Sporotrichosis: an update on epidemiology, etiopathogenesis, laboratory and clinical therapeutics

In the late 90' s there was a change in both the route of transmission and the people at risk for sporotrichosis. This zoonotic cat-man alternative transmission route elicited changes in strategies to control the epidemic. There was a progressive increase in the number of cases involving especially children and the elderly. In addition to becoming hyperendemic, uncommon clinical pictures like immunoreactive clinical presentations or severe systemic cases have emerged. New species were identified and classified through molecular tools using more virulent clinical isolates, like S. brasiliensis, compared to the environmental isolates. Likewise, different species of Sporothrix have been associated with different geographic regions. The serological and molecular techniques are used as an auxiliary tool for the diagnosis and/or for species identification, although the isolation and the identification of Sporothrix spp. in clinical specimen is still the gold standard. Currently sporotrichosis epidemics requires the knowledge of the epidemiological-molecular profile to control the disease and the specific treatment. Itraconazole, potassium iodide, terfinafine, and amphotericin B are the available drugs in Brazil to treat sporotrichosis. The drug of choice, its posology, and treatment duration vary according to the clinical presentation, the Sporothrix species, and host immune status. New treatment choices, including a vaccine, are being developednevertheless, more clinical trials are required to confirm its efficacy.Univ Estado Rio De Janeiro, FCM, Dermatol Dept, Rio De Janeiro, RJ, BrazilFundação Oswaldo Cruz INI Fiocruz, Infect Dermatol Clin Res Lab, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, RJ, BrazilUniv Fed São Paulo UNIFESP, Dept Microbiol Immunol & Parasitol, Lab Emerging Fungal Pathogen, São Paulo, SP, BrazilHosp Univ Pedro Ernesto, Med Mycol Lab, Dermatol Dept, Rio De Janeiro, RJ, BrazilUniv Fed São Paulo UNIFESP, Dept Microbiol Immunol & Parasitol, Lab Emerging Fungal Pathogen, São Paulo, SP, BrazilWeb of Scienc

Esporotricose na gestação: relato de cinco casos numa epidemia zoonótica no Rio de Janeiro, Brasil Sporotrichosis in pregnancy: case reports of 5 patients in a zoonotic epidemic in Rio de Janeiro, Brazil

Os autores apresentam cinco casos de esporotricose em gestantes numa epidemia zoonótica no Rio de Janeiro. São discutidos principalmente os aspectos clínicos e as dificuldades na escolha terapêutica desse grupo específico de pacientes.<br>Five cases of sporotrichosis occurring in pregnant women in a zoonotic epidemic in Rio de Janeiro, Brazil, are described. The main clinical features, as well as the challenging therapeutic choices for this specific group of patients, are discussed

Immunologic Diagnosis of Endemic Mycoses

The endemic mycoses blastomycosis, coccidioidomycosis, histoplasmosis, paracoccidioidomycosis, cryptococcosis, sporotrichosis, talaromycosis, adiaspiromycosis, and emergomycosis are mostly caused by geographically limited thermally dimorphic fungi (except for cryptococcosis), and their diagnoses can be challenging. Usual laboratory methods involved in endemic mycoses diagnosis include microscopic examination and culture of biological samples; however, serologic, histopathologic, and molecular techniques have been implemented in the last few years for the diagnosis of these mycoses since the recovery and identification of their etiologic agents is time-consuming and lacks in sensitivity. In this review, we focus on the immunologic diagnostic methods related to antibody and antigen detection since their evidence is presumptive diagnosis, and in some mycoses, such as cryptococcosis, it is definitive diagnosis