungal resistance and susceptibility. This study investigated the sequence variation of different constitutive genes and established a novel multilocus sequence typing (MLST) scheme for S. brasiliensis. Specific primers were designed for 16 genes using Primer-BLAST software based on the genome sequences of three S. brasiliensis strains (ATCC MYA-4823, A001 and A005). Ninety-one human, animal, and environmental S. brasiliensis isolates from different Brazilian geographic regions (South, Southeast, Midwest and Northeast) andtwo isolates from Paraguay were sequenced. The loci that presented the highest nucleotide diversity (π) were selected for the MLST scheme. Among the 16 studied genetic loci, four presented increased π value and were able to distinguish all S. brasiliensis isolates into seven distinct haplotypes. The PCR conditions were standardized for four loci. Some of the obtained haplotypes were associated with the geographic origin of the strains. This study presents an important advance in the understanding of this important agent of sporotrichosis in Brazil. It significantly increased the discriminatory power for genotyping of S. brasiliensis isolates, and enabled new contributions to the epidemiological studies of this human and animal pathogen in Brazil and in other countries.
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Affiliation(s)
- Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
| | - Marcus de Melo Teixeira
- Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - Wieland Meyer
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands; Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, Sydney Infectious Diseases Institute, University of Sydney, Westmead Hospital, Research and Education Network, Westmead Institute for Medical Research, Sydney, Australia
| | - Laszlo Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, Sydney Infectious Diseases Institute, University of Sydney, Westmead Hospital, Research and Education Network, Westmead Institute for Medical Research, Sydney, Australia
| | - Melissa Orzechowski Xavier
- Laboratório de Micologia e Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande (FAMED-FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Vanice Rodrigues Poester
- Laboratório de Micologia e Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande (FAMED-FURG), Rio Grande, Rio Grande do Sul, Brazil
| | | | - Fernando Almeida-Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Andrea Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Isabella Dib Ferreira Gremião
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | | | - Inácio José Clementino
- Departamento de Medicina Veterinária, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, 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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Gomes RDSR, do Valle ACF, Freitas DFS, de Macedo PM, Oliveira RDVC, Almeida-Paes R, Zancopé-Oliveira RM, Gutierrez-Galhardo MC. Sporotrichosis in Older Adults: A Cohort Study of 911 Patients from a Hyperendemic Area of Zoonotic Transmission in Rio de Janeiro, Brazil. J Fungi (Basel) 2023; 9:804. [PMID: 37623575 PMCID: PMC10455193 DOI: 10.3390/jof9080804] [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: 06/26/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
Generally, older people tend to suffer from more severe infections than younger adults. In addition, there are accumulations of comorbidities and immune senescence in some cases. This cohort study evaluated the clinical and epidemiological characteristics of older adults (≥60 years old) with sporotrichosis. The cohort consisted of 911 patients with a median age of 67 years, most of whom were female (72.6%), white (62.1%), and afflicted with comorbidities (64.5%). The lymphocutaneous form occurred in 62% of the patients, followed by the fixed form (25.7%), cutaneous disseminated form (8.9%), and extracutaneous/disseminated forms (3.3%). In this study, we draw attention to the frequency of osteoarticular involvement (2.1%) secondary to skin lesions such as osteomyelitis and/or tenosynovitis. A clinical cure was achieved in 87.3% of cases. Itraconazole was used in 81.1% of cases, while terbinafine was used in 22.7% of cases, usually in low doses. Survival analysis showed that the median treatment time was 119 days, and the multiple Cox model demonstrated that the presentation of a black coloration and diabetes was associated with a longer treatment time required to establish a cure. Therefore, these subgroups should be monitored more closely to reduce possible difficulties during treatment. It would be interesting to conduct more studies analyzing older adults with sporotrichosis from different geographic areas to better comprehend the disease in this group.
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Affiliation(s)
- Rachel da Silva Ribeiro Gomes
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Antonio Carlos Francesconi do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Dayvison Francis Saraiva Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Priscila Marques de Macedo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | | | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, 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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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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10
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A neglected disease. Human sporotrichosis in a densely populated urban area in São Paulo, Brazil: clinical-epidemiological and therapeutic aspects. Braz J Microbiol 2022; 53:739-748. [PMID: 35301695 PMCID: PMC9151930 DOI: 10.1007/s42770-022-00713-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/13/2022] [Indexed: 02/07/2023] Open
Abstract
Human sporotrichosis is caused by different Sporothrix species; however, Sporothrix brasiliensis is the main species, usually related to cat transmission in urban areas. A retrospective descriptive study was conducted at the Institute of Infectology Emílio Ribas from 2010 to 2018. Demography, clinical, diagnostic, and therapeutic data were obtained from medical records. Polymerase chain reaction of the calmodulin gene was performed to identify Sporothrix species. In addition, to evaluate the spread of the disease across São Paulo metropolitan region, TerraView version 4.2.2 software was used for geocoding cases according to residence addresses. Kernell's maps using QGIS software version 2.16.3 were constructed to determine the concentration of cases. Results: 260 cases of sporotrichosis were diagnosed between 2010 and 2018. We observed a 700% increment in the number of human cases in the 2016-2018 triennium compared with the 2013-2015 triennium. Female adults with a median age of 46 years old were the predominant infected group associated with cats' exposition at home care, although the age range of all patients was 01 to 86 years old. The main epidemiological risk of acquiring sporotrichosis was contact with cats, reported by 96.5% of the patients. Molecular identification showed that most of the tested isolates were Sporothrix brasiliensis. Lymphocutaneous form was observed in 59.2% and fixed cutaneous form in 37.5% of the patients. Regarding treatment, itraconazole was the main drug used (94.2%) with a cure rate of 98.8%. We observed an important spread of human sporotrichosis involving cat transmission caused by Sporothrix brasiliensis in a densely populated area of São Paulo state. These results are important to alert clinicians and dermatologists about the occurrence and progression of a neglected tropical disease in an urban area and the urgent necessity to include sporotrichosis as a differential diagnosis in the clinical investigation routine.
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11
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Neves GWP, Wong SSW, Aimanianda V, Simenel C, Guijarro JI, Walls C, Willment JA, Gow NAR, Munro CA, Brown GD, Lopes-Bezerra LM. Complement-Mediated Differential Immune Response of Human Macrophages to Sporothrix Species Through Interaction With Their Cell Wall Peptidorhamnomannans. Front Immunol 2021; 12:749074. [PMID: 34867977 PMCID: PMC8636148 DOI: 10.3389/fimmu.2021.749074] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
In this study, the human immune response mechanisms against Sporothrix brasiliensis and Sporothrix schenckii, two causative agents of human and animal sporotrichosis, were investigated. The interaction of S. brasiliensis and S. schenckii with human monocyte-derived macrophages (hMDMs) was shown to be dependent on the thermolabile serum complement protein C3, which facilitated the phagocytosis of Sporothrix yeast cells through opsonization. The peptidorhamnomannan (PRM) component of the cell walls of these two Sporothrix yeasts was found to be one of their surfaces exposed pathogen-associated molecular pattern (PAMP), leading to activation of the complement system and deposition of C3b on the Sporothrix yeast surfaces. PRM also showed direct interaction with CD11b, the specific component of the complement receptor-3 (CR3). Furthermore, the blockade of CR3 specifically impacted the interleukin (IL)-1β secretion by hMDM in response to both S. brasiliensis and S. schenckii, suggesting that the host complement system plays an essential role in the inflammatory immune response against these Sporothrix species. Nevertheless, the structural differences in the PRMs of the two Sporothrix species, as revealed by NMR, were related to the differences observed in the host complement activation pathways. Together, this work reports a new PAMP of the cell surface of pathogenic fungi playing a role through the activation of complement system and via CR3 receptor mediating an inflammatory response to Sporothrix species.
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Affiliation(s)
- Gabriela W. P. Neves
- Cell Biology Department, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | - Catherine Simenel
- Institut Pasteur, Biological NMR and HDX-MS Technological Platform, CNRS UMR3528, Paris, France
| | - J. Iñaki Guijarro
- Institut Pasteur, Biological NMR and HDX-MS Technological Platform, CNRS UMR3528, Paris, France
| | - Catriona Walls
- Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Janet A. Willment
- Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom,Medical Research Council Centre for Medical Mycology at the University of Exeter, Exeter, United Kingdom
| | - Neil A. R. Gow
- Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom,Medical Research Council Centre for Medical Mycology at the University of Exeter, Exeter, United Kingdom
| | - Carol A. Munro
- Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Gordon D. Brown
- Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom,Medical Research Council Centre for Medical Mycology at the University of Exeter, Exeter, United Kingdom
| | - Leila M. Lopes-Bezerra
- Cell Biology Department, Rio de Janeiro State University, Rio de Janeiro, Brazil,Biomedical Institute and Technology and Innovation Center (CIETEC), São Paulo University, São Paulo, Brazil,*Correspondence: Leila M. Lopes-Bezerra,
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12
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The spread of cat-transmitted sporotrichosis due to Sporothrix brasiliensis in Brazil towards the Northeast region. PLoS Negl Trop Dis 2021; 15:e0009693. [PMID: 34460830 PMCID: PMC8432896 DOI: 10.1371/journal.pntd.0009693] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/10/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Sporotrichosis is a worldwide subcutaneous mycosis caused by Sporothrix spp. In the past, this infection was associated with armadillo hunting, horticulturists, miners, and gardeners, being considered an implantation mycosis acquired by plant debris injury. Nevertheless, since the late nineties, it has been considered a zoonotic disease in Brazil. Here we report a case series of 121 patients with cat-transmitted sporotrichosis seen in Northeast Brazil. METHODOLOGY/PRINCIPAL FINDINGS Patient's demographic, clinical data, and length of treatment were recorded. In addition, a mycological examination and further PCR confirmation of species identification were performed. One hundred and twenty two patients were diagnosed with subcutaneous sporotrichosis from October 2016 to December 2019, while PCR revealed that 71 of them were due to S. brasiliensis. The majority of the individuals were female (n = 86; 70.5%). Patient's age ranged from 5 to 87 years old. The clinical forms found were lymphocutaneous (58.2%) and fixed cutaneous (39.4%). Interestingly, 115 patients reported previous contact with cats diagnosed with sporotrichosis. Patients were successfully treated with itraconazole and potassium iodide. CONCLUSIONS/SIGNIFICANCE Our study adds important contributions for the investigation of the spread of cat-transmitted subcutaneous sporotrichosis in Brazil, specifically towards the Northeast region of a continental-size country. It will also help clinicians to be aware of the existence and importance to accurately diagnose sporotrichosis and treat patients with this infectious disease in the lowest income region of Brazil.
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13
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Gremião IDF, Martins da Silva da Rocha E, Montenegro H, Carneiro AJB, Xavier MO, de Farias MR, Monti F, Mansho W, de Macedo Assunção Pereira RH, Pereira SA, Lopes-Bezerra LM. Guideline for the management of feline sporotrichosis caused by Sporothrix brasiliensis and literature revision. Braz J Microbiol 2021; 52:107-124. [PMID: 32990922 PMCID: PMC7966609 DOI: 10.1007/s42770-020-00365-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 08/10/2020] [Indexed: 02/06/2023] Open
Abstract
We herein present a Brazilian guideline for the management of feline sporotrichosis, a mycosis caused by Sporothrix brasiliensis. This guideline is an effort of a national technical group organized by the Working Group on Sporothrix and Sporotrichosis of the International Society for Human and Animal Mycology (ISHAM). This publication intends to provide information on clinical-epidemiological aspects of this zoonosis, as well as a literature revision. Moreover, it gives some practical information on diagnosis and treatment of feline sporotrichosis. It also contains information that can be helpful for the prevention and control of S. brasiliensis transmission.
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Affiliation(s)
- Isabella Dib Ferreira Gremião
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro. Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-900, Brazil.
| | | | - Hildebrando Montenegro
- Laboratório de Diagnóstico de Zoonoses, Divisão de Vigilância de Zoonoses (COVISA/SMS/PMSP), São Paulo, Brazil
| | - Aroldo José Borges Carneiro
- Secretaria Municipal da Saúde de Salvador (SMS), Salvador, Brazil
- Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Melissa Orzechowski Xavier
- Laboratório de Micologia, Faculdade de Medicina, Universidade Federal do Rio Grande (FURG), Rio Grande do Sul, Brazil
| | | | - Fabiana Monti
- Pós-graduação em Ciência Animal, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| | - Wilson Mansho
- Centro de Controle de Zoonoses (CCZ), Secretaria Municipal de Saúde de Guarulhos, São Paulo, Brazil
| | | | - Sandro Antonio Pereira
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro. Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-900, Brazil
| | - Leila M Lopes-Bezerra
- BIDiagnostics, Centro de Inovação, Empreendedorismo e Tecnologia (CIETEC)/Universidade de São Paulo, São Paulo, Brazil
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14
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Etchecopaz A, Toscanini MA, Gisbert A, Mas J, Scarpa M, Iovannitti CA, Bendezú K, Nusblat AD, Iachini R, Cuestas ML. Sporothrix Brasiliensis: A Review of an Emerging South American Fungal Pathogen, Its Related Disease, Presentation and Spread in Argentina. J Fungi (Basel) 2021; 7:jof7030170. [PMID: 33652625 PMCID: PMC7996880 DOI: 10.3390/jof7030170] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Sporotrichosis, caused by Sporothrix schenckii and related species, is the most frequent implantation mycosis in Latin America. In Argentina, over the last 8 years, there have been 0.16 new cases per month of feline sporotrichosis in 2011, increasing to 0.75 cases per month in 2019 and involving zoonotic transmission to humans. Molecular identification by polymerase chain reaction (PCR) detected Sporothrix brasiliensis in these feline and zoonotic outbreaks. This study will focus on different feline and human sporotrichosis outbreaks caused by S. brasiliensis in Argentina during 2011–2019. We will address the sources of infection and environmental hotspots, as well as the application of several treatment strategies for improving the pharmacotherapy of the different clinical forms of the disease. Finally, we will provide a detailed summary of the clinical aspects and new advances in host–pathogen interactions, virulence factors and immune response, focusing on state-of-the-art diagnostic tools and potential vaccine candidates.
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Affiliation(s)
- Alejandro Etchecopaz
- Cátedra de Enfermedades Infecciosas, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427 CWN, Argentina; (A.E.); (M.S.)
| | - María A. Toscanini
- Instituto de Nanobiotecnología (Nanobiotec), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires C1113 AAD, Argentina; (M.A.T.); (A.D.N.)
| | - Amelia Gisbert
- Cátedra de Clínica Médica, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427 CWN, Argentina; (A.G.); (J.M.)
| | - Javier Mas
- Cátedra de Clínica Médica, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427 CWN, Argentina; (A.G.); (J.M.)
| | - Miguel Scarpa
- Cátedra de Enfermedades Infecciosas, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427 CWN, Argentina; (A.E.); (M.S.)
| | - Cristina A. Iovannitti
- Centro de Micología, Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires C1121ABG, Argentina; (C.A.I.); (K.B.)
| | - Karla Bendezú
- Centro de Micología, Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires C1121ABG, Argentina; (C.A.I.); (K.B.)
| | - Alejandro D. Nusblat
- Instituto de Nanobiotecnología (Nanobiotec), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires C1113 AAD, Argentina; (M.A.T.); (A.D.N.)
| | - Ricardo Iachini
- Instituto de Zoonosis «Luis Pasteur», Buenos Aires C1405 DCD, Argentina;
| | - María L. Cuestas
- Cátedra de Enfermedades Infecciosas, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427 CWN, Argentina; (A.E.); (M.S.)
- Centro de Micología, Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires C1121ABG, Argentina; (C.A.I.); (K.B.)
- Correspondence: ; Tel.: +54-11-59509500 (ext. 2176/77)
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15
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Lima MA, Vallier R, Silva MM. Sporothrix brasiliensis meningitis in an immunocompetent patient. Pract Neurol 2021; 21:241-242. [PMID: 33627490 DOI: 10.1136/practneurol-2020-002915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 11/04/2022]
Abstract
Sporothrix brasiliensis usually causes infection limited to the skin, subcutaneous tissue and regional lymph nodes. Contamination occurs through inhalation or accidental inoculation from animal scratches and bites. Meningitis is rare and mostly occurs in immunosuppressed patients. Here, we describe an immunocompetent person who developed chronic meningitis and discuss the diagnosis, differential diagnosis and treatment of this rare condition.
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Affiliation(s)
- Marco A Lima
- Neurology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renan Vallier
- Internal Medicine Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcos M Silva
- Internal Medicine Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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16
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Affiliation(s)
- Howard M Heller
- From the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Massachusetts General Hospital, and the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Harvard Medical School - both in Boston
| | - R Gilberto Gonzalez
- From the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Massachusetts General Hospital, and the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Harvard Medical School - both in Boston
| | - Brian L Edlow
- From the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Massachusetts General Hospital, and the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Harvard Medical School - both in Boston
| | - Kevin L Ard
- From the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Massachusetts General Hospital, and the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Harvard Medical School - both in Boston
| | - Tasos Gogakos
- From the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Massachusetts General Hospital, and the Departments of Medicine (H.M.H., K.L.A.), Radiology (R.G.G.), Neurology (B.L.E.), and Pathology (T.G.), Harvard Medical School - both in Boston
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17
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Promising application of the SsCBF ELISA test to monitor the therapeutic response of feline sporotrichosis caused by Sporothrix brasiliensis from Brazilian epidemics. Braz J Microbiol 2020; 52:145-153. [PMID: 32812211 DOI: 10.1007/s42770-020-00362-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 08/08/2020] [Indexed: 10/23/2022] Open
Abstract
Sporotrichosis zoonotic transmission by cats has obtained hyperendemic magnitude in Rio de Janeiro, Brazil. Atypical cases, relapses, and reinfections as well as reduced diagnostic sensitivity of conventional methods have been reported. Previously, the anti-SsCBF enzyme-linked immunosorbent assay (ELISA) test was shown to be useful as a diagnostic tool for human sporotrichosis. Effective diagnosis and treatment are critical to interrupt the chain of transmission of this major pathogen in Brazilian Public Health. To evaluate its applicability for feline sporotrichosis diagnosis and/or therapeutic follow-up, 15 domestic cats from Rio de Janeiro were clinically and laboratory monitored by cytopathology, culture, Sporothrix genotyping, and anti-SsCBF IgG levels. Subsequently, animals were divided into satisfactory and non-satisfactory therapeutic responders. Averages of antibody serum levels obtained for diagnosis (first consultation) compared with the levels found after follow-up (last consultation) were significantly different in both groups (p = 0.0002 and p = 0.038, respectively). We conclude that the SsCBF ELISA test can predict feline sporotrichosis therapeutic responses even for animals with distinct clinical evolutions.
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18
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Arantes Ferreira GS, Watanabe ALC, Trevizoli NC, Jorge FMF, Cajá GON, Diaz LGG, Meireles LP, Araújo MCCL. Disseminated Sporotrichosis in a Liver Transplant Patient: A Case Report. Transplant Proc 2019; 51:1621-1624. [PMID: 31155205 DOI: 10.1016/j.transproceed.2019.02.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sporotrichosis is an infection caused by the fungus of the Sporothrix schenckii complex and can be particularly harmful in immunocompromised patients. We report the case of a 26-year-old male patient with a previous history of pulmonary infection who underwent a liver transplant for Budd-Chiari syndrome. After the procedure, he presented with persistent fever and leukocytosis. On the 13th post-operative day, he was diagnosed with thrombosis of the hepatic artery and underwent a second liver transplant 15 days after the first procedure. After the retransplant, he presented daily episodes of fever, even after the use of several antimicrobial, antiviral, and antifungal agents. A number of negative cultures from different sites were obtained. After an acute episode of mental confusion, the growth of S schenckii was observed in cultures from cerebrospinal fluid and ascites obtained from a diagnostic paracentesis. Treatment with amphotericin B was started but the patient died on the fourth day of antifungal treatment, from a massive gastrointestinal hemorrhage. We found no previous report in the literature of spontaneous dissemination of S schenckii to the abdominal cavity causing peritonitis.
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Affiliation(s)
- G S Arantes Ferreira
- Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil.
| | - A L C Watanabe
- Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil
| | - N C Trevizoli
- Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil
| | - F M F Jorge
- Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil
| | - G O N Cajá
- Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil
| | - L G G Diaz
- Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil
| | - L P Meireles
- Medical School, Chatolic University of Brasilia, Brasília, Brazil
| | - M C C L Araújo
- Medical School, Chatolic University of Brasilia, Brasília, Brazil
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19
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Ferreira BH, Ramírez-Prado JH, Neves GWP, Torrado E, Sampaio P, Felipe MSS, Vasconcelos AT, Goldman GH, Carvalho A, Cunha C, Lopes-Bezerra LM, Rodrigues F. Ploidy Determination in the Pathogenic Fungus Sporothrix spp. Front Microbiol 2019; 10:284. [PMID: 30858833 PMCID: PMC6397882 DOI: 10.3389/fmicb.2019.00284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 02/04/2019] [Indexed: 11/16/2022] Open
Abstract
The pathogenic clade of the Sporothrix genus comprises the etiological agents of sporotrichosis, a worldwide emergent disease. Despite the growing understanding of their successful pathogen traits, there is little information on genome sizes and ploidy within the genus. Therefore, in this work, we evaluated the ploidy of four species of the Sporothrix genus, specifically Sporothrix brasiliensis, Sporothrix schenckii, Sporothrix globosa, and Sporothrix pallida. Through cell cycle analysis of the yeast-phase cells, we showed that the DNA content of G0/G1 cells was similar to the genome size determined by whole genome sequencing. Moreover, ploidy of S. schenckii, S. brasiliensis, and S. pallida that was determined by allele composition using next-generation sequencing (NGS) data is consistent with monomorphic positions at each allele. These data show that the analyzed strains of Sporothrix are haploid, or at least aneuploid, thereby laying the foundation for the development of a molecular toolbox for Sporothrix spp.
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Affiliation(s)
- Beatriz H. Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, University of Minho, Braga, Portugal
| | | | - Gabriela W. P. Neves
- Laboratory of Cellular Mycology and Proteomics, Biology Institute, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Egídio Torrado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, University of Minho, Braga, Portugal
| | - Paula Sampaio
- Centre of Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
| | - Maria Sueli S. Felipe
- Genomic Science and Biotechnology, Catholic University of Brasília, Brasília, Brazil
- Department of Cellular Biology, University of Brasília, Brasília, Brazil
| | - Ana Tereza Vasconcelos
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | - Gustavo H. Goldman
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, University of Minho, Braga, Portugal
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, University of Minho, Braga, Portugal
| | - Leila M. Lopes-Bezerra
- Laboratory of Cellular Mycology and Proteomics, Biology Institute, University of Rio de Janeiro State, Rio de Janeiro, Brazil
- Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Fernando Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, University of Minho, Braga, Portugal
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20
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Queiroz-Telles F, Buccheri R, Benard G. Sporotrichosis In Immunocompromised Hosts. J Fungi (Basel) 2019; 5:jof5010008. [PMID: 30641918 PMCID: PMC6463096 DOI: 10.3390/jof5010008] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/07/2019] [Accepted: 01/07/2019] [Indexed: 02/06/2023] Open
Abstract
Sporotrichosis is a global implantation or subcutaneous mycosis caused by several members of the genus Sporothrix, a thermo-dimorphic fungus. This disease may also depict an endemic profile, especially in tropical to subtropical zones around the world. Interestingly, sporotrichosis is an anthropozoonotic disease that may be transmitted to humans by plants or by animals, especially cats. It may be associated with rather isolated or clustered cases but also with outbreaks in different periods and geographic regions. Usually, sporotrichosis affects immunocompetent hosts, presenting a chronic to subacute evolution course. Less frequently, sporotrichosis may be acquired by inhalation, leading to disseminated clinical forms. Both modes of infection may occur in immunocompromised patients, especially associated with human immunodeficiency virus (HIV) infection, but also diabetes mellitus, chronic alcoholism, steroids, anti-TNF treatment, hematologic cancer and transplanted patients. Similar to other endemic mycoses caused by dimorphic fungi, sporotrichosis in immunocompromised hosts may be associated with rather more severe clinical courses, larger fungal burden and longer periods of systemic antifungal therapy. A prolonged outbreak of cat-transmitted sporotrichosis is in progress in Brazil and potentially crossing the border to neighboring countries. This huge outbreak involves thousands of human and cats, including immunocompromised subjects affected by HIV and FIV (feline immunodeficiency virus), respectively. We reviewed the main epidemiologic, clinical, diagnostic and therapeutic aspects of sporotrichosis in immunocompromised hosts.
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Affiliation(s)
- Flavio Queiroz-Telles
- Department of Public Health, Federal University of Paraná, Curitiba 80060-000, Brazil.
| | - Renata Buccheri
- Emilio Ribas Institute of Infectious Diseases, São Paulo 05411-000, Brazil.
| | - Gil Benard
- Laboratory of Medical Mycology, Department of Dermatology, and Tropical Medicine Institute, University of São Paulo, Sao Paulo 05403-000, Brazil.
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Eyer-Silva WA, de Azevedo MCVM, da Silva GAR, Basílio-de-Oliveira RP, de Araujo LF, do Lago IV, Pereira FCF, Fernandes MBT, Figueiredo-Carvalho MHG, Souza Rabello VBD, Zancopé-Oliveira RM, Almeida-Paes RD, Ferry FRDA, Neves-Motta R. Palate ulcer, uvular destruction and nasal septal perforation caused by Sporothrix brasiliensis in an HIV-infected patient. Med Mycol Case Rep 2018; 23:16-19. [PMID: 30479942 PMCID: PMC6243021 DOI: 10.1016/j.mmcr.2018.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 10/29/2018] [Accepted: 11/08/2018] [Indexed: 01/19/2023] Open
Abstract
Sporotrichosis is a human and animal disease caused by dimorphic pathogenic species of the genus Sporothrix. We report a dramatic presentation of Sporothrix brasiliensis infection, with destruction of the nasal septum, soft palate, and uvula of an HIV-infected woman. She was successfully treated with amphotericin B deoxycholate followed by itraconazole. Sporotrichosis remains a neglected opportunistic infection in patients with AIDS and awareness of this potentially fatal infection is of utmost importance.
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Affiliation(s)
- Walter A. Eyer-Silva
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
- Corresponding author.
| | - Marcelo Costa Velho Mendes de Azevedo
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Rodrigo Panno Basílio-de-Oliveira
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Luciana Ferreira de Araujo
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Isabela Vieira do Lago
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Franciele Cristina Ferreira Pereira
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Miriã Boaretto Teixeira Fernandes
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | | | - Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brazil 4365, 21040-900 Rio de Janeiro, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brazil 4365, 21040-900 Rio de Janeiro, Brazil
| | - Rodrigo de Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brazil 4365, 21040-900 Rio de Janeiro, Brazil
| | - Fernando Raphael de Almeida Ferry
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Rogério Neves-Motta
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
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