PDF(Pubmed)
Abstract：
Zoonotic sporotrichosis, a subcutaneous mycosis caused by Sporothrix brasiliensis, 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.
摘要：
人畜共患病孢子丝菌病,由巴西孢子丝菌引起的皮下真菌病，在巴西已成为高流行病和严重的公共卫生问题，并在世界范围内成为新兴疾病。典型的孢子丝菌病定义为固定或淋巴皮肤病变发展。然而,非典型表现的报告已经在高流行地区进行了描述，这可能会导致更差的预后。因此，考虑到巴西报告的非典型病例和更严重的皮肤外病例和住院治疗的增加，我们旨在进行系统评价,以寻找与人畜共患孢子丝菌病相关的超敏反应(HRs)和皮外表现.进行了系统审查，遵循PRISMA指南寻找非典型/皮肤外病例(粘膜，骨关节炎,HR,肺,脑膜）人畜共患孢子丝菌病。审查了巴西11个州26年（1998-2023年）的791例已发表病例。大多数病例对应于HR(47%；n=370)，其次是粘膜（32％；n=256），多焦点(8%；n=60)，骨关节炎（7%；n=59），脑膜（4%；n=32），和肺部（2％；n=14）感染。可用时（n=607），结果为7%(n=43)的病例死亡.这里,我们显示了巴西人畜共患孢子丝菌病的频繁和令人担忧的情况，在整个巴西领土上，非典型/皮肤外病例的发病率高且分散。因此,教育措施是必要的，以使卫生专业人员和整个人口意识到这种真菌病原体在巴西以及在美洲其他国家。
