Sporotrichosis in Rio de Janeiro, Brazil: Sporothrix brasiliensis Is Associated with Atypical Clinical Presentations
Sporotrichosis in Rio de Janeiro, Brazil: Sporothrix brasiliensis Is Associated with Atypical Clinical Presentations
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DOI：
10.1371/journal.pntd.0003094
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发表时间：
2014-09-01
影响因子：
3.8
通讯作者：
Gutierrez-Galhardo, Maria Clara
中科院分区：
文献类型：
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作者：
Almeida-Paes, Rodrigo;Evangelista de Oliveira, Manoel Marques;Gutierrez-Galhardo, Maria Clara
背景：最近在申克孢子丝菌的分类上有了一些变化，在孢子菌病的临床方面也有了新的观察。在这项研究中，我们确定了在巴西巴西里约热内卢的孢子菌病流行区观察到的与孢子菌病的典型和不寻常临床方面相关的孢子菌种类的鉴定。方法/主要发现：为验证巴西芽孢杆菌是否与孢子丝菌病的临床表现相关，采用横断面研究方法，对50例临床表现不同的患者分离的孢子丝菌进行分析，并对分离的孢子丝菌进行表型和基因型分析。来自这些患者的数据显示，与严格意义的申氏孢子丝菌（n = 5）患者相比，巴西孢子丝菌（n = 45）引起的感染有明显的临床表现和治疗反应。巴西孢子虫与无基础疾病的弥散性皮肤感染、超敏反应和粘膜感染相关，而申克孢子虫患者表现为较轻且更常见的局部疾病，与先前描述的大多数孢子虫病病例相似。有趣的是，与申克沙门氏菌感染患者（中位24周）相比，巴西孢子虫感染患者总体上需要更短的伊曲康唑持续时间（中位16周）。结论/意义：这些发现提示孢子菌种类与孢子菌病的不同临床表现有关，口服伊曲康唑治疗巴西孢子菌是有效的。
Background: There have been several recent changes in the taxonomy of Sporothrix schenckii as well as new observations regarding the clinical aspects of sporotrichosis. In this study, we determined the identification of the Sporothrix species associated with both classic and unusual clinical aspects of sporotrichosis observed in the endemic area of sporotrichosis in Rio de Janeiro, Brazil.Methodology/Principal Findings: To verify whether S. brasiliensis is associated with clinical manifestations of sporotrichosis, a cross-sectional study was performed in which Sporothrix isolates from 50 patients with different clinical manifestations were analyzed and their isolates were studied by phenotypic and genotypic methods. Data from these patients revealed a distinct clinical picture and therapeutic response in infections caused by Sporothrix brasiliensis (n = 45) compared to patients with S. schenckii sensu stricto (n = 5). S. brasiliensis was associated with disseminated cutaneous infection without underlying disease, hypersensitivity reactions, and mucosal infection, whereas patients with S. schenckii presented with less severe and more often localized disease, similar to the majority of previously described sporotrichosis cases. Interestingly, S. brasiliensis-infected patients overall required shorter durations of itraconazole (median 16 weeks) compared to the individuals with S. schenckii (median 24 weeks).Conclusions/Significance: These findings suggest that Sporothrix species are linked to different clinical manifestations of sporotrichosis and that S. brasiliensis is effectively treated with oral itraconazole.