Sporothrix brasiliensis Causing Atypical Sporotrichosis in Brazil: A Systematic Review

• Published in: Journal of fungi (Basel) Vol. 10; no. 4; p. 287
• Main Authors: Poester, Vanice Rodrigues, Xavier, Melissa Orzechowski, Munhoz, Lívia Silveira, Basso, Rossana Patricia, Zancopé-Oliveira, Rosely Maria, Freitas, Dayvison Francis Saraiva, Pasqualotto, Alessandro Comarú
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 13-04-2024
• Subjects: Arthritis; Erythema; Geography; hypersensitivity; Infections; Medical personnel; Mucosa; Mycosis; nasal; ocular; Osteoarthritis; Public health; pulmonary; Software; Sporothrix brasiliensis; Sporotrichosis; Systematic review; Zoonoses; zoonosis; South America; Brazil; United States > US; nasal; hypersensitivity; osteoarthritis; meningeal disease; pulmonary; zoonosis; ocular
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof10040287

Zoonotic sporotrichosis, a subcutaneous mycosis caused by
, has become hyperendemic and a serious public health issue in Brazil and an emerging disease throughout the world. Typical sporotrichosis is defined as fixed or lymphocutaneous lesion development, however, reports of atypical presentations have been described in hyperendemic areas, which may result in a worse prognosis. Thus, considering an increase in atypical cases and in more severe extracutaneous cases and hospitalizations reported in Brazil, we aimed to perform a systematic review to search for hypersensitivity reactions (HRs) and extracutaneous presentations associated with zoonotic sporotrichosis. A systematic review was performed, following the PRISMA guidelines to search for atypical/extracutaneous cases (mucosal, osteoarthritis, HRs, pulmonary, meningeal) of zoonotic sporotrichosis. A total of 791 published cases over 26 years (1998-2023) in eleven Brazilian states were reviewed. Most cases corresponded to a HR (47%; n = 370), followed by mucosal (32%; n = 256), multifocal (8%; n = 60), osteoarthritis (7%; n = 59), meningeal (4%; n = 32), and pulmonary (2%; n = 14) infections. When available (n = 607), the outcome was death in 7% (n = 43) of cases. Here, we show a frequent and worrisome scenario of zoonotic sporotrichosis in Brazil, with a high and dispersed incidence of atypical/extracutaneous cases throughout the Brazilian territory. Therefore, educational measures are necessary to make health professionals and the overall population aware of this fungal pathogen in Brazil as well as in other countries in the Americas.