, Volume 43, Issue 3, pp 267–276 | Cite as

The impact of sporotrichosis in HIV-infected patients: a systematic review



Sporotrichosis is a fungal infection of man and animals caused by Sporothrix complex. It usually presents as a lymphocutaneous form, but disseminated disease may occur. Given the paucity of data about HIV/AIDS and sporotrichosis co-infection, a systematic review of reported cases of HIV-associated sporotrichosis found via Pubmed (1984–2013) was done. A total of 39 papers were included, and 58 patients’ data analyzed. Thirty-three (56.9 %) cases were from Brazil and 18 (31 %) from the USA. Patients’ mean age was 37.8 ± 10.4 years; males predominated (84.5 %). The median CD4+ cell count was 97 cells/mm3. The most common clinical forms were disseminated and disseminated cutaneous with 33 (56.9 %) and 10 (17.5 %) patients, respectively. There was a correlation between CD4+ count and clinical categories (p = 0.002). Mortality was 30 % and there was a correlation between central nervous system involvement and death (p < 0.001).


Sporotrichosis AIDS Neglected diseases HAART Systematic review 

Supplementary material

15010_2015_746_MOESM1_ESM.doc (50 kb)
Supplementary material 1 (DOC 49 kb)


  1. 1.
    Marimon R, Cano J, Gene J, Sutton DA, Kawasaki M, et al. Sporothrix brasiliensis, S. globosa, and S. Mexicana, three new Sporothrix species of clinical interest. J Clin Microb. 2007;45:3198–206.CrossRefGoogle Scholar
  2. 2.
    Lopes-Bezerra LM, Schubach A, Costa RO. Sporothrix schenckii and sporotrichosis. An Acad Bras Cienc. 2006;78:293–308.CrossRefPubMedGoogle Scholar
  3. 3.
    Schubach A, Barros MBL, Wanke B. Epidemic sporotrichosis. Curr Opin Infect Dis. 2008;21:129–33.CrossRefPubMedGoogle Scholar
  4. 4.
    Barros MB, Schubach ADO, do Valle AC, Galhardo MCG, Conceicao-Silva F, Schubach TM, et al. Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases. Clin Infect Dis. 2004;38:529–35.CrossRefPubMedGoogle Scholar
  5. 5.
    Mata-Essayag S, Delgado A, Colella MT, Landaeta-Nezer ME, Rosello A, Perez de Salazar C, et al. Epidemiology of sporotrichosis in Venezuela. Int J Dermatol. 2013;52:974–80.CrossRefPubMedGoogle Scholar
  6. 6.
    Pappas PG, Tellez I, Deep AE, Nolasco D, Holgado W, Bustamante B. Sporotrichosis in Peru: description of an area of hyperendemicity. Clin Infect Dis. 2000;30:65–70.CrossRefPubMedGoogle Scholar
  7. 7.
    Devi KR, Devi MU, Singh TN, Devi KS, Sharma SS, Singh LR, et al. Emergence of sporotrichosis in Manipur. Indian J Med Microbiol. 2006;24:216–9.PubMedGoogle Scholar
  8. 8.
    Song Y, Li SS, Zhong SX, Liu YY, Yao L, Huo SS. Report of 457 sporotrichosis cases from Jilin province, northeast China, a serious endemic region. J Eur Acad Dermatol Venereol. 2013;27:313–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Kauffman CA. Sporotrichosis. Clin Infect Dis. 1999;29:231–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Karp CL, Auwaerter PG. Coinfection with HIV and tropical infectious diseases. I. Protozoal pathogens. Clin Infect Dis. 2007;45:1208–13.CrossRefPubMedGoogle Scholar
  11. 11.
    Freitas DF, de Siqueira Hoagland B, do Valle AC, Fraga BB, de Barros MB, de Oliveira Schubach A, et al. Sporotrichosis in HIV-infected patients: report of 21 cases of endemic sporotrichosis in Rio de Janeiro, Brazil. Med Mycol. 2012;50:170–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Lederman MM, Funderburg NT, Sekaly RP, Klatt NR, Hunt PW. Residual immune dysregulation syndrome in treated HIV infection. Adv Immunol. 2013;119:51–83.PubMedCentralPubMedGoogle Scholar
  13. 13.
    Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRefPubMedCentralPubMedGoogle Scholar
  14. 14.
    Thompson MA, Aberg JA, Hoy JF, Telenti A, Benson C, Cahn P, et al. Antiretroviral treatment of adult HIV infection: 2012 recommendations of the International Antiviral Society-USA panel. JAMA. 2012;308:387–402.PubMedGoogle Scholar
  15. 15.
    Huis in’t Veld D, Sun HY, Hung CC, Colebunders R. The immune reconstitution inflammatory syndrome related to HIV co-infections: a review. Eur J Clin Microbiol Infect Dis. 2012;31:919–27.CrossRefGoogle Scholar
  16. 16.
    Armstrong WS. The immune reconstitution inflammatory syndrome: a clinical update. Curr Infect dis Rep. 2013;15:39–45.CrossRefPubMedGoogle Scholar
  17. 17.
    Galhardo MC, Silva MT, Lima MA, Nunes EP, Schettini LE, de Freitas RF, et al. Sporothrix schenckii meningitis in AIDS during immune reconstitution syndrome. J Neurol Neurosurg Psychiatry. 2010;81:696–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Gutierrez-Galhardo MC, do Valle AC, Fraga BL, Schubach AO, Hoagland BR, Monteiro PC, et al. Disseminated sporotrichosis as a manifestation of immune reconstitution inflammatory syndrome. Mycoses. 2010;53:78–80.CrossRefPubMedGoogle Scholar
  19. 19.
    Lipstein-Kresch E, Isenberg HD, Singer C, Cooke O, Greenwald RA. Disseminated Sporothrix schenckii infection with arthritis in a patient with acquired immunodeficiency syndrome. Rheumatol. 1985;12:805–8.Google Scholar
  20. 20.
    Bibler MR, Luber HJ, Glueck HI, Estes SA. Disseminated sporotrichosis in a patient with HIV infection after treatment for acquired factor VIII inhibitor. JAMA. 1986;256:3125–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Kurosawa A, Pollock SC, Collins MP, Kraff CR, Tso MOM. Sporothrix schenckii endophthalmitis in a patient with human immunodeficiency virus infection. Arch Ophthalmol. 1988;106:376–80.CrossRefPubMedGoogle Scholar
  22. 22.
    Fitzpatrick JE, Eubanks S. Acquired immunodeficiency syndrome presenting as disseminated cutaneous sporotrichosis. Int J Dermatol. 1988;27:406–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Shaw JC, Levinson W, Montanaro A. Sporotrichosis in the acquired immunodeficiency syndrome. J Am Acad Dermatol. 1989;21:1145–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Keiser P, Whittle D. Sporotrichosis in human immunodeficiency virus-infected patients: report of a case. Rev Infect Dis. 1991;13:1027–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Heller HM, Fuhrer J. Disseminated sporotrichosis in patients with AIDS: case report and review of the literature. AIDS. 1991;5:1243–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Oscherwitz SL, Rinaldi MG. Disseminated sporotrichosis in a patient infected with human immunodeficiency virus. Clin Infect Dis. 1992;15:568–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Penn CC, Goldstein E, Bartholomew WR. Sporothrix schenckii meningitis in a patient with AIDS. Clin Infect Dis. 1992;15:741–3.CrossRefPubMedGoogle Scholar
  28. 28.
    Donabedian H, O’Donnell E, Olszewski C, MacArthur RD, Budd N. Disseminated cutaneous and meningeal sporotrichosis in an AIDS patient. Diagn Microbiol Infect Dis. 1994;18:111–5.CrossRefPubMedGoogle Scholar
  29. 29.
    Bolao F, Podzamezer D, Ventin M, Gudiol F. Efficacy of acute phase and maintenace therapy with itraconazole in an AIDS patient with sporotrichosis. Eur J Clin Microbiol Infect Dis. 1994;13:609–12.CrossRefPubMedGoogle Scholar
  30. 30.
    Dong JA, Chren MM, Elewski BE. Bonsai tree: risk factor for disseminated sporotrichosis. J Am Acad Dermatol. 1995;33:839–40.CrossRefPubMedGoogle Scholar
  31. 31.
    Rotz LD, Slater LN, Wack MF, Boyd AL, Scott EN, Greenfield RA. Disseminated sporotrichosis with meningitis in a patient with AIDS. Infect Dis Clin Pract. 1996;5:556–8.CrossRefGoogle Scholar
  32. 32.
    Morgan M, Reves R. Invasive sinusitis due to Sporothrix schenckii in a patient with AIDS. Clin Infect Dis. 1996;23:1319–20.CrossRefPubMedGoogle Scholar
  33. 33.
    Gori S, Lupetti A, Moscato G, Parenti M, Lofaro A. Pulmonary sporotrichosis with hyphae in a human immunodefiency virus-infected patient. A case report. Acta Cytol. 1997;41:519–21.CrossRefGoogle Scholar
  34. 34.
    Al-Tawfiq JA, Wools KK. Disseminated sporotrichosis and Sporothrix schenckii fungemia as the initial presentation of human immunodefiency virus infection. Clin Infect Dis. 1998;26:1403–6.CrossRefPubMedGoogle Scholar
  35. 35.
    Neto RJP, Machado AA, Castro G, Quaglio ASS, Martinez R. Esporotricose cutanea disseminada como manifestação inicial da síndrome da imunodeficiencia adquirida—relato de caso. Rev Soc Bras Med Trop. 1999;32:57–61.CrossRefGoogle Scholar
  36. 36.
    Ware AJ, Cockerell CJ, Skiest DJ, Kussman HM. Disseminated sporotrichosis with extensive cutaneous involvement in a patient with AIDS. J Am Acad Dermatol. 1999;40:350–5.CrossRefPubMedGoogle Scholar
  37. 37.
    Goldani LZ, Aquino VR, Dargel AA. Disseminated cutaneous sporotrichosis in an AIDS patient receiving maintenance therapy with fluconazole for previous cryptococcal meningitis. Clin Infect Dis. 1999;28:1337–8.CrossRefPubMedGoogle Scholar
  38. 38.
    Edwards C, Reuther WL 3rd, Greer DL. Disseminated osteoarticular sporotrichosis: treatment in a patient with acquired immunodeficiency syndrome. South Med J. 2000;93:803–6.CrossRefPubMedGoogle Scholar
  39. 39.
    Bonifaz A, Peniche A, Mercadillo P, Saúl A. Successful treatment of AIDS-related disseminated cutaneous sporotrichosis with itraconazole. AIDS Patient Care STDs. 2001;15:603–6.CrossRefPubMedGoogle Scholar
  40. 40.
    Aarestrup FM, Guerra RO, Vieira BJ, Cunha RMC. Oral manifestation of sporotrichosis in AIDS patients. Oral Dis. 2001;7:134–6.CrossRefPubMedGoogle Scholar
  41. 41.
    Rocha MM, Dassin T, Lira R, Lima EL, Severo LC, Londero AT. Sporotrichosis in patients with AIDS: report of a case and review. Ver Iberoam Micol. 2001;18:133–6.Google Scholar
  42. 42.
    Carvalho MT, de Castro AP, Baby C, Werner B, Filus Neto J, Queiroz-Telles F. Disseminated cutaneous sporotrichosis in a patient with AIDS: report of a case. Rev Soc Bras Med Trop. 2002;35:1–5.CrossRefGoogle Scholar
  43. 43.
    Losman JA, Cavanaugh K. Cases from the Osler Medical Service at Johns Hopkins University. Diagnosis: P. carinii pneumonia and primary pulmonary sporotrichosis. Am J Med. 2004;117:353–6.CrossRefPubMedGoogle Scholar
  44. 44.
    Hardman S, Stephenson I, Jenkins DR, Wiselka MJ, Johnson EM. Disseminated Sporothrix schenckii in a patient with AIDS. J Infect. 2005;51:e73–7.CrossRefPubMedGoogle Scholar
  45. 45.
    Silva-Vergara ML, Maneira FR, De Oliveira RM, Santos CT, Etchebehere RM, Adad SJ. Multifocal sporotrichosis with meningeal involvement in a patient with AIDS. Med Mycol. 2005;43:187–90.CrossRefPubMedGoogle Scholar
  46. 46.
    Callens SF, Kitetelef F, Lukun P, Van Rie A, Behets F, et al. Pulmonary Sporothrix schenckii infection in a HIV positive child. J Trop Pediatr. 2006;52:144–6.CrossRefPubMedGoogle Scholar
  47. 47.
    Fontes PC, Kitakawa D, Carvalho YR, Brandao AA, Cabral LA, Almeida JD. Sporotrichosis in an HIV-positive man with oral lesions: case report. Acta Cytol. 2007;51:648–50.CrossRefPubMedGoogle Scholar
  48. 48.
    Vilela R, Souza GF, Fernandes G, Mendoza L. Cuatenous and meningeal sporotrichosis in a HIV patient. Rev Iberoam Micol. 2007;24:161–3.CrossRefPubMedGoogle Scholar
  49. 49.
    Bustamante B, Lama RJ, Mosquera C, Soto L. Sporotrichosis in human immunodeficiency virus infected peruvian patients. Infect Dis Clin Pract. 2009;17:78–83.CrossRefGoogle Scholar
  50. 50.
    Mello CX, Schubach ADO, Madeira MDF. Can yeast-like form of Sporothrix schenckii confuse the diract parasitological diagnosis of american cutaneous leishmaniasis? Rev Soc Bras Med Trop. 2011;44:127.CrossRefPubMedGoogle Scholar
  51. 51.
    Silva-Vergara ML, Camargo ZP, Silva PF, Abdalla MR, Sgarbieri RN, Rodrigues AM, et al. Case report: disseminated Sporothrix brasiliensis infection with endocardial and ocular involvement in an HIV-infected patient. Am J Trop Med Hyg. 2012;86:477–80.CrossRefPubMedCentralPubMedGoogle Scholar
  52. 52.
    Chang S, Hersh AM, Naughton G, Mullins K, Fung MA, Sharon VR. Disseminated cutaneous sporotrichosis. Dermatol Online J. 2013;19:8.Google Scholar
  53. 53.
    Moreira J, Quintella LP, Carvalho M, Lamas CC, Lyra MR. Disseminated sporotrichosis as the initial presentation of AIDS. Clin Res HIV/AIDS. Forthcoming 2015.Google Scholar
  54. 54.
    Ministério da Saúde do Brasil, Secretária de Vigilância em Saúde 2013. Boletim Epidemiológico Aids e DST [in Portuguese]. Available from: Accessed 12 June 2014.
  55. 55.
    Lansky A, Brooks JT, di Nenno E, Heffelfinger J, Hall HI, Mermin J. Epidemiology of HIV in the United States. J Acquir Immune Defic Syndr. 2010;55:S64–8.CrossRefPubMedGoogle Scholar
  56. 56.
    Freitas DF, Valle AC, da Silva MB, Campos DP, Lyra MR, de Souza RV, et al. Sporotrichosis: an emerging neglected opportunistic infection in HIV-infected patients in Rio de Janeiro, Brazil. PLoS Negl Trop Dis. 2014;8:e3110.CrossRefPubMedCentralPubMedGoogle Scholar
  57. 57.
    Kauffman CA, Bustamante B, Chapman SW, Pappas PG. Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin Inf Dis. 2007;45:1255–65.CrossRefGoogle Scholar
  58. 58.
    Boulware DR, Meya DB, Muzoora C, Rolfes MA, Huppler Hullsiek K, Musubire A, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med. 2014;370:2487–98.CrossRefPubMedCentralPubMedGoogle Scholar
  59. 59.
    Torok ME, Yen NT, Chau TT, Mai NT, Phu NH, Mai PP, et al. Timing of initiation of antiretroviral therapy in human immunodeficiency virus (HIV)-associated tuberculous meningitis. Clin Infect Dis. 2011;52:1374–83.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Instituto Nacional de Infectologia Evandro ChagasFundação Oswaldo CruzRio de JaneiroBrazil
  2. 2.Instituto Nacional de CardiologiaRio de JaneiroBrazil
  3. 3.Unigranrio, Adjunct Professor of Infectious DiseasesRio de JaneiroBrazil

Personalised recommendations