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.
Highlights
Cat to human transmission of sporotrichosis is an emerging public health problem in Brazil [1,2,3]
Cutaneous sporotrichosis cases diagnosed at the University Hospital of Rio Grande (UH-Universidade Federal do Rio Grande–FURG/Empresa brasileira de serviços hospitalares– Ebserh), southern Brazil, between 2017 and 2020 were included
Patients with sporotrichosis caused by S. brasiliensis were included in the study
Summary
Cat to human transmission of sporotrichosis is an emerging public health problem in Brazil [1,2,3]. Of many articles regarding cutaneous sporotrichosis treatment [2,8,9,10,11,12,13,14,15,16,17], only two focused on zoonotic transmission [2,16], and just one concerning disease caused by S. brasiliensis in southeast Brazil (Rio de Janeiro state; RJ, Brazil) [2]. We describe clinical characteristics and outcome of antifungal treatment of cutaneous human sporotrichosis caused by S. brasiliensis in southern Brazil (Rio Grande do Sul state—RS, Brazil), a region experiencing numerous zoonotic cases, and with strains whose genotype differs from those from the RJ epidemic and other hyperendemic Brazilian states [2,3,18]
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