PDF(Pubmed)
Abstract：
Generally, older people tend to suffer from more severe infections than younger adults. In addition, there are accumulations of comorbidities and immune senescence in some cases. This cohort study evaluated the clinical and epidemiological characteristics of older adults (≥60 years old) with sporotrichosis. The cohort consisted of 911 patients with a median age of 67 years, most of whom were female (72.6%), white (62.1%), and afflicted with comorbidities (64.5%). The lymphocutaneous form occurred in 62% of the patients, followed by the fixed form (25.7%), cutaneous disseminated form (8.9%), and extracutaneous/disseminated forms (3.3%). In this study, we draw attention to the frequency of osteoarticular involvement (2.1%) secondary to skin lesions such as osteomyelitis and/or tenosynovitis. A clinical cure was achieved in 87.3% of cases. Itraconazole was used in 81.1% of cases, while terbinafine was used in 22.7% of cases, usually in low doses. Survival analysis showed that the median treatment time was 119 days, and the multiple Cox model demonstrated that the presentation of a black coloration and diabetes was associated with a longer treatment time required to establish a cure. Therefore, these subgroups should be monitored more closely to reduce possible difficulties during treatment. It would be interesting to conduct more studies analyzing older adults with sporotrichosis from different geographic areas to better comprehend the disease in this group.
摘要：
一般来说,老年人往往比年轻人遭受更严重的感染。此外,在某些情况下，有合并症和免疫衰老的积累。这项队列研究评估了患有孢子丝菌病的老年人（≥60岁）的临床和流行病学特征。该队列由911名患者组成，中位年龄为67岁，其中大多数是女性(72.6%)，白色（62.1%），并患有合并症(64.5%)。62％的患者发生了淋巴皮肤形式，其次是固定形式(25.7%)，皮肤播散形式（8.9％），和皮外/播散形式(3.3%)。在这项研究中,我们提请注意皮肤病变如骨髓炎和/或腱鞘炎继发的骨关节受累的频率(2.1%).87.3%的病例实现了临床治愈。伊曲康唑用于81.1%的病例,而22.7%的病例使用了特比萘芬，通常是低剂量的。生存分析显示中位治疗时间为119天,多重Cox模型表明，黑色着色和糖尿病的表现与建立治愈所需的更长治疗时间有关。因此,应更密切地监测这些亚组,以减少治疗期间可能出现的困难.进行更多的研究分析来自不同地理区域的孢子丝菌病的老年人，以更好地理解该组中的疾病，这将是很有趣的。
