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Nabil S, Isa MF, Abdul Wahab BI, Isa NM. Oral mucosa sporotrichosis: Report of a rare case acquired by direct inoculation. Med Mycol Case Rep 2024; 43:100631. [PMID: 38318120 PMCID: PMC10839577 DOI: 10.1016/j.mmcr.2024.100631] [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: 12/15/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Abstract
Sporotrichosis is a rare type of fungal infection caused by Sporothrix fungus. Transmissions are commonly by traumatic inoculation of the fungus through the skin and subcutaneous tissue either from environmental exposure or contact with infected animals. Due to its mode of transmission, it is commonly affecting the upper limbs. Definitive diagnosis can be obtained by fungal culture test on secretion fluids, pus, bloods or tissue biopsy. We report a rare presentation of this disease appearing as a solitary chronic ulcer of the lip which was successfully treated with itraconazole.
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Affiliation(s)
- Syed Nabil
- Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Malaysia, Malaysia
| | - Mohd Ferdaus Isa
- Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Malaysia, Malaysia
| | | | - Nurismah Md Isa
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia, Malaysia
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2
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Barrs VR, Beczkowski PM, Talbot JJ, Hobi S, Teoh SN, Hernandez Muguiro D, Shubitz LF, Sandy J. Invasive Fungal Infections and Oomycoses in Cats: 1. Diagnostic approach. J Feline Med Surg 2024; 26:1098612X231219696. [PMID: 38189288 PMCID: PMC10949879 DOI: 10.1177/1098612x231219696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
CLINICAL RELEVANCE In contrast to superficial fungal infections, such as dermatophytosis, invasive fungal infections (IFIs) are characterised by penetration of tissues by fungal elements. Disease can spread locally within a region or can disseminate haematogenously or via the lymphatics. The environment is the most common reservoir of infection. Since fungal spores are airborne, indoor cats are also susceptible to IFIs. Some environmental fungi are ubiquitous and present globally, while others are endemic or hyperendemic within specific geographic regions. Zoonotic pathogens include Microsporum canis, Sporothrix schenckii and Sporothrix brasiliensis. AIM In the first of a two-part article series, the approach to the investigation of feline IFIs and oomycoses is reviewed. As well as tips for diagnosis, and information on the ecological niche and distribution of fungal pathogens, the review covers clinical presentation of the most common IFIs, including cryptococcosis, histoplasmosis, blastomycosis, coccidioidomycosis, sporotrichosis, phaeohyphomycosis, aspergillosis and dermatophytic pseudomycetoma, as well as the oomycoses pythiosis, lagenidiosis and paralagenidiosis. In Part 2, the spectrum of activity, mechanisms of action, pharmacokinetic and pharmacodynamic properties and adverse effects of antifungal drugs are reviewed, and the treatment and prognosis for specific IFIs and oomycoses are discussed. EVIDENCE BASE The review draws on published evidence and the authors' combined expertise in feline medicine, mycology, dermatology, clinical pathology and anatomical pathology.
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Affiliation(s)
- Vanessa R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Paweł M Beczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | | | - Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Shu Ning Teoh
- Veterinary Specialists Aotearoa, Henderson, Auckland, New Zealand
| | | | - Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, AZ, USA
| | - Jeanine Sandy
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
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3
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Yingchanakiat K, Limsivilai O, Sunpongsri S, Niyomtham W, Lugsomya K, Yurayart C. Phenotypic and Genotypic Characterization and Antifungal Susceptibility of Sporothrix schenckii sensu stricto Isolated from a Feline Sporotrichosis Outbreak in Bangkok, Thailand. J Fungi (Basel) 2023; 9:jof9050590. [PMID: 37233301 DOI: 10.3390/jof9050590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
Sporotrichosis, an invasive fungal infection caused by Sporothrix schenckii, has emerged in Southeast Asia, affecting cats and posing a potential zoonotic risk to humans. We evaluated 38 feline sporotrichosis cases in and around Bangkok, Thailand, from 2017 to 2021. The isolates were phenotypically and genotypically characterized. The cats infected with sporotrichosis were mainly young adults, males, and domestic short hairs with uncontrolled outdoor access, and they lived in Bangkok. All isolates showed low thermotolerance and converted to the yeast phase at 35 °C. Based on the internal transcribed spacer region of rDNA sequences, our strains belonged to S. schenckii sensu stricto and clustered with clinical clade D. Based on the concatenated tree of calmodulin and beta-tubulin genes, five groups of S. schenckii were generated, and the monophyletic clade, Group II, of Thai strains was recognized. In vitro antifungal susceptibility testing demonstrated that the MIC50 of our isolates to amphotericin B, itraconazole, and posaconazole were within the limit of the species-specific epidemiological cutoff values, suggesting that the organisms were the wild type. Addressing the outbreak of feline sporotrichosis in Thailand by providing guidelines for diagnosis and effective treatment may help control the spread of disease and reduce the risk of cat-transmitted sporotrichosis to humans.
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Affiliation(s)
- Kanokporn Yingchanakiat
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Kasetsart University, 50 Ngamwongwan Road, Bangkok 10900, Thailand
| | - Orawan Limsivilai
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Kasetsart University, 50 Ngamwongwan Road, Bangkok 10900, Thailand
| | - Supita Sunpongsri
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, 50 Ngamwongwan Road, Bangkok 10900, Thailand
| | - Waree Niyomtham
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand
| | - Kittitat Lugsomya
- Antimicrobial Resistance and Infectious Diseases Laboratory, Harry Butler Institute, Murdoch University, 90, South Street, Murdoch, Perth 6150, Australia
| | - Chompoonek Yurayart
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Kasetsart University, 50 Ngamwongwan Road, Bangkok 10900, Thailand
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4
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Gómez-Gaviria M, Martínez-Álvarez JA, Mora-Montes HM. Current Progress in Sporothrix brasiliensis Basic Aspects. J Fungi (Basel) 2023; 9:jof9050533. [PMID: 37233242 DOI: 10.3390/jof9050533] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
Sporotrichosis is known as a subacute or chronic infection, which is caused by thermodimorphic fungi of the genus Sporothrix. It is a cosmopolitan infection, which is more prevalent in tropical and subtropical regions and can affect both humans and other mammals. The main etiological agents causing this disease are Sporothrix schenckii, Sporothrix brasiliensis, and Sporothrix globosa, which have been recognized as members of the Sporothrix pathogenic clade. Within this clade, S. brasiliensis is considered the most virulent species and represents an important pathogen due to its distribution and prevalence in different regions of South America, such as Brazil, Argentina, Chile, and Paraguay, and Central American countries, such as Panama. In Brazil, S. brasiliensis has been of great concern due to the number of zoonotic cases that have been reported over the years. In this paper, a detailed review of the current literature on this pathogen and its different aspects will be carried out, including its genome, pathogen-host interaction, resistance mechanisms to antifungal drugs, and the caused zoonosis. Furthermore, we provide the prediction of some putative virulence factors encoded by the genome of this fungal species.
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Affiliation(s)
- Manuela Gómez-Gaviria
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, col. Noria Alta, Guanajuato 36050, Mexico
| | - José A Martínez-Álvarez
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, col. Noria Alta, Guanajuato 36050, Mexico
| | - Héctor M Mora-Montes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, col. Noria Alta, Guanajuato 36050, Mexico
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Zhuang K, Dai Y, Zhou Y, Ke Y, Ran X, Ran Y. Oral treatment with 10% potassium iodide solution for refractory cutaneous-disseminated sporotrichosis in an immunocompetent adult: Case report. Front Microbiol 2022; 13:994197. [PMID: 36386665 PMCID: PMC9650217 DOI: 10.3389/fmicb.2022.994197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/23/2022] [Indexed: 05/29/2024] Open
Abstract
Sporotrichosis has multiple clinical manifestations, and its cutaneous-disseminated form is uncommon and, in most cases, related to immunosuppressive conditions. We report the case of a 47-year-old male patient who presented with multiple cutaneous nodules and ulcers on the left upper limb and the right thigh, with no other comorbidities. Until the diagnosis was confirmed, the patient was initially given empiric antifungal treatment with itraconazole, which showed unsatisfactory results at a local hospital. Then, he was treated with voriconazole, which led to the slow improvement of his skin lesions. At one point during the voriconazole treatment course, the patient briefly self-discontinued voriconazole for economic reasons, and the lesions recurred and worsened. The patient was finally diagnosed with cutaneous-disseminated sporotrichosis based on the isolation and identification of Sporothrix globosa. Susceptibility testing revealed that the isolate was resistant to itraconazole, fluconazole, voriconazole, terbinafine, and amphotericin. Considering the patient's poor financial condition, potassium iodide was administered. After 1-month of therapy with potassium iodide, he reported rapid improvement of his skin lesions. The patient continued potassium iodide treatment for another 5 months until the full resolution of lesions was achieved.
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Affiliation(s)
- Kaiwen Zhuang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yaling Dai
- Department of Lab Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yike Zhou
- West China Hospital, West China School Medicine, Sichuan University, Chengdu, China
| | - Yujing Ke
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Ran
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yuping Ran
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Rodrigues AM, Gonçalves SS, de Carvalho JA, Borba-Santos LP, Rozental S, de Camargo ZP. Current Progress on Epidemiology, Diagnosis, and Treatment of Sporotrichosis and Their Future Trends. J Fungi (Basel) 2022; 8:776. [PMID: 35893145 PMCID: PMC9331723 DOI: 10.3390/jof8080776] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/14/2022] [Accepted: 07/16/2022] [Indexed: 01/19/2023] Open
Abstract
Sporotrichosis, a human and animal disease caused by Sporothrix species, is the most important implantation mycosis worldwide. Sporothrix taxonomy has improved in recent years, allowing important advances in diagnosis, epidemiology, and treatment. Molecular epidemiology reveals that S. brasiliensis remains highly prevalent during the cat-transmitted sporotrichosis outbreaks in South America and that the spread of S. brasiliensis occurs through founder effects. Sporothrix globosa and S. schenckii are cosmopolitan on the move, causing major sapronoses in Asia and the Americas, respectively. In this emerging scenario, one-health approaches are required to develop a creative, effective, and sustainable response to tackle the spread of sporotrichosis. In the 21st century, it has become vital to speciate Sporothrix, and PCR is the main pillar of molecular diagnosis, aiming at the detection of the pathogen DNA from clinical samples through multiplex assays, whose sensitivity reaches remarkably three copies of the target. The treatment of sporotrichosis can be challenging, especially after the emergence of resistance to azoles and polyenes. Alternative drugs arising from discoveries or repositioning have entered the radar of basic research over the last decade and point to several molecules with antifungal potential, especially the hydrazone derivatives with great in vitro and in vivo activities. There are many promising developments for the near future, and in this review, we discuss how these trends can be applied to the Sporothrix-sporotrichosis system to mitigate the advance of an emerging and re-emerging disease.
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Affiliation(s)
- Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil; (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of Infectious Diseases, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil
| | - Sarah Santos Gonçalves
- Infectious Diseases Postgraduate Program, Center for Research in Medical Mycology, Federal University of Espírito Santo (UFES), Vitoria 29043900, Brazil;
| | - Jamile Ambrósio de Carvalho
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil; (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of Infectious Diseases, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil
| | - Luana P. Borba-Santos
- Cell Biology and Parasitology Program, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941902, Brazil; (L.P.B.-S.); (S.R.)
| | - Sonia Rozental
- Cell Biology and Parasitology Program, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941902, Brazil; (L.P.B.-S.); (S.R.)
| | - Zoilo Pires de Camargo
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil; (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of Infectious Diseases, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil
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Sporothrix brasiliensis and Feline Sporotrichosis in the Metropolitan Region of Rio de Janeiro, Brazil (1998–2018). J Fungi (Basel) 2022; 8:jof8070749. [PMID: 35887504 PMCID: PMC9325134 DOI: 10.3390/jof8070749] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023] Open
Abstract
Feline sporotrichosis is enzootic in different regions of Brazil, especially in Rio de Janeiro. This study compared the genotype profiles of Sporothrix sp. isolated from cats in Rio de Janeiro between 1998 and 2018 and evaluated their association with clinical and epidemiological characteristics. One hundred nineteen Sporothrix sp. isolates from a cohort of cats with sporotrichosis seen at INI/Fiocruz were included. Clinical and epidemiological data were obtained from the medical records of the animals. T3B PCR fingerprinting was used for molecular identification of the Sporothrix species. All isolates were characterized as Sporothrix brasiliensis, with the observation of low intraspecific variation in 31 isolates (31.3%). The interval between lesion onset and first medical visit at INI/Fiocruz, as well as treatment duration until clinical cure, was longer in cats from the first decade of the epizootic. In addition, the frequency of the variables “good general status” and “presence of lymphadenomegaly” was higher among cats whose strains did not exhibit intraspecific variation. So far, S. brasiliensis has been the only species identified in feline cases of sporotrichosis since the beginning of the epizootic in Rio de Janeiro at INI/Fiocruz.
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A neglected disease. Human sporotrichosis in a densely populated urban area in São Paulo, Brazil: clinical-epidemiological and therapeutic aspects. Braz J Microbiol 2022; 53:739-748. [PMID: 35301695 PMCID: PMC9151930 DOI: 10.1007/s42770-022-00713-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/13/2022] [Indexed: 02/07/2023] Open
Abstract
Human sporotrichosis is caused by different Sporothrix species; however, Sporothrix brasiliensis is the main species, usually related to cat transmission in urban areas. A retrospective descriptive study was conducted at the Institute of Infectology Emílio Ribas from 2010 to 2018. Demography, clinical, diagnostic, and therapeutic data were obtained from medical records. Polymerase chain reaction of the calmodulin gene was performed to identify Sporothrix species. In addition, to evaluate the spread of the disease across São Paulo metropolitan region, TerraView version 4.2.2 software was used for geocoding cases according to residence addresses. Kernell's maps using QGIS software version 2.16.3 were constructed to determine the concentration of cases. Results: 260 cases of sporotrichosis were diagnosed between 2010 and 2018. We observed a 700% increment in the number of human cases in the 2016-2018 triennium compared with the 2013-2015 triennium. Female adults with a median age of 46 years old were the predominant infected group associated with cats' exposition at home care, although the age range of all patients was 01 to 86 years old. The main epidemiological risk of acquiring sporotrichosis was contact with cats, reported by 96.5% of the patients. Molecular identification showed that most of the tested isolates were Sporothrix brasiliensis. Lymphocutaneous form was observed in 59.2% and fixed cutaneous form in 37.5% of the patients. Regarding treatment, itraconazole was the main drug used (94.2%) with a cure rate of 98.8%. We observed an important spread of human sporotrichosis involving cat transmission caused by Sporothrix brasiliensis in a densely populated area of São Paulo state. These results are important to alert clinicians and dermatologists about the occurrence and progression of a neglected tropical disease in an urban area and the urgent necessity to include sporotrichosis as a differential diagnosis in the clinical investigation routine.
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Rabello VBS, Almeida MA, Bernardes-Engemann AR, Almeida-Paes R, de Macedo PM, Zancopé-Oliveira RM. The Historical Burden of Sporotrichosis in Brazil: a Systematic Review of Cases Reported from 1907 to 2020. Braz J Microbiol 2022; 53:231-244. [PMID: 34825345 PMCID: PMC8882507 DOI: 10.1007/s42770-021-00658-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/21/2021] [Indexed: 01/26/2023] Open
Abstract
Sporotrichosis is a cosmopolitan subcutaneous mycosis caused by Sporothrix species. Recently, this mycosis has gained notoriety due to the appearance of new endemic areas, recognition of new pathogenic species, changes in epidemiology, occurrence of outbreaks, and increasing numbers of cases. The purpose of this study is to analyze the peculiarities of sporotrichosis cases in Brazil since its first report in the country until 2020. In this work, ecological, epidemiological, clinical, and laboratorial characteristics were compiled. A systematic review of human sporotrichosis diagnosed in Brazil and published up to December 2020 was performed on PubMed/MEDLINE, SciELO, Web of Science, and LILACS databases. Furthermore, animal sporotrichosis and environmental isolation of Sporothrix spp. in Brazil were also evaluated. The study included 230 papers, resulting in 10,400 human patients. Their ages ranged from 5 months to 92 years old and 55.98% were female. The lymphocutaneous form was predominant (56.14%), but systemic involvement was also notably reported (14.34%), especially in the lungs. Besides, hypersensitivity manifestations (4.55%) were described. Most patients had the diagnosis confirmed by isolation of Sporothrix spp., mainly from skin samples. Sporothrix brasiliensis was the major agent identified. HIV infection, cardiovascular diseases, and diabetes were the most common comorbidities. Cure rate was 85.83%. Concerning animal sporotrichosis, 8538 cases were reported, mostly in cats (90.77%). Moreover, 13 Sporothrix spp. environmental strains were reported. This review highlights the burden of the emergent zoonotic sporotrichosis in Brazil, reinforcing the importance of "One Health" based actions to help controlling this disease.
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Affiliation(s)
- Vanessa Brito Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marcos Abreu Almeida
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Andrea Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Priscila Marques de Macedo
- Laboratório de Pesquisa Clínica Em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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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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Human sporotrichosis: recommendations from the Brazilian Society of Dermatology for the clinical, diagnostic and therapeutic management. An Bras Dermatol 2022; 97:757-777. [PMID: 36155712 PMCID: PMC9582924 DOI: 10.1016/j.abd.2022.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The increase in the zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis, which started in the late 1990s in Rio de Janeiro and is now found in almost all Brazilian states, has been equally advancing in neighboring countries of Brazil. Changes in the clinical-epidemiological profile, advances in the laboratory diagnosis of the disease, and therapeutic difficulties have been observed throughout these almost 25 years of the epidemic, although there is no national consensus. The last international guideline dates from 2007. OBJECTIVES Update the clinical classification, diagnostic methods and recommendations on the therapeutic management of patients with sporotrichosis. METHODS Twelve experts in human sporotrichosis were selected from different Brazilian regions, and divided into three work groups: clinical, diagnosis and treatment. The bibliographic research was carried out on the EBSCOHost platform. Meetings took place via electronic mail and remote/face-to-face and hybrid settings, resulting in a questionnaire which pointed out 13 divergences, resolved based on the opinion of the majority of the participants. RESULTS The clinical classification and laboratory diagnosis were updated. Therapeutic recommendations were made for the different clinical forms. CONCLUSION Publication of the first national recommendation, carried out by the Brazilian Society of Dermatology, aimed at the Brazilian scientific community, especially dermatologists, infectologists, pediatricians, family medicine personnel, and laboratory professionals who work in the management of human sporotrichosis.
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Muhammed J, Ahmad-Fauzi S, Abd-Manan N, Yusof NS, Ibrahim M, Mohamad SA. Ocular sporotrichosis from a tertiary referral center in Malaysia and review of literature in Southeast Asia. Taiwan J Ophthalmol 2022; 12:237-241. [PMID: 35813792 PMCID: PMC9262025 DOI: 10.4103/tjo.tjo_93_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/21/2020] [Indexed: 12/02/2022] Open
Abstract
Ocular sporotrichosis is rare in Malaysia and Southeast Asia and is increasingly reported in endemic areas of Brazil and Peru. We describe six cases of ocular sporotrichosis involving the bulbar conjunctiva and lid with a literature review on ocular sporotrichosis in Southeast Asia. In these series, four patients presented with similar findings of granulomatous lesion at the palpebral conjunctiva within 1–3 weeks. There was one case mistakenly diagnosed as conjunctival concretion due to its multiple yellowish nodules on the palpebral conjunctiva and another case as chalazion due to swelling of the lower lid. All patients showed immunocompetence. Four patients had an immediate contact with sick cats, one patient had a history of skin scratched by a healthy cat, and another patient had a history of gardening without direct contact with cat. Culture from conjunctival biopsy obtained from five patients and from ruptured lower lid nodules of one patient yielded Sporothrix schenckii. The patients were successfully treated with oral itraconazole 200 mg twice daily. Two patients developed symblepharon after completing treatment, while four patients showed good results without any sequelae.
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Abstract
Sporothrix schenckii sensu lato is currently recognized as a species complex with only Sporothrix brasiliensis, Sporothrix schenckii sensu stricto, Sporothrix globosa and Sporothrix pallida identified to cause disease in the cat. Feline sporotrichosis in Asia is mainly reported from Malaysia where a single clonal strain of clinical clade D, Sporothrix schenckii sensu stricto manifesting low susceptibility to major antifungal classes, has been identified as the agent of the disease. Sporothrix globosa has been identified to cause disease from a single cat in Japan while the specific species of agent has not been identified yet for the disease in Thailand. Despite efforts to elucidate and describe the pathogenicity of the agent and the disease it causes, the paucity of data highlights the need for further molecular epidemiological studies to characterize this fungus and the disease it causes in Asia. Its prognosis remains guarded to poor due to issues pertaining to cost, protracted treatment course, zoonotic potential and low susceptibility of some strains to antifungals.
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Affiliation(s)
- Hock Siew Han
- Vetderm Animal Skin and Ear Specialist Clinic, 9-1 JLN 23/70A, Plaza Crystalville 1, Desa Sri Hartamas, 50480, Kuala Lumpur, Malaysia.
| | - Rui Kano
- Department of Veterinary Dermatology, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252-0880, Japan
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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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Kamal Azam NK, Selvarajah GT, Santhanam J, Abdul Razak MF, Ginsapu SJ, James JE, Suetrong S. Molecular epidemiology of Sporothrix schenkii isolates in Malaysia. Med Mycol 2021; 58:617-625. [PMID: 31642485 DOI: 10.1093/mmy/myz106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022] Open
Abstract
Sporothrix schenkii is a dimorphic fungus that causes infections in both humans and animals. We report on 25 S. schenkii isolates collected in 2017 from humans and cats clinically diagnosed with sporotrichosis, in Malaysia. These isolates were phenotypically identified as S. schenkii sensu lato and further defined as S. schenckii sensu stricto based on partial calmodulin gene sequence. Isolates from both humans and cats were genotypically identical but displayed phenotypic variation. Phylogenetic analyses based on partial calmodulin sequence showed that the Malaysian isolates clustered with global S. schenkii sensu stricto strains, in particular, of the AFLP type E. This analysis also revealed that partial calmodulin sequence alone was sufficient for classifying global S. schenckii sensu stricto strains into their respective AFLP types, from A to E. The genetically conserved S. schenkii sensu stricto species isolated from humans and cats is suggestive of a clonal strain present in Malaysia. To the best of our knowledge, this is the first report on molecular identification of Sporothrix schenkii strains from human infections in Malaysia. Further studies are required in order to elucidate the clonal nature of Malaysian S. schenkii isolates. Our findings indicate the presence of a predominant S. schenkii genotype in the environment, causing infections in both cats and humans in Malaysia.
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Affiliation(s)
- Nurul Khalisah Kamal Azam
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | | | - Jacinta Santhanam
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | | | | | - Jasper Elvin James
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Satinee Suetrong
- National Center for Genetic Engineering and Biotechnology (BIOTEC), Thailand Science Park, Pathum Thani, Thailand
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Rossow JA, Queiroz-Telles F, Caceres DH, Beer KD, Jackson BR, Pereira JG, Ferreira Gremião ID, Pereira SA. A One Health Approach to Combatting Sporothrix brasiliensis: Narrative Review of an Emerging Zoonotic Fungal Pathogen in South America. J Fungi (Basel) 2020; 6:E247. [PMID: 33114609 PMCID: PMC7712324 DOI: 10.3390/jof6040247] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/21/2022] Open
Abstract
Cat-transmitted sporotrichosis caused by Sporothrix brasiliensis has become a major public health concern and presents a distinct divergence from the traditional epidemiology of sporotrichosis. This emerging fungal pathogen spreads readily among cat populations, and human infections occur exclusively via zoonotic transmission. While sporotrichosis is an implantation mycosis that typically manifests as cutaneous lesions in humans and cats, severe extracutaneous manifestations are more common with S. brasiliensis than other Sporothrix species infections. Rapid diagnosis and appropriate treatment regimens are critical for successful clinical resolution of sporotrichosis in both cats and humans. Species-level identification of Sporothrix is possible with molecular diagnostics and necessary for tracking the geographic expansion of S. brasiliensis and better understanding its epidemiology. Combatting cat-transmitted sporotrichosis requires a One Health approach to successfully implement public health control measures.
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Affiliation(s)
- John A. Rossow
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Flavio Queiroz-Telles
- Department of Public Health, Hospital de Cíinicas, Federal University of Parana, Curitiba 82015-154, Brazil;
| | - Diego H. Caceres
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
- Center of Expertise in Mycology, Radboudumc/CWZ, 6532 SZ Nijmegen, The Netherlands
| | - Karlyn D. Beer
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
| | - Brendan R. Jackson
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.A.R.); (D.H.C.); (K.D.B.)
| | - Jose Guillermo Pereira
- Ministry of Public Health and Social Welfare, National Leprosy Control Program, National Directorate of Health Surveillance, Dermatology Specialty Center, San Lorenzo 2160, Paraguay;
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-360, Brazil; (I.D.F.G.); (S.A.P.)
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-360, Brazil; (I.D.F.G.); (S.A.P.)
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Conjunctival sporotrichosis from cat to human: Case report. Am J Ophthalmol Case Rep 2020; 20:100898. [PMID: 32875165 PMCID: PMC7452082 DOI: 10.1016/j.ajoc.2020.100898] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/19/2020] [Accepted: 08/16/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To report a case of conjunctival plaque infected from Sporothrix schenckii, which was possible transmitted from a cat. Observations A case of Thai woman presented with chronic painless ulcerated conjunctiva with white plaque. The lesion was not healed for one month after excision. She became concerned of getting infection from her cat because it developed chronic and multiple skin lesions on its legs. Identification of Sporothrix schenckii by PCR method was confirmed in the tissues from her conjunctiva and cat's skin. Conclusion and Importance The diagnosis of Sporothrix infection should be suspected in atypical conjunctival lesion in patient who had closed contact with infected cat. This brought awareness to doctors and cat owners, even though it was uncommon.
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Sporotrichosis: The case series in Thailand and literature review in Southeast Asia. Med Mycol Case Rep 2020; 27:59-63. [PMID: 32123658 PMCID: PMC7036545 DOI: 10.1016/j.mmcr.2020.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 12/22/2019] [Accepted: 01/13/2020] [Indexed: 11/29/2022] Open
Abstract
Human Sporotrichosis is an infection caused by dimorphic fungus, Sporothrix schenckii complex, via direct inoculation. We are herein report proven 2 cases of sporotrichosis along with a literature review about human sporotrichosis in the southeast Asian region. The first case was a 76-year-old female with a non-progressive erythematous plaque at the right ankle. The second case was a 36-year-old female with sporotrichoid lesion for six weeks. Both were treated with itraconazole with an excellent outcome.
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White M, Adams L, Phan C, Erdag G, Totten M, Lee R, Lu X, Mehta S, Miller LS, Zhang SX. Disseminated sporotrichosis following iatrogenic immunosuppression for suspected pyoderma gangrenosum. THE LANCET. INFECTIOUS DISEASES 2019; 19:e385-e391. [PMID: 31473127 DOI: 10.1016/s1473-3099(19)30421-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 06/14/2019] [Accepted: 06/19/2019] [Indexed: 01/19/2023]
Abstract
Sporotrichosis is an infection caused by the dimorphic fungus Sporothrix schenckii and related species that often arises from traumatic inoculation of inhabited soil and organic debris into skin. The infection is usually limited to the skin in immunocompetent patients, usually as lymphocutaneous sporotrichosis. Accurate diagnosis rests on clinical data and culture, and might be facilitated by biopsy identification of suppurative and granulomatous inflammation with fungal elements. In this Grand Round, we present a dramatic case of cutaneous sporotrichosis initially presented with an atypical large ulcer without associated lymphocutaneous spread, clinically mimicking pyoderma gangrenosum, and subsequently progressed to disseminated sporotrichosis in the setting of iatrogenic immunosuppression. We further review the clinical features, risk factors, and treatment of these disseminated sporotrichosis cases, and discuss the need for improved awareness of this fungus' potential link to cause disseminated and invasive fungal infections.
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Affiliation(s)
- Marissa White
- Department of Pathology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - La'Tonzia Adams
- Department of Pathology and Laboratory Medicine, Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, OR, USA
| | - Casey Phan
- Department of Pathology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Gulsun Erdag
- Department of Pathology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Marissa Totten
- Department of Pathology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Richard Lee
- Microbiology Laboratory, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Xuelian Lu
- Department of Dermatology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Seema Mehta
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Lloyd S Miller
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA; Department of Dermatology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Sean X Zhang
- Department of Pathology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA; Microbiology Laboratory, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA.
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20
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Khaitan BK, Gupta V, Asati DP, Seshadri D, Ramam M. Successful treatment outcome with itraconazole and potassium iodide in disseminated sporotrichosis. Indian J Dermatol Venereol Leprol 2017; 84:101-104. [PMID: 29210361 DOI: 10.4103/ijdvl.ijdvl_958_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Binod K Khaitan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinesh P Asati
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Seshadri
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - M Ramam
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Han HS, Kano R, Chen C, Noli C. Comparison of two in vitro antifungal sensitivity tests and monitoring during therapy of Sporothrix schenckii sensu stricto in Malaysian cats. Vet Dermatol 2017; 28:156-e32. [PMID: 28133872 DOI: 10.1111/vde.12417] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Feline sporotrichosis is common in Malaysia. Thermosensitivity and effects of azole treatment on fungal susceptibility are unknown. OBJECTIVES To evaluate thermotolerance and antifungal susceptibility of feline Malaysian Sporothrix isolates, compare microdilution (MD) and E-test results, and investigate changes in susceptibility during azole therapy. METHODS Sporothrix schenckii sensu stricto was isolated from 44 cats. Thermotolerance was determined via culture at 37°C for 7 days. Susceptibility to itraconazole (ITZ), ketoconazole (KTZ) and terbinafine (TRB) was assessed in 40 isolates by MD; to amphotericin B (AMB), KTZ, ITZ, fluconazole (FLC) and posaconazole (POS) by E-test. Results were statistically compared by Pearson's Product Moment. In eight ketoconazole treated cats, susceptibility testing to itraconazole and ketoconazole was repeated every two months for six months. RESULTS Thermotolerance was observed in 36 of 44 (82%) isolates. Assuming that isolates growing at antifungal concentrations ≥4 mg/mL were resistant, all were resistant on E-test to FLC and AMB, 11 (28%) to POS, 6 (15%) to ITZ and 1 (3%) to KTZ. On MD, 27 of 40 (68%) were resistant to TRB, 2 (5%) to ITZ and 3 (8%) to KTZ. There was no correlation between E-test and MD results (KTZ r = 0.10, P = 0.54, and ITZ r = 0.11, P = 0.48). MD values for ITZ and KTZ did not exceed 4 mg/L during KTZ therapy. CONCLUSION The majority of feline isolates in Malaysia are thermosensitive. Lack of correlation between E-test and MD suggests that the E-test is unreliable to test antifungal susceptibility for Sporothrix spp. compared to MD. KTZ was the antifungal drug with the lowest MIC. Prolonged KTZ administration may not induce changes in antifungal susceptibility.
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Affiliation(s)
- Hock Siew Han
- Han Veterinary Surgery, 50 JLN Molek 2/2, TMN Molek, 81100, Johor Bahru, Johor, Malaysia
| | - Rui Kano
- Department of Pathobiology, Nihon University College of Bioresource Sciences, 1866, Kameino, Fujisawa, Kanagawa, 252-0880, Japan
| | - Charles Chen
- Asian Veterinary Specialist Referral Center, 109 Section 4, XinYi Road, Taipei, Taiwan
| | - Chiara Noli
- Servizi Dermatologici Veterinari, Strada Bedale della Ressia 2, 12016, Peveragno (CN), Italy
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Gremião IDF, Miranda LHM, Reis EG, Rodrigues AM, Pereira SA. Zoonotic Epidemic of Sporotrichosis: Cat to Human Transmission. PLoS Pathog 2017; 13:e1006077. [PMID: 28103311 PMCID: PMC5245785 DOI: 10.1371/journal.ppat.1006077] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luisa Helena Monteiro Miranda
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Erica Guerino Reis
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anderson Messias Rodrigues
- Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
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Kano R, Okubo M, Siew HH, Kamata H, Hasegawa A. Molecular typing of Sporothrix schenckii isolates from cats in Malaysia. Mycoses 2015; 58:220-4. [PMID: 25727965 DOI: 10.1111/myc.12302] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 01/13/2015] [Accepted: 01/13/2015] [Indexed: 01/19/2023]
Abstract
Epidemiological data on the aetiologic agents of feline sporotrichosis in Malaysia have not been reported, though human sporotrichosis in Malaysia is reported to be transmitted primarily via cat scratch. To the best of our knowledge, the present report is the first study of the molecular epidemiology of Sporothrix schenckii isolates from cats with sporotrichosis in Malaysia. In the present work, we characterised 18 clinical isolates from cats in Malaysia based on molecular properties, including sequence analyses of the calmodulin gene and the rDNA ITS region and selective PCR of mating type (MAT) loci. In this study, isolates from feline sporotrichosis were identified as a S. schenckii sensu stricto by sequence analyses of the calmodulin gene and the internal transcribed spacer (ITS) region. Notably, phylogenetic analysis of the ITS confirmed assignment to clinical clade D (and not C) of S. schenckii sensu stricto. Therefore, clinical clade D of S. schenckii sensu stricto appeared to be the prevailing source of feline sporotrichosis in Malaysia. The ratio of MAT1-1-1:MAT1-2-1 in these Malaysian isolates was found to be 1 : 0. This result suggested that a clonal strain of S. schenckii is the prevailing causative agent of feline sporotrichosis in Malaysia.
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Affiliation(s)
- Rui Kano
- Department of Veterinary Pathobiology, Nihon University College of Bioresource Sciences, Fujisawa, Kanagawa, Japan
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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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Subcutaneous Mycoses: An Aetiological Study of 15 Cases in a Tertiary Care Hospital at Dibrugarh, Assam, Northeast India. Mycopathologia 2015; 179:425-35. [DOI: 10.1007/s11046-015-9861-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 01/06/2015] [Indexed: 01/19/2023]
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Subedi S, Kidd SE, Baird RW, Coatsworth N, Ralph AP. Case report: Sporotrichosis from the Northern Territory of Australia. Am J Trop Med Hyg 2014; 91:1263-8. [PMID: 25200259 DOI: 10.4269/ajtmh.14-0456] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We report three cases of lymphocutaneous infection caused by the thermally dimorphic fungus, Sporothrix schenckii from Australia's tropical Northern Territory. Two cases were acquired locally, making them the first to be reported from this region. All three cases presented with ulceration in the limb; however, the classical sporotrichoid spread was present only in the first two cases. Their occurrence within several weeks of each other was suggestive of a common source of environmental contamination such as hay used as garden mulch. Diagnoses were delayed in each case, with each patient having substantial exposure to ineffective antibiotics before the correct diagnosis was made. These cases bring the total number of reported sporotrichosis cases in Australia since 1951 to 199. Lessons from these cases are to consider the diagnosis of sporotrichosis in lesions of typical appearance, even in geographical settings from where this pathogen has not previously been reported.
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Affiliation(s)
- Shradha Subedi
- National Mycology Reference Center, SA Pathology, Adelaide, South Australia; Royal Darwin Hospital, Microbiology, Darwin, Northern Territory, Australia; Royal Darwin Hospital, Department of Medicine, Royal Darwin Hospital, Northern Territory, Australia; Global Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Sarah E Kidd
- National Mycology Reference Center, SA Pathology, Adelaide, South Australia; Royal Darwin Hospital, Microbiology, Darwin, Northern Territory, Australia; Royal Darwin Hospital, Department of Medicine, Royal Darwin Hospital, Northern Territory, Australia; Global Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Robert W Baird
- National Mycology Reference Center, SA Pathology, Adelaide, South Australia; Royal Darwin Hospital, Microbiology, Darwin, Northern Territory, Australia; Royal Darwin Hospital, Department of Medicine, Royal Darwin Hospital, Northern Territory, Australia; Global Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Nicholas Coatsworth
- National Mycology Reference Center, SA Pathology, Adelaide, South Australia; Royal Darwin Hospital, Microbiology, Darwin, Northern Territory, Australia; Royal Darwin Hospital, Department of Medicine, Royal Darwin Hospital, Northern Territory, Australia; Global Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Anna P Ralph
- National Mycology Reference Center, SA Pathology, Adelaide, South Australia; Royal Darwin Hospital, Microbiology, Darwin, Northern Territory, Australia; Royal Darwin Hospital, Department of Medicine, Royal Darwin Hospital, Northern Territory, Australia; Global Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
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Emerging sporotrichosis is driven by clonal and recombinant Sporothrix species. Emerg Microbes Infect 2014; 3:e32. [PMID: 26038739 PMCID: PMC4051365 DOI: 10.1038/emi.2014.33] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 03/10/2014] [Accepted: 03/14/2014] [Indexed: 01/17/2023]
Abstract
Sporotrichosis, caused by agents of the fungal genus Sporothrix, occurs
worldwide, but the infectious species are not evenly distributed. Sporothrix
propagules usually gain entry into the warm-blooded host through minor trauma to the skin
from contaminated plant debris or through scratches or bites from felines carrying the
disease, generally in the form of outbreaks. Over the last decade, sporotrichosis has
changed from a relatively obscure endemic infection to an epidemic zoonotic health
problem. We evaluated the impact of the feline host on the epidemiology, spatial
distribution, prevalence and genetic diversity of human sporotrichosis. Nuclear and
mitochondrial markers revealed large structural genetic differences between S.
brasiliensis and S. schenckii populations, suggesting that the interplay
of host, pathogen and environment has a structuring effect on the diversity, frequency and
distribution of Sporothrix species. Phylogenetic data support a recent habitat
shift within S. brasiliensis from plant to cat that seems to have occurred in
southeastern Brazil and is responsible for its emergence. A clonal structure was found in
the early expansionary phase of the cat–human epidemic. However, the prevalent
recombination structure in the plant-associated pathogen S. schenckii generates a
diversity of genotypes that did not show any significant increase in frequency as
etiological agents of human infection over time. These results suggest that closely
related pathogens can follow different strategies in epidemics. Thus, species-specific
types of transmission may require distinct public health strategies for disease
control.
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