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Poester VR, Basso RP, Stevens DA, Munhoz LS, de Souza Rabello VB, Almeida-Paes R, Zancopé-Oliveira RM, Zanchi M, Benelli JL, Xavier MO. Treatment of Human Sporotrichosis Caused by Sporothrix brasiliensis. J Fungi (Basel) 2022; 8:jof8010070. [PMID: 35050010 PMCID: PMC8779703 DOI: 10.3390/jof8010070] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 01/19/2023] Open
Abstract
We describe the successful treatment of a series of 30 zoonotic sporotrichosis cases from southern Brazil. Sporothrix brasiliensis was the species genotypically identified in all 25 confirmed cases. Five other cases were classified as probable, without laboratory confirmation, but with clinical and epidemiological data of cat-transmitted sporotrichosis. Two isolates were sequenced by translation elongation factor-1 alpha (EF1α) loci in order to compare their sequences, and both of them showed distinct genotypes from S. brasiliensis strains from other Brazilian states. Itraconazole (ITZ) or potassium iodide (KI) were the first choice treatment in 28 and 2 cases, respectively. Microdilution assay showed a wild-type profile of S. brasiliensis isolates to ITZ. However, a lack of clinical response occurred in 42% of cases, especially those treated with ITZ 100 mg/day, and treatment needed modifications, by either increased doses or antifungal combinations. Clinical cure required a mean of 187 days of treatment, which was dependent on the clinical form of the disease and age of patients. Therapy, including dosages and durations, for cutaneous forms of sporotrichosis requires re-evaluation, since cases caused by S. brasiliensis may influence treatment efficacy.
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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, RS, Brazil; (R.P.B.); (L.S.M.); (M.O.X.)
- Programa de Pós Graduação em Bioquímica Toxicológica, Universidade Federal de Santa Maria (UFSM), Santa Maria 97105-900, RS, Brazil
- Laboratório de Micologia, FAMED, FURG, Rio Grande 96200-190, RS, Brazil
- Correspondence: (V.R.P.); (J.L.B.)
| | - 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, RS, Brazil; (R.P.B.); (L.S.M.); (M.O.X.)
- Laboratório de Micologia, FAMED, FURG, Rio Grande 96200-190, RS, Brazil
- Hospital Universitário-UH-FURG/Empresa Brasileira de Serviços Hospitalares—Ebserh, Rio Grande 96200-190, RS, Brazil;
| | - David A. Stevens
- California Institute for Medical Research, San Jose, CA 95128, USA;
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical School, Stanford, CA 94305, USA
| | - 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, RS, Brazil; (R.P.B.); (L.S.M.); (M.O.X.)
- Laboratório de Micologia, FAMED, FURG, Rio Grande 96200-190, RS, Brazil
| | - Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, RJ, Brazil; (V.B.d.S.R.); (R.A.-P.); (R.M.Z.-O.)
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, RJ, Brazil; (V.B.d.S.R.); (R.A.-P.); (R.M.Z.-O.)
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, RJ, Brazil; (V.B.d.S.R.); (R.A.-P.); (R.M.Z.-O.)
| | - Mariza Zanchi
- Hospital Universitário-UH-FURG/Empresa Brasileira de Serviços Hospitalares—Ebserh, Rio Grande 96200-190, RS, Brazil;
| | - Jéssica Louise Benelli
- Laboratório de Micologia, FAMED, FURG, Rio Grande 96200-190, RS, Brazil
- Hospital Universitário-UH-FURG/Empresa Brasileira de Serviços Hospitalares—Ebserh, Rio Grande 96200-190, RS, Brazil;
- Correspondence: (V.R.P.); (J.L.B.)
| | - 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, RS, Brazil; (R.P.B.); (L.S.M.); (M.O.X.)
- Laboratório de Micologia, FAMED, FURG, Rio Grande 96200-190, RS, Brazil
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Yao L, Song Y, Cui Y, Zhou JF, Zhong SX, Zhao DY, Li SS. Pediatric Sporotrichosis in Jilin Province of China (2010-2016): a Retrospective Study of 704 Cases. J Pediatric Infect Dis Soc 2020; 9:342-348. [PMID: 31356658 DOI: 10.1093/jpids/piz052] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 06/27/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Pediatric patients make a substantial contribution to the epidemiologic profile of sporotrichosis in Jilin Province, a region of China in which the disease is strongly endemic. However, the exact epidemiologic and clinical manifestations of childhood sporotrichosis in China are unclear. METHODS The medical records of 704 pediatric patients aged <15 years with sporotrichosis diagnosed by fungus culture at the Department of Dermatology at the First Hospital of Jilin University in a 7-year period (January 2010 to December 2016) were reviewed retrospectively. The patients were from rural areas of Jilin Province, located in northeast China. RESULTS Among the 704 pediatric patients, the male/female ratio was 1.41:1, and the highest incidence of sporotrichosis (63%) occurred in those aged 0 to 6 years; 561 patients (80%) contracted sporotrichosis in a colder month. Overall, 655 (93%) patients had lesions in the facial region, whereas 602 (86%) patients had fixed cutaneous sporotrichosis. The incidence of the fixed cutaneous form in the 0- to 6-year age group was significantly higher than that in the 7- to 14-year age group (P = .009). Patients were treated with 10% potassium iodide solution, itraconazole, or terbinafine. CONCLUSIONS The characteristics of pediatric sporotrichosis in Jilin Provence include the following: (1) a more frequent occurrence in the colder months; (2) the facial region is affected predominantly, in most cases manifesting in the fixed cutaneous form; and (3) significantly more cases occur in younger children than in older ones. Decaying cornstalks used as fire materials might be the source of infection in this population; however, additional research is needed to explore the exact mechanism of infection.
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Affiliation(s)
- Lei Yao
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Song
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China
| | - Yan Cui
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China
| | - Jun-Feng Zhou
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China
| | - Shu-Xia Zhong
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China
| | - Dong-Yang Zhao
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China
| | - Shan-Shan Li
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China
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Li J, Zhan P, Jiang Q, Gao Y, Jin Y, Zhang L, Luo Y, Fan X, Sun J, de Hoog S. Prevalence and antifungal susceptibility of Sporothrix species in Jiangxi, central China. Med Mycol 2020; 57:954-961. [PMID: 30657948 DOI: 10.1093/mmy/myy163] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/20/2018] [Indexed: 11/12/2022] Open
Abstract
Sporotrichosis is a subcutaneous mycosis caused by traumatic inoculation of pathogenic Sporothrix species. Until recently, Sporothrix globosa was considered as the unique Chinese species causing this disorder. In the present study, 33 clinical Sporothrix strains isolated from Jiangxi, China, were classified and antifungal susceptibility for each strain was determined. Thirteen S. globosa strains and 20 S. schenckii strains were identified by morphology and by multilocus analysis using rDNA ITS, CAL, and EF1α (i.e., internal transcribed spacer, calmodulin and elongation factor-1α). In vitro antifungal susceptibility testing of yeast phases indicated that itraconazole, terbinafine, and posaconazole were most effective against both species, followed by amphotericin B and voriconazole, while fluconazole, 5-fluorocytosine had low efficacy with high MICs. Co-occurrence of S. schenckii and S. globosa in central China may indicate different routes of transmission in this area.
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Affiliation(s)
- Jie Li
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
| | - Ping Zhan
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
- Jiangxi Provincial People's Hospital, Nanchang, China
| | - Qing Jiang
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
| | - Yangmin Gao
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
| | - Yun Jin
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
| | - Lei Zhang
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
| | - Yunpeng Luo
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
| | - Xinyi Fan
- Dermatology Hospital of Jiangxi Provinces and Jiangxi Dermatology Institute, Nanchang, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention. Guangzhou, Guangdong, China
| | - Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
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Abstract
The endemic mycoses are a group of infections caused by fungi with a distinct geographic distribution, defined by climatic and environmental conditions. The systemic endemic mycoses, namely histoplasmosis, blastomycosis, talaromycosis, coccidioidomycosis and paracoccidioidomycosis, occur after the inhalation of fungal spores. The cutaneous endemic mycoses, including sporotrichosis, mycetoma, entomophthoramycosis and chromoblastomycosis, enter the host via traumatic inoculation of the skin. Clinical presentation varies between these relatively heterogeneous infections, as does the susceptibility of immunosuppressed patients to disease. An understanding of the geographic range, typical manifestations, diagnostic methods, and treatment of the endemic mycoses is key in assessing patients presenting with atypical infections who may have traveled to endemic areas.
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Fernandes B, Caligiorne RB, Coutinho DM, Gomes RR, Rocha-Silva F, Machado AS, Santrer EFRL, Assunção CB, Guimarães CF, Laborne MS, Nunes MB, Vicente VA, de Hoog S. A case of disseminated sporotrichosis caused by Sporothrix brasiliensis. Med Mycol Case Rep 2018; 21:34-36. [PMID: 30046514 PMCID: PMC6058009 DOI: 10.1016/j.mmcr.2018.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/16/2018] [Indexed: 11/17/2022] Open
Abstract
This paper presents a case of disseminated sporotrichosis in a 13-year-old female, originating from a rural area in Minas Gerais state, Brazil. The patient was hospitalized in Santa Casa hospital of Belo Horizonte, with hyporexia, prostration, fever and disseminated ulcerative lesions, besides anemia, leucopenia and sepsis of probable cutaneous focus. The patient was admitted without proven immunosuppression. She was diagnosed with cutaneous-disseminated sporotrichosis. The drug therapy chosen was itraconazole during 12 months, leading to important clinical improvement and healing of cutaneous lesions.
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Affiliation(s)
- Blenda Fernandes
- Center of Post-Graduation and Research-IEP, Santa Casa de Belo Horizonte Hospital, MG, Brazil
| | | | | | - Renata R. Gomes
- Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil
| | - Fabiana Rocha-Silva
- Center of Post-Graduation and Research-IEP, Santa Casa de Belo Horizonte Hospital, MG, Brazil
| | - Amanda Sanchez Machado
- Center of Post-Graduation and Research-IEP, Santa Casa de Belo Horizonte Hospital, MG, Brazil
| | | | | | | | | | | | - Vania A. Vicente
- Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil
| | - Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, The Netherlands
- Center of Expertise in Mycology of Radboudumc / Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
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Conceição-Silva F, Morgado FN. Immunopathogenesis of Human Sporotrichosis: What We Already Know. J Fungi (Basel) 2018; 4:jof4030089. [PMID: 30065160 PMCID: PMC6162489 DOI: 10.3390/jof4030089] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 12/19/2022] Open
Abstract
Sporotrichosis is a subacute/chronic mycosis caused by dimorphic fungus of the genus Sporothrix. This mycosis may affect both human and domestic animals and in the last few years, the geographic dispersion and increase of sporotrichosis worldwide has been observed. The occurrence of cases related to scratching/bites of domestic felines have increased, characterizing the disease as predominantly a zoonosis. In humans, sporotrichosis mainly involves the cutaneous tegument of infected patients, but other tissues may also present the infection. The main forms of clinical presentation are lymphocutanous sporotrichosis (LC) and fixed sporotrichosis (F). Although less common, mucosal, cutaneous disseminated, and extracutaneous forms have also been described. Multiple factors from the fungus and host can play a role in driving the clinical evolution of sporotrichosis to benign or severe disease. In this review, we discuss the immunopathological aspects involved in human sporotrichosis. Putting together the two branches of knowledge—host immune response and fungal evading mechanisms—we may perceive new possibilities in understanding the fungus–host interaction in order to be in a position to go further in the control of sporotrichosis.
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Affiliation(s)
- Fatima Conceição-Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute, IOC/Fiocruz, Avenida Brasil 4365 Pavilhão 26 sala 408-Manguinhos, Rio de Janeiro 21040-360, Brazil.
| | - Fernanda Nazaré Morgado
- Laboratory of Leishmaniasis Research, Oswaldo Cruz Institute, IOC/Fiocruz, Avenida Brasil 4365 Pavilhão 26 sala 509-Manguinhos, Rio de Janeiro 21040-360, Brazil.
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Ramírez Soto MC. Sporotrichosis among children of a hyperendemic area in Peru: an 8-year retrospective study. Int J Dermatol 2017; 56:868-872. [PMID: 28488313 DOI: 10.1111/ijd.13643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 02/13/2017] [Accepted: 03/29/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The clinical and epidemiologic characteristics of pediatric sporotrichosis are poorly understood. OBJECTIVE To describe the incidence and clinical characteristics of cases of sporotrichosis in children 14 years of age and younger reported in Abancay from 2004 to 2011, stratified according to age. METHODS We performed a retrospective review of pediatric patients 14 years of age and younger who were diagnosed with sporotrichosis in a referral center at Abancay, a poor area located in the south central highlands of Peru, to estimate the incidence rates (per 100,000 person-years) according to age and sporotrichosis type (lymphocutaneous and fixed), and clinical characteristics of these patients. RESULTS Of the 240 pediatric cases identified, 131 (54.6%) were male. The median age at baseline was 6 years. The mean incidence rate was 81.4 cases per 100,000 person-years for the period from 2004 to 2011, and was highest among children ranging in age from 5-9 years. The incidence of lymphocutaneous sporotrichosis and fixed sporotrichosis was 55 and 27 cases per 100,000 person-years, respectively, and the face was the most commonly affected anatomic site. Ninety-six of the 240 patients (40%) reported previous contact with cats, and 46 (19.2%) had a clear history of traumatic inoculation with plant material. The therapeutic response to treatment with potassium iodide was satisfactory. CONCLUSION In this retrospective study, we described a high incidence of sporotrichosis in children in the south central highlands of Peru, which increased with age. Lymphocutaneous sporotrichosis was the more common type with an incidence rate twice that of the fixed type. The face was the most commonly affected anatomic site, and infection appeared to be acquired predominantly through contact with cats.
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Chen S, Sun KY, Feng XW, Ran X, Lama J, Ran YP. Efficacy and safety of itraconazole use in infants. World J Pediatr 2016; 12:399-407. [PMID: 27286691 DOI: 10.1007/s12519-016-0034-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/18/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Itraconazole has been used to treat fungal infections, in particular invasive fungal infections in infants or neonates in many countries. DATA SOURCES Literature search was conducted through Ovid EMBASE, PubMed, ISI Web of Science, CNKI and Google scholarship using the following key words: "pediatric" or "infant" or "neonate" and "fungal infection" in combination with "itraconazole". Based on the literature and our clinical experience, we outline the administration of itraconazole in infants in order to develop evidence-based pharmacotherapy. RESULTS Of 45 articles on the use of itraconazole in infancy, 13 are related to superficial fungal infections including tinea capitis, sporotrichosis, mucosal fungal infections and opportunistic infections. The other 32 articles are related to systemic fungal infections including candidiasis, aspergillosis, histoplasmosis, zygomycosis, trichosporonosis and opportunistic infections as caused by Myceliophthora thermophila. CONCLUSION Itraconazole is safe and effective at a dose of 5 mg/kg per day in a short duration of therapy for superficial fungal infections and 10 mg/kg per day for systemic fungal infections in infants. With a good compliance, it is cost-effective in treating infantile fungal infections. The profiles of adverse events induced by itraconazole in infants are similar to those in adults and children.
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Affiliation(s)
- Shuang Chen
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Kai-Yi Sun
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiao-Wei Feng
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xin Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jebina Lama
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yu-Ping Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Phylogeography and evolutionary patterns in Sporothrix spanning more than 14 000 human and animal case reports. Persoonia - Molecular Phylogeny and Evolution of Fungi 2015; 35:1-20. [PMID: 26823625 PMCID: PMC4713101 DOI: 10.3767/003158515x687416] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/21/2014] [Indexed: 01/19/2023]
Abstract
Pathology to vertebrate hosts has emerged repeatedly in the order Ophiostomatales. Occasional infections have been observed in Sporothrix mexicana at a low level of virulence, while the main pathogenic species cluster in a derived clade around S. schenckii s.str. In this paper, phylogeny and epidemiology of the members of this clade were investigated for 99 clinical and 36 environmental strains using four genetic loci, viz. rDNA ITS and partial CAL, TEF1, and TEF3; data are compared with amplified fragment length polymorphism (AFLP) genotyping. The four main species of the pathogenic clade were recognised. The species proved to show high degrees of endemicity, which enabled interpretation of literature data where live material or genetic information is lacking. The clade of four species comprised nine subclusters, which often had limited geographic distribution and were separate from each other in all partitions, suggesting low degrees of interbreeding between populations. In contrast, S. globosa exhibited consistent global distribution of identical AFLP types, suggesting another type of dispersal. Sporothrix brasiliensis is known to be involved in an expanding zoonosis and transmitted by cats, whereas S. globosa infections originated from putrid plant material, causing a sapronosis. Sporothrix schenckii s.str., the most variable species within the clade, also had a plant origin, with ecological similarities to that of S. globosa. A hypothesis was put forward that highly specific conditions in the plant material are required to promote the growth of Sporothrix. Fermented, self-heated plant debris may stimulate the thermodependent yeast-like invasive form of the fungus, which facilitates repeated infection of mammals.
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Sporotrichosis: an overview and therapeutic options. Dermatol Res Pract 2014; 2014:272376. [PMID: 25614735 PMCID: PMC4295339 DOI: 10.1155/2014/272376] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 12/12/2014] [Indexed: 01/19/2023] Open
Abstract
Sporotrichosis is a chronic granulomatous mycotic infection caused by Sporothrix schenckii, a common saprophyte of soil, decaying wood, hay, and sphagnum moss, that is endemic in tropical/subtropical areas. The recent phylogenetic studies have delineated the geographic distribution of multiple distinct Sporothrix species causing sporotrichosis. It characteristically involves the skin and subcutaneous tissue following traumatic inoculation of the pathogen. After a variable incubation period, progressively enlarging papulo-nodule at the inoculation site develops that may ulcerate (fixed cutaneous sporotrichosis) or multiple nodules appear proximally along lymphatics (lymphocutaneous sporotrichosis). Osteoarticular sporotrichosis or primary pulmonary sporotrichosis are rare and occur from direct inoculation or inhalation of conidia, respectively. Disseminated cutaneous sporotrichosis or involvement of multiple visceral organs, particularly the central nervous system, occurs most commonly in persons with immunosuppression. Saturated solution of potassium iodide remains a first line treatment choice for uncomplicated cutaneous sporotrichosis in resource poor countries but itraconazole is currently used/recommended for the treatment of all forms of sporotrichosis. Terbinafine has been observed to be effective in the treatment of cutaneous sporotrichosis. Amphotericin B is used initially for the treatment of severe, systemic disease, during pregnancy and in immunosuppressed patients until recovery, then followed by itraconazole for the rest of the therapy.
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Chakrabarti A, Bonifaz A, Gutierrez-Galhardo MC, Mochizuki T, Li S. Global epidemiology of sporotrichosis. Med Mycol 2014; 53:3-14. [PMID: 25526781 DOI: 10.1093/mmy/myu062] [Citation(s) in RCA: 309] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Sporotrichosis is an endemic mycosis caused by the dimorphic fungus Sporothrix schenckii sensu lato. It has gained importance in recent years due to its worldwide prevalence, recognition of multiple cryptic species within the originally described species, and its distinctive ecology, distribution, and epidemiology across the globe. In this review, we describe the current knowledge of the taxonomy, ecology, prevalence, molecular epidemiology, and outbreaks due to S. schenckii sensu lato. Despite its omnipresence in the environment, this fungus has remarkably diverse modes of infection and distribution patterns across the world. We have delved into the nuances of how sporotrichosis is intimately linked to different forms of human activities, habitats, lifestyles, and environmental and zoonotic interactions. The purpose of this review is to stimulate discussion about the peculiarities of this unique fungal pathogen and increase the awareness of clinicians and microbiologists, especially in regions of high endemicity, to its emergence and evolving presentations and to kindle further research into understanding the unorthodox mechanisms by which this fungus afflicts different human populations.
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Affiliation(s)
- Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Alexandro Bonifaz
- Department of Mycology & Service of Dermatology, General Hospital of Mexico, México city, Mexico
| | - Maria Clara Gutierrez-Galhardo
- Laboratório de Dermatologia Infecciosa, Instituto de Pesquisa Clínica Evandro Chagas, Fundaçã Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - Shanshan Li
- Department of Dermatology and Venereology, First Hospital of Jilin University, Changchun, Jilin, China
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Teixeira MM, de Almeida LGP, Kubitschek-Barreira P, Alves FL, Kioshima ÉS, Abadio AKR, Fernandes L, Derengowski LS, Ferreira KS, Souza RC, Ruiz JC, de Andrade NC, Paes HC, Nicola AM, Albuquerque P, Gerber AL, Martins VP, Peconick LDF, Neto AV, Chaucanez CB, Silva PA, Cunha OL, de Oliveira FFM, dos Santos TC, Barros ALN, Soares MA, de Oliveira LM, Marini MM, Villalobos-Duno H, Cunha MML, de Hoog S, da Silveira JF, Henrissat B, Niño-Vega GA, Cisalpino PS, Mora-Montes HM, Almeida SR, Stajich JE, Lopes-Bezerra LM, Vasconcelos ATR, Felipe MSS. Comparative genomics of the major fungal agents of human and animal Sporotrichosis: Sporothrix schenckii and Sporothrix brasiliensis. BMC Genomics 2014; 15:943. [PMID: 25351875 PMCID: PMC4226871 DOI: 10.1186/1471-2164-15-943] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 09/25/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The fungal genus Sporothrix includes at least four human pathogenic species. One of these species, S. brasiliensis, is the causal agent of a major ongoing zoonotic outbreak of sporotrichosis in Brazil. Elsewhere, sapronoses are caused by S. schenckii and S. globosa. The major aims on this comparative genomic study are: 1) to explore the presence of virulence factors in S. schenckii and S. brasiliensis; 2) to compare S. brasiliensis, which is cat-transmitted and infects both humans and cats with S. schenckii, mainly a human pathogen; 3) to compare these two species to other human pathogens (Onygenales) with similar thermo-dimorphic behavior and to other plant-associated Sordariomycetes. RESULTS The genomes of S. schenckii and S. brasiliensis were pyrosequenced to 17x and 20x coverage comprising a total of 32.3 Mb and 33.2 Mb, respectively. Pair-wise genome alignments revealed that the two species are highly syntenic showing 97.5% average sequence identity. Phylogenomic analysis reveals that both species diverged about 3.8-4.9 MYA suggesting a recent event of speciation. Transposable elements comprise respectively 0.34% and 0.62% of the S. schenckii and S. brasiliensis genomes and expansions of Gypsy-like elements was observed reflecting the accumulation of repetitive elements in the S. brasiliensis genome. Mitochondrial genomic comparisons showed the presence of group-I intron encoding homing endonucleases (HE's) exclusively in S. brasiliensis. Analysis of protein family expansions and contractions in the Sporothrix lineage revealed expansion of LysM domain-containing proteins, small GTPases, PKS type1 and leucin-rich proteins. In contrast, a lack of polysaccharide lyase genes that are associated with decay of plants was observed when compared to other Sordariomycetes and dimorphic fungal pathogens, suggesting evolutionary adaptations from a plant pathogenic or saprobic to an animal pathogenic life style. CONCLUSIONS Comparative genomic data suggest a unique ecological shift in the Sporothrix lineage from plant-association to mammalian parasitism, which contributes to the understanding of how environmental interactions may shape fungal virulence. . Moreover, the striking differences found in comparison with other dimorphic fungi revealed that dimorphism in these close relatives of plant-associated Sordariomycetes is a case of convergent evolution, stressing the importance of this morphogenetic change in fungal pathogenesis.
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Affiliation(s)
- Marcus M Teixeira
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | | | - Paula Kubitschek-Barreira
- />Departamento de Biologia Celular, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Fernanda L Alves
- />Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
- />Grupo Informática de Biossistemas, Centro de Pesquisas René Rachou, FIOCRUZ, Minas, Belo Horizonte, MG Brazil
| | - Érika S Kioshima
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
- />Departamento de Análises Clínicas, Universidade Estadual de Maringá, Maringá, PR Brazil
| | - Ana KR Abadio
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Larissa Fernandes
- />Programa de Pós-Graduação em Ciências e Tecnologias em Saúde, Universidade de Brasília, Ceilândia, Brasília, DF Brazil
| | - Lorena S Derengowski
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Karen S Ferreira
- />Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Campus Diadema, São Paulo, SP Brazil
| | - Rangel C Souza
- />Laboratório Nacional de Computação Científica, Petrópolis, RJ Brazil
| | - Jeronimo C Ruiz
- />Grupo Informática de Biossistemas, Centro de Pesquisas René Rachou, FIOCRUZ, Minas, Belo Horizonte, MG Brazil
| | - Nathalia C de Andrade
- />Departamento de Biologia Celular, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Hugo C Paes
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - André M Nicola
- />Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF Brazil
- />Programa de pós-graduação em Medicina Tropical, Universidade de Brasília, Brasília, DF Brazil
| | - Patrícia Albuquerque
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
- />Programa de pós-graduação em Medicina Tropical, Universidade de Brasília, Brasília, DF Brazil
| | | | - Vicente P Martins
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Luisa DF Peconick
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Alan Viggiano Neto
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Claudia B Chaucanez
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Patrícia A Silva
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Oberdan L Cunha
- />Laboratório Nacional de Computação Científica, Petrópolis, RJ Brazil
| | | | - Tayná C dos Santos
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Amanda LN Barros
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
| | - Marco A Soares
- />Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
| | - Luciana M de Oliveira
- />Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
- />Programa de pós-graduação em Bioinformática, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Marjorie M Marini
- />Departamento de Microbiologia Imunobiologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, SP Brazil
| | - Héctor Villalobos-Duno
- />Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Cientificas, Caracas, Venezuela
| | - Marcel ML Cunha
- />Departamento de Biologia Celular, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Sybren de Hoog
- />CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - José F da Silveira
- />Departamento de Microbiologia Imunobiologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, SP Brazil
| | - Bernard Henrissat
- />Centre National de la Recherche Scientifique, Aix-Marseille, Université, CNRS, Marseille, France
| | - Gustavo A Niño-Vega
- />Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Cientificas, Caracas, Venezuela
| | - Patrícia S Cisalpino
- />Grupo Informática de Biossistemas, Centro de Pesquisas René Rachou, FIOCRUZ, Minas, Belo Horizonte, MG Brazil
| | | | - Sandro R Almeida
- />Departamento de Análises Clínicas e Toxicológicas, Universidade de São Paulo, São Paulo, SP Brazil
| | - Jason E Stajich
- />Department of Plant Pathology & Microbiology, University of California, Riverside, CA USA
| | - Leila M Lopes-Bezerra
- />Departamento de Biologia Celular, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | | | - Maria SS Felipe
- />Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF Brazil
- />Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF Brazil
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Liu TT, Zhang K, Zhou X. Molecular identification of Sporothrix clinical isolates in China. J Zhejiang Univ Sci B 2014; 15:100-8. [PMID: 24390750 DOI: 10.1631/jzus.b1300136] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In this study, we investigated the molecular phylogeny of 64 clinical isolates which were identified as Sporothrix schenckii sensu lato by morphological identification. All of the strains were isolates from patients from several provinces in China. The phylogeny was inferred by DNA sequence analyses based on datasets of the ribosomal internal transcribed spacer (ITS) and a combined ITS and partial β-tubulin region. Reference sequences were retrieved from GenBank. Results showed that all of the isolates were clustered in a distinct clade with a type of Sporothrix globosa. Our analysis showed that S. globosa is the causal agent of the tested sporotrichosis in China, rather than S. schenckii that was generally believed to be the case. The existence of S. schenckii in China remains to be confirmed. This study improved our understanding of the distribution of the species in S. schenckii complex.
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Affiliation(s)
- Ting-ting Liu
- Department of Dermatology, Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
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16
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Pana ZD, Vikelouda K, Roilides E. Rare Fungal Infections in Children: An Updated Review of the Literature. CURRENT FUNGAL INFECTION REPORTS 2014. [DOI: 10.1007/s12281-014-0175-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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17
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Affiliation(s)
- Yaqin Zhang
- Department of Dermatology and Venereology, The Second Hospital of Jilin University, Changchun, China.
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18
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Phenotypic and molecular identification of Sporothrix isolates of clinical origin in Northeast China. Mycopathologia 2013; 176:67-74. [PMID: 23771481 PMCID: PMC3731519 DOI: 10.1007/s11046-013-9668-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 05/31/2013] [Indexed: 01/19/2023]
Abstract
Sporotrichosis is the most common deep mycosis in Northeast China which is an area of high epidemicity due to contact with reeds or cornstalks. In this study, we have characterized a total of 74 clinical isolates from fixed cutaneous, lymphocutaneous and disseminated clinical forms and from Heilongjiang, Jilin, and Liaoning provinces, respectively. All isolates (previously as Sporothrix schenckii) were identified as Sporothrix globosa according to their phenotypic characteristics and calmodulin gene sequences analysis. They were subdivided into two sub-clades (S. globosa I and S. globosa II). Most of our isolates (71/74) presented restricted growth at 37 °C, which differed from a previous report. Up to now, S. globosa is the only pathogenic species in Northeast China, no matter what kind of clinical form and which region it is isolated from. Most of our clinical isolates (68/74) were clustered with three Chinese environmental isolates reported in the literature. The new findings of S. globosa isolates on division and thermotolerance at 37 °C described in this study will help us gain a better understanding of S. globosa.
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