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A neglected disease. Human sporotrichosis in a densely populated urban area in São Paulo, Brazil: clinical–epidemiological and therapeutic aspects

  • Clinical Microbiology - Research Paper
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Abstract

Human sporotrichosis is caused by different Sporothrix species; however, Sporothrix brasiliensis is the main species, usually related to cat transmission in urban areas. A retrospective descriptive study was conducted at the Institute of Infectology Emílio Ribas from 2010 to 2018. Demography, clinical, diagnostic, and therapeutic data were obtained from medical records. Polymerase chain reaction of the calmodulin gene was performed to identify Sporothrix species. In addition, to evaluate the spread of the disease across São Paulo metropolitan region, TerraView version 4.2.2 software was used for geocoding cases according to residence addresses. Kernell’s maps using QGIS software version 2.16.3 were constructed to determine the concentration of cases. Results: 260 cases of sporotrichosis were diagnosed between 2010 and 2018. We observed a 700% increment in the number of human cases in the 2016–2018 triennium compared with the 2013–2015 triennium. Female adults with a median age of 46 years old were the predominant infected group associated with cats’ exposition at home care, although the age range of all patients was 01 to 86 years old. The main epidemiological risk of acquiring sporotrichosis was contact with cats, reported by 96.5% of the patients. Molecular identification showed that most of the tested isolates were Sporothrix brasiliensis. Lymphocutaneous form was observed in 59.2% and fixed cutaneous form in 37.5% of the patients. Regarding treatment, itraconazole was the main drug used (94.2%) with a cure rate of 98.8%. We observed an important spread of human sporotrichosis involving cat transmission caused by Sporothrix brasiliensis in a densely populated area of São Paulo state. These results are important to alert clinicians and dermatologists about the occurrence and progression of a neglected tropical disease in an urban area and the urgent necessity to include sporotrichosis as a differential diagnosis in the clinical investigation routine.

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Article Open access 30 October 2020

Conchita Toriello, Carolina Brunner-Mendoza, … María del Rocío Reyes-Montes

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References

  1. Orofino-Costa R, Macedo PM, Rodrigues AM, Bernardes-Engemann AR (2017) Sporotrichosis: an update on epidemiology, etiopathogenesis, laboratory and clinical therapeutics. An Bras Dermatol 92(5):606–20. https://doi.org/10.1590/abd1806-4841.2017279

    Article  PubMed  PubMed Central  Google Scholar 

  2. de Beer ZW, Duong TA, Wingfield MJ (2016) The divorce of Sporothrix and Ophiostoma: solution to a problematic relationship. Stud Mycol 83:165–191. https://doi.org/10.1016/j.simyco.2016.07.001

    Article  PubMed  PubMed Central  Google Scholar 

  3. Marimon R, Cano J, Gené J, Sutton DA, Kawasaki M, Guarro J (2007) Sporothrix brasiliensis, S. globosa, and S. mexicana, three new Sporothrix species of clinical interest. J Clin Microbiol 45(10):3198–206. https://doi.org/10.1128/JCM.00808-07

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Zhang Y, Hagen F, Stielow B et al (2015) Phylogeography and evolutionary patterns in Sporothrix spanning more than 14 000 human and animal case reports. Persoonia 35:1–20. https://doi.org/10.3767/003158515X687416

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gremião ID, Miranda LH, Reis EG, Rodrigues AM, Pereira AS (2017) Zoonotic Epidemic of Sporotrichosis: Cat to Human Transmission. PLoS Pathog 13(1). https://doi.org/10.1371/journal.ppat.1006077

  6. Tang MM, Tang JJ, Gill P, Chang CC, Baba R (2012) Cutaneous sporotrichosis: a six-year review of 19 cases in a tertiary referral center in Malaysia. Int J Dermatol 51(6):702–708. https://doi.org/10.1111/j.1365-4632.2011.05229.x

    Article  PubMed  Google Scholar 

  7. Han HS, Kano R (2021) Feline sporotrichosis in Asia. Braz J Microbiol 52(1):125–134. https://doi.org/10.1007/s42770-020-00274-5

    Article  PubMed  Google Scholar 

  8. Siew HH (2017) The Current Status of Feline Sporotrichosis in Malaysia. Med Mycol J 58(3):E107–E113. https://doi.org/10.3314/mmj.17.014

    Article  PubMed  Google Scholar 

  9. Poester VR, Mattei AS, Madrid IM et al (2018) Sporotrichosis in Southern Brazil, towards an epidemic? Zoonoses Public Health 65(7):815–821. https://doi.org/10.1111/zph.12504

    Article  PubMed  Google Scholar 

  10. Macêdo-Sales PA, Souto SRLS, Destefani CA, Lucena RP, Machado RLD, Pinto MR, Rodrigues AM, Lopes-Bezerra LM, Rocha EMS, Baptista ARS (2018) Domestic feline contribution in the transmission of Sporothrix in Rio de Janeiro State, Brazil: a comparison between infected and non-infected populations. BMC Vet Res. Jan 18;14(1):19. https://doi.org/10.1186/s12917-018-1340-4

  11. Lecca LO, Paiva MT, de Oliveira CSF, et al (2020) Associated factors and spatial patterns of the epidemic sporotrichosis in a high density human populated area: A cross-sectional study from 2016 to 2018. Prev Vet Med 176 https://doi.org/10.1016/j.prevetmed.2020.104939

  12. Gremião IDF, Rocha EMS, Montenegro H, Carneiro AJB et al (2021) Guideline for the management of feline sporotrichosis caused by Sporothrix brasiliensis and literature revision. Braz J Microbiol 52(1):107–124. https://doi.org/10.1007/s42770-020-00365-3

    Article  PubMed  Google Scholar 

  13. Cruz ILR, Freitas DFS, de Macedo PM, Gutierrez-Galhardo MC, do Valle ACF, Almeida MA, Coelho RA, Brito-Santos F, Figueiredo-Carvalho MHG, Zancopé-Oliveira RM, Almeida-Paes R (2021) Evolution of virulence-related phenotypes of Sporothrix brasiliensis isolates from patients with chronic sporotrichosis and acquired immunodeficiency syndrome. Braz J Microbiol 52(1):5–18. https://doi.org/10.1007/s42770-020-00297-y

    Article  CAS  PubMed  Google Scholar 

  14. Cruz-Choappa R, Pérez Gaete S, Rodríguez Badilla V, VieilleOyarzo P, Opazo Sanchez H (2016) Virulencia de Sporothrix globosa en modelos murinos [Virulence of Sporothrix globosa in murine models]. Rev Argent Microbiol. 48(3):196–199. https://doi.org/10.1016/j.ram.2016.04.007 (Spanish)

    Article  PubMed  Google Scholar 

  15. Fernandes GF, dos Santos PO, Rodrigues AM, Sasaki AA, Burger E, de Camargo ZP (2013) Characterization of virulence profile, protein secretion and immunogenicity of different Sporothrix schenckii sensu stricto isolates compared with S. globosa and S. brasiliensis species. Virulence 4(3):241–9. https://doi.org/10.4161/viru.23112

    Article  PubMed  PubMed Central  Google Scholar 

  16. Castro RA, Kubitschek-Barreira PH, Teixeira PA, Sanches GF, Teixeira MM, Quintella LP, Almeida SR, Costa RO, Camargo ZP, Felipe MS, de Souza W, Lopes-Bezerra LM (2013) Differences in cell morphometry, cell wall topography and gp70 expression correlate with the virulence of Sporothrix brasiliensis clinical isolates. PLoS One 8(10):e75656. https://doi.org/10.1371/journal.pone.0075656

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Falcão EMM, de Lima Filho JB, Campos DP, et al (2019) Hospitalizations and deaths related to sporotrichosis in Brazil (1992–2015). Cad Saude Publica; 35(4). https://doi.org/10.1590/0102-311X00109218

  18. Mialski R, de Almeida JN, da Silva LH, et al (2018) Chronic Meningitis and Hydrocephalus due to Sporothrix brasiliensis in Immunocompetent Adults: A Challenging Entity. Open Forum Infect Dis 5(5). https://doi.org/10.1093/ofid/ofy081

  19. Almeida-Paes R, de Oliveira MM, Freitas DF, do Valle AC, Zancopé-Oliveira RM, Gutierrez-Galhardo MC (2014) Sporotrichosis in Rio de Janeiro, Brazil: Sporothrix brasiliensis is associated with atypical clinical presentations. PLoS Negl Trop Dis 8(9). https://doi.org/10.1371/journal.pntd.0003094

  20. Silva-Vergara ML, de Camargo ZP, Silva PF et al (2012) Disseminated Sporothrix brasiliensis infection with endocardial and ocular involvement in an HIV-infected patient. Am J Trop Med Hyg 86(3):477–480. https://doi.org/10.4269/ajtmh.2012.11-0441

    Article  PubMed  PubMed Central  Google Scholar 

  21. Gremião IDF, Oliveira MME, Monteiro de Miranda LH, Saraiva Freitas DF, Pereira AS (2020) Geographic Expansion of Sporotrichosis. Brazil Emerg Infect Dis 26(3):621–624. https://doi.org/10.3201/eid2603.190803

    Article  PubMed  Google Scholar 

  22. Eudes Filho J, Santos IBD, Reis CMS et al (2020) A novel Sporothrix brasiliensis genomic variant in Midwestern Brazil: evidence for an older and wider sporotrichosis epidemic. Emerg Microbes Infect 9(1):2515–2525. https://doi.org/10.1080/22221751.2020.1847001

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Caus ALO, Zanotti RL, Faccini-Martínez ÁA, Paterlini GV, Falqueto A (2019) Epidemiological and Clinical Aspects of Sporotrichosis in Espírito Santo State, Southeast Brazil: A Study of Three Decades (1982–2012). Am J Trop Med Hyg 100(3):706–713. https://doi.org/10.4269/ajtmh.18-0667

    Article  PubMed  Google Scholar 

  24. Benvegnú AM, Dallazzem LND, Chemello RML, Beber AAC, Chemello D (2020) Case series of sporotrichosis at a teaching hospital in Brazil. Rev Soc Bras Med Trop 53:e20190509. https://doi.org/10.1590/0037-8682-0509-2019

    Article  PubMed  PubMed Central  Google Scholar 

  25. Grisolia JC, Santos LA, Coelho LML, Silva RR, de Camargo ZP, Velloso TRG, Coelho LFL, Chavasco JK, Malaquias LCC (2021) Seroepidemiological survey on sporotrichosis-infection in rural areas of the south of Minas Gerais State, Brazil. Braz J Microbiol 52(1):41–47. https://doi.org/10.1007/s42770-020-00279-0

    Article  CAS  PubMed  Google Scholar 

  26. Rossow JA, Queiroz-Telles F, Caceres DH et al (2020) A One Health Approach to Combatting Sporothrix brasiliensis Narrative Review of an Emerging Zoonotic Fungal Pathogen in South America. J Fungi (Basel) 6(4):247. https://doi.org/10.3390/jof6040247

    Article  CAS  Google Scholar 

  27. Silva EA, Bernardi F, Mendes MCNC, et al. (2015) Surto de esporotricose em gatos – investigação e ações de controle, município de São Paulo/SP. Vol. 113. Boletim Epidemiológico Paulista, 1–16 (article in Portuguese)

  28. Montenegro H, Rodrigues AM, Dias MA, da Silva EA, Bernardi F, de Camargo ZP (2014) Feline sporotrichosis due to Sporothrix brasiliensis: an emerging animal infection in São Paulo. Brazil BMC Vet Res 10:269. https://doi.org/10.1186/s12917-014-0269-5

    Article  PubMed  Google Scholar 

  29. Rodrigues AM, Najafzadeh MJ, de Hoog GS, de Camargo Z (2015) Rapid Identification of Emerging Human-Pathogenic Sporothrix Species with Rolling Circle Amplification. Front Microbiol 6:1385. https://doi.org/10.3389/fmicb.2015.01385

    Article  PubMed  PubMed Central  Google Scholar 

  30. Lopes-Bezerra LM, Mora-Montes HM, Zhang Y et al (2018) Sporotrichosis between 1898 and 2017: The evolution of knowledge on a changeable disease and on emerging etiological agents. Med Mycol 56:126–143. https://doi.org/10.1093/mmy/myx103

    Article  CAS  PubMed  Google Scholar 

  31. Marques GF, Martins AL, Sousa JM, Brandão LS, Wachholz PA, Masuda PY (2015) Characterization of sporotrichosis cases treated in a dermatologic teaching unit in the state of São Paulo - Brazil, 2003–2013. An Bras Dermatol 90(2):273–275. https://doi.org/10.1590/abd1806-4841.20153447

    Article  PubMed  PubMed Central  Google Scholar 

  32. Marques SA, Franco SR, de Camargo RM, Dias LD, Haddad Júnior V, Fabris VE (1993) Sporotrichosis of the domestic cat (Felis catus): human transmission. Rev Inst Med Trop Sao Paulo 35(4):327–30 ((article in Portuguese))

    Article  CAS  Google Scholar 

  33. Barros MB, Schubach AO, do Valle AC et al (2004) Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases. Clin Infect Dis 38(4):529–535. https://doi.org/10.1086/381200

    Article  PubMed  Google Scholar 

  34. Schubach A, Schubach TM, Barros MB, Wanke B (2005) Cat-transmitted sporotrichosis, Rio de Janeiro. Brazil Emerg Infect Dis 11(12):1952–1954. https://doi.org/10.3201/eid1112.040891

    Article  PubMed  Google Scholar 

  35. Silva MB, Costa MM, Torres CC et al (2012) Urban sporotrichosis: a neglected epidemic in Rio de Janeiro, Brazil. Cad Saude Publica 28(10):1867–80 ((article in Portuguese))

    Article  Google Scholar 

  36. Brandolt TM, Madrid IM, Poester VR et al (2018) Human sporotrichosis: A zoonotic outbreak in southern Brazil, 2012–2017. Med Mycol. https://doi.org/10.1093/mmy/myy082

    Article  PubMed  Google Scholar 

  37. Veasey JV, Neto MFN, Ruiz LRB, Zaitz C (2021) Clinical and laboratory profile of urban sporotrichosis in a tertiary hospital in the city of São Paulo. An Bras Dermatol 96(2):245–248. https://doi.org/10.1016/j.abd.2020.07.010

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ramos-e-Silva M, Vasconcelos C, Carneiro S, Cestari T (2007) Sporotrichosis. Clin Dermatol 25(2):181–187. https://doi.org/10.1016/j.clindermatol.2006.05.006

    Article  PubMed  Google Scholar 

  39. Mahajan VK (2014) Sporotrichosis: an overview and therapeutic options. Dermatol Res Pract. https://doi.org/10.1155/2014/272376

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Instituto de Infectologia Emílio Ribas, São Paulo, Brazil

    Amanda Azevedo Bittencourt, Luiza Keiko Matsuka Oyafuso, Roberta Figueiredo Cavalin, Renata Bacic Palhares, Renata Buccheri & José Angelo Lauletta Lindoso

  2. Departamento de Dermatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Gil Benard

  3. Laboratório de Micologia (LIM-53-HC-FMUSP), Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Gil Benard, Viviane Mazo Fávero Gimenes, Gilda Maria Barbaro Del Negro, Lumena Pereira Machado Siqueira & Roseli Santos de Freitas Xavier

  4. Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil

    Leila M. Lopes-Bezerra

  5. Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Enéas de Carvalho Aguiar, 450, Cerqueira Cesar, São Paulo, SP, CEP 05403-000, Brazil

    José Angelo Lauletta Lindoso

  6. Laboratório de Protozoologia (LIM-49-HC-FMUSP), Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    José Angelo Lauletta Lindoso

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  1. Amanda Azevedo Bittencourt
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  2. Luiza Keiko Matsuka Oyafuso
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Contributions

AAB contributed with conception, design, data collection and writing. LKMO contributed with data collection and patient assessment. RFC contributed with geocoding of human cases and epidemiological data. RNP contributed with histopathological analysis. GB, LMLB, and RB contributed with writing and review. VMFG, GMBDN, LPMS, and RSFX contributed with microbiology and molecular biology tests. JALL contributed with conception, design, data collection, writing and review.

All authors read and approved the final and reviewed the manuscript.

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Correspondence to José Angelo Lauletta Lindoso.

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Ethics approval

The Research Ethics Committee of the Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, approved this study under the protocol number 36/2018.

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The informed consent form was applied to the participant and, when the subject was not available, the consent was waived, and a researcher responsibility and confidentiality term were used for all cases.

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Bittencourt, A.A., Oyafuso, L.K.M., Cavalin, R.F. et al. A neglected disease. Human sporotrichosis in a densely populated urban area in São Paulo, Brazil: clinical–epidemiological and therapeutic aspects. Braz J Microbiol 53, 739–748 (2022). https://doi.org/10.1007/s42770-022-00713-5

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