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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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2
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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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3
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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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Shimokawa A, Kobayashi A, Saeki Y, Uchio E. A case of fungal conjunctivitis with giant papillae treated surgically. Taiwan J Ophthalmol 2021; 11:417-420. [PMID: 35070676 PMCID: PMC8757520 DOI: 10.4103/tjo.tjo_46_20] [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: 05/25/2020] [Accepted: 07/11/2020] [Indexed: 12/03/2022] Open
Abstract
Fungal conjunctivitis is a rare disorder, with low incidence and difficulty in diagnosis due to a lack of specific clinical findings. We report a case of fungal conjunctivitis which exhibited a specific clinical feature of giant papilla formation, and its diagnosis was a complex process. A 19-year-old woman with a history of atopic dermatitis and hard contact lens use was referred to us with a 3-month history of giant papillary conjunctivitis of the right eye in spite of treatment with antiallergic and corticosteroid eye drops, complicated by intraocular pressure elevation. The left eye showed no symptom of ocular surface disorder throughout the clinical course. The right eye did not respond to oral corticosteroid. Polymerase chain reaction of conjunctival scrapings against Chlamydia trachomatis was negative, and she was treated surgically by total papilla resection. Conjunctival giant papilla recurrence was not observed after surgery. Although the primary histopathological diagnosis was chronic inflammation due to atopic keratoconjunctivitis, repeated histopathological survey of excised conjunctival tissue including immunohistochemical staining revealed histiocytes, yeast type spores and hyphae, and phagocytosed spores and hyphae in macrophages. The causative organism was identified morphologically as a Candida species. Later, histopathological examination of a cervical swab revealed the presence of Candida sp. This rare case indicates that a fungal organism may underlie refractory conjunctivitis with specific giant papillary hypertrophy mimicking vernal keratoconjunctivitis.
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Affiliation(s)
- Asami Shimokawa
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Ayaka Kobayashi
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
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5
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Ramírez-Oliveros JF, Casz Schechtman R, de Vries HJ, Lora L, Cardoso Arinelli A, da Costa Nery JA, Saraiva Freitas DF. Ocular adnexal sporotrichosis: A case series. JAAD Case Rep 2021; 13:52-56. [PMID: 34150968 PMCID: PMC8190125 DOI: 10.1016/j.jdcr.2021.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Joaquín Felipe Ramírez-Oliveros
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA), Santa Casa da Misericórdia do Rio de Janeiro-Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Regina Casz Schechtman
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA), Santa Casa da Misericórdia do Rio de Janeiro-Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Henry John de Vries
- Department of Dermatology, Amsterdam UMC & Amsterdam Infection and Immunity Institute (AI&II), Amsterdam, The Netherlands.,Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Leonardo Lora
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA), Santa Casa da Misericórdia do Rio de Janeiro-Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andrea Cardoso Arinelli
- Laboratory of Clinical Research in Infectious Ophthalmology, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - José Augusto da Costa Nery
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA), Santa Casa da Misericórdia do Rio de Janeiro-Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Dayvison Francis Saraiva Freitas
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratory of Clinical Research in Infectious Dermatology, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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6
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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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Liborio Neto AO, Rubim Caetano T, Pestana Gervasio NH, Camargo Carneiro R. Conjunctival and bulbar sporotrichosis as Parinaud's oculoglandular syndrome acquired by blood inoculation. GMS OPHTHALMOLOGY CASES 2021; 11:Doc02. [PMID: 33654649 PMCID: PMC7894194 DOI: 10.3205/oc000175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Parinaud's oculoglandular syndrome (POS) is a clinical condition characterized by granulomatous conjunctivitis associated with homolateral neck pain and anterior preauricular lymphadenopathy. Several reports of this condition occurred and some bacterial etiological agents were identified. However, fungal infections have also been associated, especially sporotrichosis. A 40-year-old female patient complained about a "little ball" in the lower eyelid of the left eye. On ocular examination, visual acuity and fundoscopy were normal. The biomicroscopy revealed a granulomatous lesion in the lower eyelid of the left eye associated with yellowish discharge. The patient returned the next day, reporting worsening of the condition accompanied by low fever, malaise, preauricular and submandibular lymphadenomegaly. The examination showed the evolution of conjunctival edema and various conjunctival granulomas in the lower and upper tarsus of the left eye, a clinical picture compatible with POS. In the investigation of the clinical history, the patient remembered an episode of contact with blood of cats. During the investigation, we discarded differential diagnoses such as tuberculosis, toxoplasmosis, CMV, herpes virus and Bartonella. Serology was positive for Sporothrix. Treatment with itraconazole 100 mg once daily was started. By the eighth week, the conjunctival granulomas had disappeared, and the medication was discontinued after 90 days of treatment, after about 2 weeks of total remission. According to the literature, there are no cases of primarily ocular manifestation of blood sporotrichosis transmission. However, in the report, the form of transmission of the disease occurred by inoculation by direct contact with the blood of contaminated cats.
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Affiliation(s)
- Adail Orrith Liborio Neto
- Federal University of Rio de Janeiro, Campus Macaé (UFRJ), Rio de Janeiro, Brazil,*To whom correspondence should be addressed: Adail Orrith Liborio Neto, Federal University of Rio de Janeiro, Campus Macaé (UFRJ), Av. Aluizio da Silva Gomes, 50 – Novo Cavaleiros, Macaé, Rio de Janeiro 27930-560, Brazil, E-mail:
| | - Tiago Rubim Caetano
- Federal University of Rio de Janeiro, Campus Macaé (UFRJ), Rio de Janeiro, Brazil
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8
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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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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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10
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Arinelli A, Aleixo ALQDC, Freitas DFS, do Valle ACF, Almeida-Paes R, Gutierrez-Galhardo MC, Curi ALL. Ocular Sporotrichosis: 26 Cases with Bulbar Involvement in a Hyperendemic Area of Zoonotic Transmission. Ocul Immunol Inflamm 2019; 28:764-771. [PMID: 31411512 DOI: 10.1080/09273948.2019.1624779] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To describe 26 cases of bulbar conjunctival sporotrichosis. METHODS Review of clinical records of patients with bulbar conjunctivitis due to culture-proven Sporothrix spp. infection, in Rio de Janeiro, from 2007 to 2017. RESULTS Twenty-six patients were identified. Median age was 25 years. Adults were more affected (53.8%), followed by adolescents (26.9%). There was a predominance of women (73.1%). Twenty-four patients (96%) reported contact with cats with sporotrichosis. Twenty-one patients (80.8%) presented a primary ocular sporotrichosis. Five patients presented associated eyelid lesions, and 21 (80.8%) tarsal conjunctivitis. Parinaud oculoglandular syndrome was observed in 17 (81%) patients. Eight patients (36.4%) reported the use of steroid drops before diagnosis was made. All patients but one were treated with oral itraconazole. Twenty-three patients (88.5%) were completely cured and three (11.5%) were lost to follow-up. Eight patients (34.8%) developed ocular sequelae. CONCLUSION Bulbar conjunctivitis is an important clinical presentation of ocular sporotrichosis. It can lead to ocular sequelae. Sporotrichosis should be considered in the differential diagnosis of ophthalmic external diseases, especially in patients with cat contact history.
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Affiliation(s)
- Andrea Arinelli
- Laboratory of Clinical Research in Infectious Ophthalmology, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
| | | | | | | | - Rodrigo Almeida-Paes
- Laboratory of Mycology, at Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
| | | | - André Luiz Land Curi
- Laboratory of Clinical Research in Infectious Ophthalmology, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
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11
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Brandolt TM, Madrid IM, Poester VR, Sanchotene KO, Basso RP, Klafke GB, Rodrigues MDL, Xavier MO. Human sporotrichosis: A zoonotic outbreak in southern Brazil, 2012-2017. Med Mycol 2019; 57:527-533. [PMID: 30265327 DOI: 10.1093/mmy/myy082] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/17/2018] [Accepted: 08/28/2018] [Indexed: 12/17/2023] Open
Abstract
Zoonotic sporotrichosis has undergone a geographical expansion in Brazil in the last decade. Rio Grande do Sul (RS) is the second state of the country in which a number of feline sporotrichosis cases have been described. Since cats are the main zoonotic source of infection, this study aimed to describe 100 cases of human sporotrichosis occurring in the last 5 years in the southern region of RS, Brazil. In addition, we aimed to illustrate the zoonotic importance of the disease, describing four cases in the same family due to transmission by their cat. This great number of human cases in a short period of evaluation highlights the severity of sporotrichosis as a public health problem in the region, suggesting that a possible outbreak is occurring that requires immediate public intervention actions to weaken its impact.
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Affiliation(s)
- Tchana Martinez Brandolt
- Post-Graduation Program in Health Science, Federal University of Rio Grande (FURG), Rio Grande, Brazil
| | | | - Vanice Rodrigues Poester
- Post-Graduation Program in Health Science, Federal University of Rio Grande (FURG), Rio Grande, Brazil
| | - Karine Ortiz Sanchotene
- Post-Graduation Program in Health Science, Federal University of Rio Grande (FURG), Rio Grande, Brazil
| | - Rossana Patricia Basso
- Post-Graduation Program in Health Science, Federal University of Rio Grande (FURG), Rio Grande, Brazil
| | | | | | - Melissa Orzechowski Xavier
- Post-Graduation Program in Health Science, Federal University of Rio Grande (FURG), Rio Grande, Brazil
- Faculty of Medicine, FURG, Rio Grande, Brazil
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Ferreira TA, Sodré CT, Costa JM, Setta CRP, Ramos-e-Silva M. Primary conjunctival sporotrichosis: An atypical presentation of the disease. JAAD Case Rep 2018; 4:497-499. [PMID: 29984295 PMCID: PMC6031559 DOI: 10.1016/j.jdcr.2018.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Thiago Amparo Ferreira
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celso Tavares Sodré
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Julia Magarão Costa
- Sector of Endocrinology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cláudia Regina Pimenta Setta
- Sector of Medical Clinics, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-e-Silva
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Correspondence to: Marcia Ramos-e-Silva, MD, PhD, Rua Dona Mariana 143/C-32, 22280-020, Rio de Janeiro, Brazil.
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Ocular sporotrichosis: A frequently misdiagnosed cause of granulomatous conjunctivitis in epidemic areas. Am J Ophthalmol Case Rep 2017; 8:35-38. [PMID: 29260114 PMCID: PMC5731672 DOI: 10.1016/j.ajoc.2017.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 08/30/2017] [Accepted: 09/21/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose Sporotrichosis is a subcutaneous mycosis caused by Sporothrix sp., a dimorphic fungus. Although the cutaneous form is the most frequent form, the ocular presentation has been increasingly diagnosed in epidemic areas. We describe three cases of ocular sporotrichosis with the involvement of the ocular adnexa due to autoinoculation without trauma with successful antifungal treatment. Observations Patient 1: A 68-year-old woman presented with granulomatous conjunctivitis of the right eye with an ulcerated nodule on the right temporal region for 5 months. Patient 2: A 46-year-old woman with conjunctival hyperemia of the left eye with associated periorbital edema and erythema for the past 4 months was referred to the Dermatology Department due to an ulcerated nodule on the left malar region. Patient 3: A 14-year-old boy presented to the emergency department with inferior palpebral edema with a 5-day evolution. Specimens were obtained from the lesions of the three patients, and the cultures were positive for Sporothrix sp. The three cases were diagnosed as ocular sporotrichosis and were successfully treated with itraconazole (200–400 mg/d). Two of the three patients developed sequelae such as conjunctival fibrosis and symblepharon. Conclusions and importance We emphasize the importance of the ophthalmologist being familiar with the diagnosis and management of this rare and frequently misdiagnosed form of sporotrichosis.
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14
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Ramírez Soto MC. Sporotrichosis in the Ocular Adnexa: 21 Cases in an Endemic Area in Peru and Review of the Literature. Am J Ophthalmol 2016; 162:173-179.e3. [PMID: 26585212 DOI: 10.1016/j.ajo.2015.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 11/08/2015] [Accepted: 11/09/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the clinical and epidemiologic characteristics of sporotrichosis in ocular adnexa and give an insight into factors associated with this condition. DESIGN Retrospective case series and literature review. METHODS We retrospectively reviewed all cases of sporotrichosis in ocular adnexa between 2004 and 2014 in the Santa Teresa Clinic of Abancay, Peru and reviewed all case reports of sporotrichosis in ocular adnexa in the literature. RESULTS We reviewed records of 21 patients with sporotrichosis in ocular adnexa; 12 (57.1%) of them were male and their median age surrounded 9 years. In our series, 19 patients had lesions in the eyelids and 2 in the eyebrows. The lymphocutaneous form occurred in 62% of them. Ten patients (47.6%) were cured with potassium iodide. Among 65 patients with sporotrichosis in ocular adnexa (our 21 patients and 44 from the literature), the average age was 9 years, and 78% were ≤15 years of age; 54% were male. The lesions were more frequent on the eyelids (n = 53 [82%]), followed by the lacrimal gland (n = 5), conjunctiva (n = 4), and eyebrows (n = 3). The lymphocutaneous clinical form (54%) was the most frequent. Fifty patients were cured: 31 of them with potassium iodide, 16 with itraconazole, and 3 with a combination including potassium iodide, itraconazole, and fluconazole. Twenty-nine patients (44.6%) resided in a hyperendemic region, and 5 patients reported contact with cats that had sporotrichosis. CONCLUSIONS Sporotrichosis in ocular adnexa is associated with children ≤15 years of age, and in 82% of these cases the disease is limited to the eyelids.
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Affiliation(s)
- Max Carlos Ramírez Soto
- Unidad de Postgrado, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru.
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Ferreira CP, Nery JAD, de Almeida ACO, Ferreira LC, Corte-Real S, Conceição-Silva F. Parinaud's oculoglandular syndrome associated with Sporothrix schenckii. IDCases 2014; 1:38-9. [PMID: 26955523 PMCID: PMC4762793 DOI: 10.1016/j.idcr.2014.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 05/04/2014] [Accepted: 05/07/2014] [Indexed: 11/25/2022] Open
Abstract
The Parinaud oculoglandular syndrome is a rare eye disease caused by different etiologic agents, including bacteria, viruses and fungi. It is characterized by a granulomatous conjunctivitis, accompanied by adjacent preauricular lymphadenopathy and can bring consequences if not treated promptly. We present a case of Parinaud oculoglandular syndrome caused by Sporothrix schenckii from the sporotrichosis epidemic in its zoonotic form occurring in Rio de Janeiro, Brazil.
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Affiliation(s)
- Cassio Porto Ferreira
- Souza Araújo Outpatient Clinic, Brazil; Leprosy Laboratory-Lahan, Brazil; OswaldoCruz Institute-IOC, Brazil; OswaldoCruz Foundation-Fiocruz, Brazil
| | - José Augusto daCosta Nery
- Souza Araújo Outpatient Clinic, Brazil; Leprosy Laboratory-Lahan, Brazil; OswaldoCruz Institute-IOC, Brazil; OswaldoCruz Foundation-Fiocruz, Brazil
| | | | | | - Suzana Corte-Real
- OswaldoCruz Institute-IOC, Brazil; OswaldoCruz Foundation-Fiocruz, Brazil
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16
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Bustamante B, Campos PE. Sporotrichosis: a forgotten disease in the drug research agenda. Expert Rev Anti Infect Ther 2014; 2:85-94. [PMID: 15482174 DOI: 10.1586/14787210.2.1.85] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Potassium iodide was discovered in the 19th century and still remains as one of the more effective and most prescribed treatments for sporotrichosis. No new drugs have been evaluated in large randomized clinical trials in comparison with standard or alternative treatments for sporotrichosis during the last decades. The emergence of disseminated sporotrichosis in AIDS patients has uncovered the need for more effective treatments. Sporotrichosis is only a public health problem in a few geographical areas, mostly located in developing countries; and its usually harmless history could explain the limited investment in sporotrichosis treatment research. Better understanding of the virulence factors, such as the melanization process, could reveal new potential drug targets.
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Affiliation(s)
- Beatriz Bustamante
- Institute of Tropical Medicine 'Alexander von Humboldt', Cayetano Heredia University, Department of Infectious Diseases and Dermatology, Cayetano Heredia National Hospital, Lima, Peru.
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Abstract
Sporotrichosis, which is caused by the dimorphic fungus Sporothrix schenckii, is currently distributed throughout the world, especially in tropical and subtropical zones. Infection generally occurs by traumatic inoculation of soil, plants, and organic matter contaminated with the fungus. Certain leisure and occupational activities, such as floriculture, agriculture, mining, and wood exploitation, are traditionally associated with the mycosis. Zoonotic transmission has been described in isolated cases or in small outbreaks. Since the end of the 1990s there has been an epidemic of sporotrichosis associated with transmission by cats in Rio de Janeiro, Brazil. More than 2,000 human cases and 3,000 animal cases have been reported. In humans, the lesions are usually restricted to the skin, subcutaneous cellular tissue, and adjacent lymphatic vessels. In cats, the disease can evolve with severe clinical manifestations and frequent systemic involvement. The gold standard for sporotrichosis diagnosis is culture. However, serological, histopathological, and molecular approaches have been recently adopted as auxiliary tools for the diagnosis of this mycotic infection. The first-choice treatment for both humans and cats is itraconazole.
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Abstract
An 87-year-old patient presented with a 6-week history of an isolated progressive destructive nodular eyelid mass, secondary nodular and ulcerative lesions, and regional painful lymphadenopathy. After 4 weeks, fungal cultures demonstrated Sporothrix schenckii. S. schenckii is a rare dimorphic fungus that can occasionally involve the periocular skin. The authors' case demonstrates typical clinical features, emphasizes the delay in diagnosis, and shows effective treatment with oral itraconazole.
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20
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Antunes TDA, Nobre MDO, Faria ROD, Meinerz ARM, Martins AA, Cleff MB, Fernandes CG, Meireles MCA. [Experimental cutaneous sporotrichosis: in vivo evaluation of itraconazole and terbinafine]. Rev Soc Bras Med Trop 2010; 42:706-10. [PMID: 20209359 DOI: 10.1590/s0037-86822009000600018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 10/30/2009] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the in vivo activity of itraconazole and terbinafine for treating experimental cutaneous sporotrichosis. Eighty Wistar rats were used, divided into four groups (TERB20, TERB30, ITRA and CONT). They were inoculated in the left plantar pad with 0.2 ml of solution containing 2x10(3) cell/ml of Sporothrix schenckii and treated with terbinafine (20 and 30 mg/kg), itraconazole (10 mg/kg) or placebo for 13 weeks. The lesions at the inoculation site were evaluated and measured weekly, along with their dissemination. Mycological and histopathological analyses were performed subsequently. The results showed that the animals in the ITRA group differed statistically in all parameters evaluated, in relation to CONT. For terbinafine, there were no statistical differences between the treated and control groups. It could be confirmed that itraconazole presented good activity for treating sporotrichosis, while terbinafine was ineffective for this disease at the doses used. However, more studies on the latter antifungal agent are needed.
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Affiliation(s)
- Tatiana de Avila Antunes
- Pós-Graduação em Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, RS.
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21
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Almeida-Paes R, Pimenta MA, Monteiro PCF, Nosanchuk JD, Zancopé-Oliveira RM. Immunoglobulins G, M, and A against Sporothrix schenckii exoantigens in patients with sporotrichosis before and during treatment with itraconazole. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2007; 14:1149-57. [PMID: 17634504 PMCID: PMC2043312 DOI: 10.1128/cvi.00149-07] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sporotrichosis is an important subcutaneous mycosis, with an increasing worldwide incidence. However, few data are available regarding the immunological aspects of Sporothrix schenckii infection, particularly the humoral responses to the fungus. In this study we measured immunoglobulin G (IgG), IgM, and IgA in sera from 41 patients with sporotrichosis before antifungal treatment and from another 35 patients with sporotrichosis during itraconazole treatment by using a recently described S. schenckii exoantigen enzyme-linked immunosorbent assay (ELISA). More than 95% of patients had detectable IgA antibodies, and more than 85% had IgM and IgG antibodies before treatment. The number of patients with IgG antibodies increased to 91% during treatment. Conversely, significantly fewer samples from treated patients were positive for IgM (71%) and IgA (89%). Overall, 78% of patients had detectable levels of all isotypes tested at diagnosis, and this percentage dropped to 62.9% in patients receiving itraconazole. Testing of all three isotypes improved the sensitivity; at least two isotypes were detected in 93% of patients before and 89% after treatment. The reactivity of 94 sera from patients with other diseases and healthy individuals was also tested. Cross-reactivity occurred in 33% of the heterologous sera. Most of them were positive only in one isotype, 8.5% were positive for at least two isotypes, and only one serum (1.1%) was positive for the three isotypes. Antibodies produced during S. schenckii infection are diverse, and we demonstrate that an exoantigen ELISA for the detection of combinations of IgA, IgG, and IgM antibodies is a highly sensitive and specific diagnostic assay for sporotrichosis.
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Affiliation(s)
- Rodrigo Almeida-Paes
- Serviço de Micologia do Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro 21045-900, Brazil
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22
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Appenzeller S, Amaral TN, Amstalden EMI, Bertolo MB, Neto JFM, Samara AM, Fernandes SRM. Sporothrix schenckii infection presented as monoarthritis: report of two cases and review of the literature. Clin Rheumatol 2005; 25:926-8. [PMID: 16333559 DOI: 10.1007/s10067-005-0095-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2005] [Revised: 09/13/2005] [Accepted: 09/14/2005] [Indexed: 11/26/2022]
Abstract
Septic arthritis demands early diagnosis and correct treatment if the function of the joint is to be restored. Sometimes, as in fungal infection, signs and symptoms may be mild and the diagnosis delayed. Nevertheless, the outcome of fungal arthritis is severe and usually causes joint disability. The authors report two patients with chronic monoarthritis due to Sporothrix schenckii infection diagnosed by synovial fluid cultures. Their clinical presentation, laboratory and image findings, and their treatment and follow-up are analyzed and compared to previously reported cases. These cases illustrate the differential diagnosis of monoarthritis in immunocompetent adults and picture clinical features that could lead to early diagnosis and proper treatment.
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Affiliation(s)
- Simone Appenzeller
- Department of Rheumatology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), P.O. Box 6111, 13083-970, Campinas, SP, Brazil.
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Chen JL, Wang CC, Sheu SJ, Yeh TI. Conjunctival aspergilloma with multiple mulberry nodules: a case report. Kaohsiung J Med Sci 2005; 21:286-90. [PMID: 16035573 DOI: 10.1016/s1607-551x(09)70203-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A 30-year-old healthy female presented with a 1-year history of chronic mucous discharge, tearing, and irritation in the left eye. Slit-lamp examination revealed severe papillary and follicular reaction surrounding a movable subconjunctival mass on the left upper tarsal conjunctiva. Incision and curettage were performed to establish the diagnosis. Multiple peculiar black mulberry nodules were obtained. The clumps of septate hyphae seen with periodic acid-Schiff stain were characteristic of fungus ball (aspergilloma). The patient's symptoms improved significantly after surgery without any antifungal therapy. Although rarely reported, aspergillus is a common fungus in the conjunctiva that may seed into the subconjunctiva. We present this case to remind ophthalmologists of such a rare cause of recalcitrant conjunctival inflammation in immunocompetent patients.
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Affiliation(s)
- Jiunn-Liang Chen
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
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Schubach A, de Lima Barros MB, Schubach TMP, Francesconi-do-Valle AC, Gutierrez-Galhardo MC, Sued M, de Matos Salgueiro M, Fialho-Monteiro PC, Reis RS, Marzochi KBF, Wanke B, Conceição-Silva F. Primary Conjunctival Sporotrichosis. Cornea 2005; 24:491-3. [PMID: 15829813 DOI: 10.1097/01.ico.0000151504.26695.3e] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To describe Sporothrix schenckii conjunctivitis in 2 owners of cats with sporotrichosis. METHODS Small case series and literature review. RESULTS Two women had been caring for their pet cats with sporotrichosis for 2 months but did not recall any traumatic injury such as scratches or bites. Each presented a conjunctival granulomatous lesion measuring 4 to 5 mm accompanied by local hyperemia, secretion, and edema, in addition to painful facial subcutaneous nodes and regional lymph node enlargement. Pyogenic material was collected from the conjunctival sac and from cutaneous lesions on the cats. In both the patients and their respective cats, fungal colonies were isolated and identified as S. schenckii. Treatment with oral itraconazole 100 mg/d for 3 months resulted in complete healing of lesions in both patients. Patients remained clinically cured 15 months after end of treatment. CONCLUSION Sporotrichosis is presently occurring as an emerging zoonosis in Rio de Janeiro, and some unusual clinical forms have been diagnosed in humans. The cases reported here suggest atraumatic exposure to cats infected by S. schenckii.
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Affiliation(s)
- Armando Schubach
- Serviço de Zoonoses, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil.
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Disease Watch. Expert Rev Anti Infect Ther 2004; 2:8. [PMID: 15482166 DOI: 10.1586/14787210.2.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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