Zoonotic acquisition of cutaneousSporothrix braziliensisinfection in the UK

Abstract

A veterinarian presented with multiple erythematous tender nodules over his right hand and arm. One month prior to the appearance of the lesions, he had treated a cat imported from Brazil who had ulcerated pustular cutaneous lesions. Despite antibiotic treatment there had been no improvement in his symptoms.Biopsies from the patient were sent for histology, bacterial and fungal culture. Periodic acid-Schiff (PAS) stains showed a PAS positive oval yeast-like micro-organism with surrounding necrosis. Fungal cultures resembling Sporothrix species grew after 18 days with typical appearances seen on direct microscopy; this was confirmed as Sporothrix brasiliensis on 18S PCR. The patient was treated with oral itraconazole.This is a unique case of cutaneous S. brasiliensis acquired from an infected imported cat. S. brasiliensis is a rare pathogen in the UK. This case has clinical relevance due to its unusual aetiology and in raising awareness of rarer infections associated with importation of pets and global travel. Clinicians should be aware of sporotrichosis as a differential diagnosis for cutaneous and extracutaneous infection in patients with a high risk of exposure, as well as the use of appropriate diagnostic tests.

Current Progress on Epidemiology, Diagnosis, and Treatment of Sporotrichosis and Their Future Trends

“…Therefore, the only viable hypothesis to justify the detection of a genotype from the parental population of Rio de Janeiro in areas as remote as the state of Pernambuco in the northeast region (>2000 km) is the introduction of sick cats via humans who migrate with their pets, since sporotrichosis is not a disease of direct person-to-person transmission or even a zooanthroponosis. This hypothesis may also explain the introduction of sick cats in other South American countries, such as Argentina and Paraguay [ 109 , 110 , 111 ], or even the European continent, as recently reported in England [ 80 ]. Establishing sanitary barriers to contain the migration of sick felines is a fundamental measure for controlling the expansion of S. brasiliensis ( Figure 3 ).…”

“…However, the disease has decreased its incidence considerably since then, with rare case reports mainly from the United Kingdom, Spain, and Italy [ 18 , 75 , 76 , 77 , 78 , 79 ]. Notwithstanding, with the introduction of S. brasiliensis in England [ 80 ], our attention should be focused on the evolution of the number of cases in the coming years.…”

“…To date, Argentina and Paraguay have reported the occurrence of S. brasiliensis in humans and cats outside Brazil [ 109 , 110 , 111 ], and there are suspected cases in Bolivia, Colombia, and Panama [ 112 , 113 ]. Recently, a zoonotic case was reported in the UK after a veterinarian treated a cat with sporotrichosis imported from Brazil [ 80 ]. In the absence of official epidemiological data, case reports show the importance of the disease, its local and regional escalation, and the urgent need to establish sanitary barriers to mitigate the advance of S. brasiliensis and the cat-transmitted sporotrichosis.…”

Trends in Molecular Diagnostics and Genotyping Tools Applied for Emerging Sporothrix Species

“…Notwithstanding, recent reports demonstrate the presence of this highly virulent species in neighboring countries such as Argentina and Paraguay [ 43 , 44 ] and suspected cases occurring in Bolivia, Colombia, and Panama [ 45 , 46 ]. A human case was recently reported in the UK associated with the importation of pets and global travel [ 47 ]. Sporothrix schenckii , on the other hand, follows a sapronotic route and is widely distributed across Africa, the Americas, and Oceania [ 48 , 49 ].…”

CRISPR-based tools for genetic manipulation in pathogenicSporothrixspecies

“…Over about 25 years, a sporotrichosis outbreak that started in the state of Rio de Janeiro has spread throughout almost all the Brazilian territory and into few of its neighbouring countries in Latin America, such as Argentina (Etchecopaz et al, 2021;Orofino-Costa et al, 2022). Furthermore, at least one case of sporotrichosis, transmitted by an imported infected cat, has been reported in the United Kingdom (Rachman et al, 2022).…”