Sporotrichosis in Rio de Janeiro, Brazil: Sporothrix brasiliensis Is Associated with Atypical Clinical Presentations

Almeida‐Paes, Rodrigo; Oliveira, Manoel Marques Evangelista; Freitas, Dayvison Francis Saraiva; Valle, Antônio Carlos Francesconi do; Zancopé‐Oliveira, Rosely Maria; Gutierrez-Galhardo, Maria Clara

doi:10.1371/journal.pntd.0003094

Cited by 154 publications

(189 citation statements)

References 34 publications

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“…35 Moreover, S. brasiliensis is associated with zoonotic transmission and atypical clinical presentations in humans. [36][37][38] However, the isolates of S. brasiliensis from Rio Grande do Sul differ molecularly of those from Rio de Janeiro, São Paulo and Minas Gerais, 1,12 which deserves more investigation.…”

Section: Discussionmentioning

confidence: 99%

Sporothrix brasiliensis outbreaks and the rapid emergence of feline sporotrichosis

Sanchotene

Madrid

Klafke

et al. 2015

Mycoses

145

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Sporotrichosis is the main subcutaneous mycosis in Brazil, and is caused by Sporothrix schenckii and allied species. Sporothrix propagules present on soil and plant debris may be traumatically inoculated into the cutaneous/ subcutaneous tissues of the warm-blooded host. An alternative route involves direct animal-animal and animal-human transmissions through deep scratches and bites of diseased cats. Sporotrichosis is much more common than previously appreciated with several cases emerging over the years especially in South and Southeast Brazil. We conducted an epidemiological surveillance in endemic areas of feline sporotrichosis in the southern region of Rio Grande do Sul state, Brazil. Over the last 5-year period the number of feline sporotrichosis in Rio Grande increased from 0.75 new cases per month in 2010 to 3.33 cases per month in 2014. The wide geographic distribution of diagnosed cases highlights the dynamics of Sporothrix transmission across urban areas with high population density. Molecular identification down to species level by PCR-RFLP of cat-transmitted Sporothrix revealed the emergence of the clonal offshoot S. brasiliensis during feline outbreaks; this scenario is similar to the epidemics taking place in the metropolitan areas of Rio de Janeiro and São Paulo. Controlling and preventing sporotrichosis outbreaks are essential steps to managing the disease among humans and animals.

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Section: Discussionmentioning

confidence: 99%

Sporothrix brasiliensis outbreaks and the rapid emergence of feline sporotrichosis

Sanchotene

Madrid

Klafke

et al. 2015

Mycoses

145

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“…Most patients infected with S. brasiliensis respond well to these drugs (Francesconi et al 2011, Almeida-Paes et al 2014, Macedo et al 2015), although therapeutic failures have been reported (Almeida-Paes et al 2016). In order to guide therapy, antifungal susceptibility tests were developed (CLSI 2008).…”

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confidence: 99%

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Almeida‐Paes

Brito‐Santos

Figueiredo-Carvalho

et al. 2017

Mem. Inst. Oswaldo Cruz

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BACKGROUNDSporothrix brasiliensis is the most virulent sporotrichosis agent. This species usually responds to antifungal drugs, but therapeutic failure can occur in some patients. Antifungal susceptibility tests have been performed on this species, but no clinical breakpoints (CBPs) are available. In this situation, minimal inhibitory concentration (MIC) distributions and epidemiological cutoff values (ECVs) support the detection of identification of resistant strains.OBJECTIVES To study the MIC distributions of five antifungal drugs against S. brasiliensis and to propose tentative ECVs.METHODS MICs of amphotericin B (AMB), itraconazole (ITR), ketoconazole (KET), posaconazole (POS), and terbinafine (TRB) against 335 S. brasiliensis strains were determined by the Clinical and Laboratory Standards Institute broth microdilution method.FINDINGS The proposed ECV, in µg/mL, for AMB, ITR, KET, POS, and TRB were 4.0, 2.0, 1.0, 2.0, and 0.25, respectively. Percentages of wild-type strains in our population for the above antifungal drugs were 98.48, 95.22, 95.33, 100, and 97.67%, respectively.MAIN CONCLUSIONS These ECVs will be useful to detect strains with resistance, to define CBPs, and to elaborate specific therapeutic guidelines for S. brasiliensis. Rational use of antifungals is strongly recommended to avoid the emergence of resistant strains and ensure the therapeutic effectiveness of sporotrichosis.

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“…Sporotrichosis is considered a rare disease in dogs, with isolated cases in the literature [18]. However, an increasing number of cases have been reported in Rio de Janeiro, associated with an epidemic outbreak in cats, from 1998 to 2009 [2,6,20]. In the present report, contact with cats was deemed an important risk factor, detected in the anamnesis, which allowed the inclusion of sporotrichosis as a differential diagnosis for the presented lesions.…”

Section: Discussionmentioning

confidence: 60%

Sporotrichosis Outburst after Cancer Chemotherapy in a Dog

Silva

Intra

Ferraz

et al. 2019

Acta Scientiae. Vet.

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Background: Sporotrichosis is a dermatozoonosis that affects mammals in general, with the domestic feline (Felis catus) being the most epidemiologically important species. However, diagnosis of this disease in dogs is important considering the proximity with people and with other communicants. The epidemiology of sporotrichosis is already known in some states of Brazil, especially in the southeast region, but to the best of our knowledge there are no reports of sporotrichosis in non-human species in the state of Espírito Santo. This paper aimed at describing the first case of canine sporotrichosis in Espírito Santo, Brazil.Case: A 10 year-old Bull Terrier male dog was presented with nodular non-ulcerated lesions on the head and nodular ulcerated lesion on the nasal planum. The dog had a previous diagnosis of a low-grade mast cell tumour and palpebral melanoma. Mast cell tumour was treated with scrotum ablation (and orchiectomy) and bilateral inguinal lymph node removal, followed by chemotherapy with twelve intravenous infusion of vinblastine, along with prednisolone. Cutaneous lesions in the head and nasal planum appeared two months after finishing chemotherapy. At further anamnesis, the pet´s responsible reported that the dog had the habit of hunting cats that entered the residence, which raised the hypothesis of sporotrichosis. An undiagnostic cytology was performed, followed by a fungal culture, positive for Sporothrix schenckii. Treatment was then initiated with itraconazol (Oficial generic drug), at a dose of 10mg/kg/SID, until clinical remission, obtained after 60 days, maintaining it for 60 more days. Patient showed completed recovery, with no further complatints after a follow-up of more than 220 days.Discussion: Sporotrichosis is considered a rare disease in dogs, with isolated cases in the literature. The dog of the present report was diagnosed with sporotrichosis two months after the end of a chemotherapy treatment for a mast cell tumour. Therefore, it is suggested that the patient in this study was infected during an immunosuppressive phase. The same can occur with other immunosuppressive treatments, such as glucocorticoid, also included in the chemotherapy treatment of this patient, calcineurin inhibitors (cyclosporine) and mercaptopurine derivatives (azathioprine). Cytology is usually unconclusive for such lesions in dogs, once only a few yeast might be present. Nevertheless, the definitive diagnosis was obtained through fungal microculture. Treatment with itraconazol was successful but dogs might also present favorable responses to ioidine. Itraconazole is a fungistatic drug, fungicidal only in high doses. For this reason, if the fungistatic dose is not administered for sufficient time, recurrences may occur. In the last three years, Espirito Santo has become a new epidemiological scenario for sporotrichosis, and it is placed in the route of transmission, closely to Rio de Janeiro. Cats are the most affected animals and are commonly responsible for transmission to other species, including humans. The increase in cases of canine sporotrichosis requires its inclusion in the differential diagnosis of nodular-ulcerative lesions, along with cutaneous neoplasias and immune-mediated diseases.

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Sporotrichosis in Rio de Janeiro, Brazil: Sporothrix brasiliensis Is Associated with Atypical Clinical Presentations

Cited by 154 publications

References 34 publications

Sporothrix brasiliensis outbreaks and the rapid emergence of feline sporotrichosis

Sporothrix brasiliensis outbreaks and the rapid emergence of feline sporotrichosis

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Sporotrichosis Outburst after Cancer Chemotherapy in a Dog

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