Search Results (15)

Sporotrichosis, the most common implantation mycosis worldwide, is caused by dimorphic fungi of several species of the genus Sporothrix. Sporothrix brasiliensis, the most virulent species, has emerged in Latin America as an epi-zoonotic pathogen linked to domestic cats, dogs and humans. This report describes a confirmed human case of lymphocutaneous sporotrichosis caused by S. brasiliensis in Chile, associated with feline exposure in a veterinarian. Diagnosis was supported by morphological and molecular analyses of the internal transcribed spacer (ITS) and β-tubulin gene. The patient responded favorably to itraconazole therapy. This case highlights the growing relevance of S. brasiliensis in Chile and reinforces the need for integrated One Health surveillance strategies. Full article

Sporothrix schenckii is a thermodimorphic fungus and one of the main etiological agents of sporotrichosis, a globally distributed subcutaneous mycosis that primarily affects the skin, subcutaneous tissue, and lymphatic system. Historically regarded as the classical species within the Sporothrix pathogenic clade, S. schenckii remains a clinically relevant pathogen and an important biological model for studying fungal dimorphism, virulence, and host–pathogen interactions. Major virulence factors include melanin production, thermotolerance, hydrolytic enzymes, and adhesins, all of which contribute to its survival and dissemination within the host. Clinically, S. schenckii causes a broad spectrum of manifestations ranging from fixed and lymphocutaneous cutaneous forms to disseminated and extracutaneous infections, particularly in immunocompromised individuals. This species exhibits a cosmopolitan distribution with endemic foci in the Americas, Asia, and Africa, and can be transmitted through both sapronotic and zoonotic routes. Diagnosis relies on fungal isolation, molecular identification, and histopathological examination, whereas treatment mainly involves itraconazole, potassium iodide, and amphotericin B for severe cases. This review integrates current knowledge on the biology, virulence, immune response, epidemiology, and treatment of S. schenckii, providing an updated overview of its significance as a medically important fungal pathogen with global relevance. Full article

Sporotrichosis is a globally distributed mycosis caused by thermally dimorphic fungi of the Sporothrix schenckii species complex. In Brazil, sporotrichosis is considered endemic and is usually acquired through zoonotic transmission from infected cats. The clinical manifestations may be cutaneous, lymphocutaneous, or systemic, the latter being more commonly observed in immunosuppressed patients. The limited effectiveness of antifungal treatments against this mycosis, particularly in immunocompromised individuals, has led to the search for more effective and safer therapies. Based on several studies demonstrating the efficient use of dendritic cells as tools for the development of antifungal vaccines, this work aimed to evaluate the protective capacity of bone marrow-derived dendritic cells (BMDCs) activated with cell wall proteins of S. schenckii (SsCWP) in mice infected with S. schenckii sensu stricto. BMDCs were stimulated with SsCWP and analyzed for the surface expression of costimulatory molecules as well as proinflammatory cytokine secretion. Subsequently, mice were vaccinated once or twice to assess immunogenicity, and finally, the therapeutic effect of BMDCs on S. schenckii infection was evaluated. Our results show that SsCWP was able to activate BMDCs. Immunization of healthy mice with SsCWP-stimulated BMDCs induced a balanced Th1/Th17-based immune response. Vaccination of mice previously infected with S. schenckii induced a mixed Th1/Th17 response and reduced fungal burden in the spleen. Overall, these findings demonstrate that therapeutic vaccination with SsCWP-stimulated BMDCs improves fungal control, supporting the notion that dendritic cells represent a promising therapeutic strategy against sporotrichosis. Full article

This case report detailed a rare co-infection of Pseudomonas asiatica and Enterobacter hormaechei in a 9-year-old warmblood mare, leading to severe cellulitis and secondary lymphangitis following traditional hoof blood-letting therapy. The mare exhibited acute limb swelling, fever, cutaneous ulceration, lymphatic dysfunction and unknown anemia. Comprehensive diagnostics, including bacterial culture, whole-genome sequencing, anti-elastin antibody (AEAb) ELISA, and diagnostic imaging, confirmed the pathogens causing cellulitis and secondary lymphangitis. AEAb levels were elevated, correlating with lymphatic degradation, while radiography and lymphangiography ruled out laminitis but identified tortuous lymphatic vessels. The treatment integrated systemic antimicrobials, anti-inflammatory therapy, combined decongestive therapy, and traditional Chinese herbal medicine, resulting in resolution of infection, improved hematological parameters, and restored athletic performance. The therapeutic regimen primarily included gentamicin, enrofloxacin, oxytetracycline, and the Wei Qi Booster. The case highlights the critical role of pathogen-directed antimicrobial selection and the potential benefits of combining conventional and holistic therapies. This report emphasizes the necessity of early, multifaceted interventions to prevent life-threatening complications in equine cellulitis–lymphangitis cases. Full article

Cutaneous nocardiosis is an uncommon bacterial infection caused by Nocardia spp.; Nocardia brasiliensis is the agent involved in most cases. This infection is acquired through the direct traumatic inoculation of soil, plants, or other substrates where the bacteria are found. Clinically, it usually manifests as an erythematous ulcerated nodule. In one-third of cases, nodules or gummas are distributed over the lymphatic pathways that resemble lymphocutaneous sporotrichosis. Its manifestations vary and can present acutely or more frequently with a latent clinical picture over time. Diagnosis is established mainly by Gram staining, biopsy, exudate culture, and molecular biology. Nocardia infections can recur, implying that antimicrobial therapy must be prolonged (between 6 and 12 months) and involve monitoring patients for at least 6 months after the end of treatment. Early diagnosis and targeted treatment may reduce patient mortality rates. We report the case of an 82-year-old woman who presented with four nodules with a lymphangitic spread on her left hand and forearm, one week after the trauma. Molecular identification was performed using 16S rDNA gene sequencing, and Nocardia brasiliensis was identified. Full article

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. Full article

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. Full article

Sporothrix brasiliensis is the main agent of zoonotic sporotrichosis transmitted by domestic cats in South America. In humans, sporotrichosis commonly presents with cutaneous or lymphocutaneous lesions, and in cats, with multiple ulcerated skin lesions associated with enlarged lymph nodes and respiratory signs. Fungal virulence factors may affect the clinical presentation of the mycoses. Sporothrix spp. present some virulence factors. This study aims to compare 24 S. brasiliensis strains from 12 familiar outbreaks of cat-to-human transmitted sporotrichosis. Fungal growth in different substrates, thermotolerance, resistance to oxidative stress, and production of enzymes were evaluated. An invertebrate model of experimental infection was used to compare the virulence of the strains. The strains grew well on glucose and N-acetyl-D-glucosamine but poorly on lactate. Their thermotolerance was moderate to high. All strains were susceptible to hydrogen peroxide, and the majority produced hemolysins but not phospholipase and esterase. There was no significant difference in the putative virulence-associated factors studied among the different hosts. Moreover, strains isolated from a human and a cat from four familiar outbreaks presented a very similar profile of expression of these factors, reinforcing the zoonotic transmission of S. brasiliensis in Brazil and demonstrating the plasticity of this species in the production of virulence factors. Full article

Background: Sporotrichosis is a subacute or chronic mycosis caused by a dimorphic fungus of the genus Sporothrix. Zoonotic-transmitted sporotrichosis has become a major public health concern and is characterised by a different clinical pattern from the traditional epidemiology of sporotrichosis. Case presentation: We present the details of four patients with mucosal sporotrichosis with regional lymphadenopathy (three cases of granulomatous conjunctivitis and one case of nasal sporotrichosis). The patients’ age range was between 23 to 46 years old and their gender was three female and one male patient. All four patients shared the same ethnicity, Malay, and they had a common history of owning domestic cats as pets. Sporothrix schenckii were isolated from all the culture samples and its antifungal susceptibility patterns were compared in the mycelial and yeast phases. All four patients recovered with oral itraconazole treatment, but the treatment duration was variable among patients. Conclusions: People who have a history of contact with domestic cats should be aware of the possibility of sporotrichosis infection. It can present in cutaneous, lymphocutaneous, disseminated, or systemic forms. Early treatment and the prevention of disease progression are more beneficial to patients. The published data concludes that antifungal treatment is highly efficacious, although the reported treatment duration is variable. Full article

Cutaneous nocardiosis is a rare bacterial infection that can result in various dermatologic manifestations such as actinomycetoma, lymphocutaneous infection, superficial skin infection, and secondary infection due to hematogenous dissemination. We report on a Chinese patient with erythema nodosum-like exanthema, possibly secondary to nocardiosis. Our diagnosis for this patient was based on the clinical presentation, histopathological evidence, and microbiological findings. Given the protean manifestation of Nocardia, persistent reports on new presentations of the disease are important for early identification and treatment. Full article

Background: Sporotrichosis is a fungal infection caused by species of the Sporothrix genus. Presently, the prevalence of sporotrichosis in the Americas is unknown, so this study aims to analyze the cases reported in the past 10 years. Methods: An advanced search was conducted from 2012 to 2022 in English and Spanish in PUBMED, SciELO, and Cochrane, with the terms: “sporotrichosis”, “lymphocutaneous sporotrichosis”, “fixed sporotrichosis”, “mycosis”, “Sporothrix spp.”, “Sporothrix complex”, “S. schenckii sensu stricto”, “S. schenckii sensu lato”, “S. globose”, “S. brasiliensis”, “S. luriei”. Sporotrichosis is a fungal infection caused by species of the Sporothrix genus associated with “pathogenicity” or “epidemiology”. Results: A total of 124 articles were found in the Americas, corresponding to 12,568 patients. Of these, 87.38% of cases were reported in South America, 11.62% in North America, and 1.00% in Central America and the Caribbean. Brazil, Peru, and Mexico had the highest number of cases. The most prevalent etiological agents were S. schenckii complex/Sporothrix spp. (52.91%), S. schenckii (42.38%), others (4.68%), and Not Determined (ND) (0.03%). The most frequent form of the disease was lymphocutaneous infection; however, the infection type was not determined in 5639 cases. Among the diagnostic methods, culture was the most used. Conclusions: There is a high occurrence of cases reported in the literature. South America is the region with the highest number of reports because of its environment (climate, inhalation of spores, etc.), zoonotic transmission (scratches and sneezes from contaminated animals), and possible traumatic inoculation due to outdoor activities (agriculture, gardening, and related occupations). Molecular diagnosis has not been sufficiently developed due to its high cost. Full article

Nocardia spp. is a Gram-positive, partially acid-fast aerobic bacterium usually associated with infection in immunocompromised people. The most common sites of infection are the skin, lungs, and the brain, however disease can disseminate and affect every organ. Clinical manifestations of cutaneous disease are varied and frequently misdiagnosed. We present a case of an immunocompetent 66-year-old man who sustained a left finger injury while gardening. He was misdiagnosed on several occasions and treated with inappropriate antibiotics against Streptococcus spp. and Staphylococcus spp. When infection spread cutaneously, sporotrichoid (lymphocutaneous) nocardiosis was suspected and the patient was started on appropriate therapy with Bactrim which resulted in a cure. We also summarize the literature on lymphocutaneous infection by Nocardia brasiliensis. By reporting this case, we want to raise awareness among clinicians about unusual causes of cellulitis, the differential diagnosis of lymphocutaneous infection and the importance of obtaining a detailed exposure history to assist in the prompt diagnosis of nocardiosis. Full article

Sporotrichosis is a subacute/chronic mycosis caused by dimorphic fungus of the genus Sporothrix. This mycosis may affect both human and domestic animals and in the last few years, the geographic dispersion and increase of sporotrichosis worldwide has been observed. The occurrence of cases related to scratching/bites of domestic felines have increased, characterizing the disease as predominantly a zoonosis. In humans, sporotrichosis mainly involves the cutaneous tegument of infected patients, but other tissues may also present the infection. The main forms of clinical presentation are lymphocutanous sporotrichosis (LC) and fixed sporotrichosis (F). Although less common, mucosal, cutaneous disseminated, and extracutaneous forms have also been described. Multiple factors from the fungus and host can play a role in driving the clinical evolution of sporotrichosis to benign or severe disease. In this review, we discuss the immunopathological aspects involved in human sporotrichosis. Putting together the two branches of knowledge—host immune response and fungal evading mechanisms—we may perceive new possibilities in understanding the fungus–host interaction in order to be in a position to go further in the control of sporotrichosis. Full article

Prompt and accurate diagnosis of Nocardia skin infections is important in immunocompromised hosts, especially transplant patients. The sporotrichoid form, which is otherwise known as the lymphocutaneous form of Nocardia skin involvement, can mimic other conditions, including those caused by fungi, mycobacteria, spirochetes, parasites and other bacteria. Delayed or inaccurate diagnosis and treatment of Nocardia skin infections in transplant patients could lead to dissemination of disease and other poor outcomes. Nocardia brasiliensis is a rare cause of lymphocutaneous nocardiosis in solid organ transplant patients with only two other cases reported to our knowledge. This case describes a middle-aged man, who presented 16 years post kidney transplant. He developed a sporotrichoid lesion on his upper extremity one week after gardening. Ultrasound showed a 35-cm abscess tract on his forearm, which was subsequently drained. Nocardia brasiliensis was isolated from pus culture and he was treated successfully with amoxicillin/clavulanate for 6 months. A review of the relevant literature is included. Full article

Nodular lymphangitis, also known as sporotrichoid lymphocutaneous infections, is characterized by suppurative inflammatory nodules along the lymphatic vessels. This manifestation is classic of sporotrichosis, however, other infections such as nocardiosis, atypical mycobacteriosis, leishmaniasis, among others, can also express this clinical pattern. Sporotrichosis, which often occurs in gardeners, remains the most recognized cause of nodular lymphangitis. The histopathological studies, as well as the culture are diagnostic standards of lesions that do not respond to empirical treatment. In this article, we will review the main causes of nodular lymphangitis or lymphocutaneous sporotrichoid infections. Full article