Abstract
Sporotrichosis, caused by Sporothrix schenckii and related species, is the most frequent implantation mycosis in Latin America. In Argentina, over the last 8 years, there have been 0.16 new cases per month of feline sporotrichosis in 2011, increasing to 0.75 cases per month in 2019 and involving zoonotic transmission to humans. Molecular identification by polymerase chain reaction (PCR) detected Sporothrix brasiliensis in these feline and zoonotic outbreaks. This study will focus on different feline and human sporotrichosis outbreaks caused by S. brasiliensis in Argentina during 2011–2019. We will address the sources of infection and environmental hotspots, as well as the application of several treatment strategies for improving the pharmacotherapy of the different clinical forms of the disease. Finally, we will provide a detailed summary of the clinical aspects and new advances in host–pathogen interactions, virulence factors and immune response, focusing on state-of-the-art diagnostic tools and potential vaccine candidates.
Highlights
Introduction published maps and institutional affilSporotrichosis is a fungal implantation disease of subacute course caused by certain species of the Sporothrix schenckii complex, order Ophiostomatales, affecting the skin and lymph nodes
The immune reconstitution inflammatory syndrome (IRIS) was associated with a more complicated course of sporotrichosis among human immunodeficiency virus (HIV)-infected patients, with a paradoxical clinical worsening after starting antifungal therapy [91]. Another severe and atypical presentations of cat-transmitted sporotrichosis (CTS) due to S. brasiliensis in immunocompromised patients included sporotrichosis of the mucosal surfaces of the mouth and nose that might lead to the destruction of the nasal septum, soft palate and uvula [90] and a meningeal and multiorgan disseminated sporotrichosis [92]. These findings highlight the potential aggressiveness of S. brasiliensis in immunocompromised patients, in those with HIV/acquired immunodeficiency syndrome (AIDS), living in endemic areas for sporotrichosis and the necessity to include this fungal disease in the differential diagnosis of all mentioned severe clinical forms associated with poor prognosis
21 cases of sporotrichosis during pregnancy were reported in the literature during the sporotrichosis epidemic in Rio de Janeiro, Brazil, and the majority of cases were associated with CTS [93,94,95]
Summary
In Argentina, sporotrichosis is, along with chromoblastomycosis, the second most common subcutaneous mycosis after mycetoma [32]. In Buenos Aires, most cases occurred in the Northern area of the province bordering the Reconquista River basin (Cuenca del Rio Reconquista) (Figure 3), indicating that this region is the hotspot of this emerging fungal disease. Among humans with sporotrichosis related to S. brasiliensis or to CTS, of them (n = 16)the had a positive culture and reported scratches, bites or contact with 76.2%. The molecular characterization of Sporothrix could be performed, confirming the involvement of S. brasiliensis in these feline cases of sporotrichosis. In another 10 cats, the epidemiological nexus were human cases with sporotrichosis caused by S. brasiliensis who were bitten or scratched by these sick animals.
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