RESUMEN
Sporotrichosis in immunocompromised patients has a high morbidity and may cause deaths. Particularly, patients with acquired immunodeficiency syndrome (AIDS) with low T CD4 counts develop a chronic disease, with severe and widespread forms. Recently, the ability of Sporothrix brasiliensis, the main agent of zoonotic sporotrichosis, to increase its virulence in a diabetic patient without HIV infection was described. Since it was a unique finding, it is not known how often this occurs in patients with chronic and refractory sporotrichosis. The aim of this study is to compare sequential Sporothrix isolates obtained from patients with sporotrichosis and AIDS in order to detect changes in virulence-related phenotypes and acquisition of antifungal resistance during the evolution of the disease. Fungal growth in different substrates, antifungal susceptibility, thermotolerance, resistance to oxidative stress, and production of hydrolytic enzymes were evaluated. Correlations were assessed between clinical and phenotypic variables. Sixteen isolates, all identified as S. brasiliensis, obtained from five patients were studied. They grew well on glucose and N-acetyl-D-glucosamine, but poorly on lactate. Except from isolates collected from two patients, which were non-wild type for terbinafine, they were considered wild type for the antifungal drugs tested. Thermotolerance of the isolates was moderate to high. Except for phytase and phospholipase, isolates were able to produce virulence-related enzymes on different levels. Changes in all studied phenotypes were observed during the course of the disease in some patients. The results show that the HIV-driven immunosuppression is more relevant than fungal phenotypes on the unfavorable outcomes of disseminated sporotrichosis.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Sporothrix/patogenicidad , Esporotricosis/microbiología , Acetilglucosamina/metabolismo , Adulto , Animales , Antifúngicos/farmacología , Evolución Biológica , Farmacorresistencia Fúngica , Femenino , Glucosa/metabolismo , Humanos , Ácido Láctico/metabolismo , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Fenotipo , Sporothrix/efectos de los fármacos , Sporothrix/genética , Sporothrix/metabolismo , Esporotricosis/etiología , Virulencia/efectos de los fármacos , Adulto JovenAsunto(s)
Factores Inmunológicos/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Esclerosis Múltiple/microbiología , Natalizumab/uso terapéutico , Esporotricosis/etiología , Humanos , Factores Inmunológicos/efectos adversos , Masculino , Persona de Mediana Edad , Natalizumab/efectos adversosRESUMEN
Brazil has experienced geographic expansion of zoonotic sporotrichosis. Social problems in the country contribute substantially to the expansion. A comprehensive sporotrichosis control program is beyond the sphere of public health. A One Health approach is needed to control the disease in animals and humans.
Asunto(s)
Brotes de Enfermedades , Esporotricosis/epidemiología , Bienestar del Animal , Animales , Brasil/epidemiología , Gatos , Humanos , Sporothrix/aislamiento & purificación , Esporotricosis/etiología , ZoonosisRESUMEN
A esporotricose é uma micose subcutânea de distribuição mundial, sendo observada em surtos de proporções variáveis, com predominância em áreas de clima temperado e tropical. Algumas áreas de endemicidade já foram relatadas. No Brasil, seus agentes etiológicos encontraram não só condições climáticas e estruturais ideais, mas também fontes de infecções extremamente eficientes. Nas últimas décadas, o país tem observado um aumento exponencial no número de casos de esporotricose humana e animal. Esse aumento e o surgimento de resistência aos antifúngicos tornam a situação alarmante. Apesar de essa epidemia se perpetuar há anos, existem poucas políticas de saúde no Brasil para o controle dos casos de esporotricose humana e animal, principalmente na atenção primária à saúde. Assim, intervenções sociais, ambientais e populacionais devem ser feitas para conter essa epidemia negligenciada.
Sporotrichosis is a subcutaneous mycosis with a worldwide distribution, which has been observed in outbreaks of variable proportions in all continents, with predominance in temperate and tropical climate zones. Some areas of endemicity have already been reported. In Brazil, its etiological agents found not only ideal climatic and structural conditions, but also extremely efficient sources of infections. In the last decades, the country has suffered an exponential increase in the number of human and animal cases of sporotrichosis. This increase, combined with the emergence of antifungal resistance makes the situation alarming. Although this epidemic has been perpetuating for years, there are few health policies in Brazil to control it/the disease, especially in primary health care. Therefore, social, environmental and population-based interventions should be organized in order to contain this neglected epidemic.
Asunto(s)
Humanos , Animales , Masculino , Femenino , Esporotricosis/epidemiología , Enfermedades Desatendidas/epidemiología , Política de Salud , Atención Primaria de Salud , Esporotricosis/etiología , Esporotricosis/veterinaria , Brasil/epidemiología , Enfermedades Desatendidas/etiología , Enfermedades Desatendidas/veterinaria , EpidemiasRESUMEN
Resumo A esporotricose humana e animal é uma infecção subaguda a crônica causada pelo fungo dimórfico Sporothrix schenckii. A esporotricose ocular tem ganhado destaque em função da epidemia de esporotricose urbana enfrentada pelo estado do Rio de Janeiro na última década e se apresenta classicamente como conjuntivite granulomatosa, mas formas atípicas podem ocorrer. Este artigo tem por objetivo relatar 2 casos atípicos de esporotricose ocular em pacientes imunocompetentes, ambos apresentando quadro clínico compatível com a síndrome oculoglandular de Parinaud associada à dacriocistite em um caso e presumivelmente à coroidite no outro caso.
Abstract Human and animal sporotrichosis is an infection caused by the dimorphic fungus Sporothrix schenckii, which is classified from subacute to chronic. Ocular sporotrichosis has been highlighted due to the epidemic of urban sporotrichosis faced by the state of Rio de Janeiro in the last decade and presents classically as granulomatous conjunctivitis, but atypical forms may occur. This article aims to report two atypical cases of ocular sporotrichosis in immunocompetent patients, both presenting a clinical picture compatible with Parinaud oculoglandular syndrome associated with dacryocystitis in one case and presumably to choroiditis in the other case.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Esporotricosis/diagnóstico , Esporotricosis/etiología , Trastornos de la Motilidad Ocular/complicaciones , Trastornos de la Motilidad Ocular/diagnóstico , Coroiditis/complicaciones , Coroiditis/diagnóstico , Itraconazol/uso terapéutico , Dacriocistitis/complicaciones , Dacriocistitis/diagnóstico , Antifúngicos/uso terapéutico , Diagnóstico DiferencialRESUMEN
In the late 90's there was a change in both the route of transmission and the people at risk for sporotrichosis. This zoonotic cat-man alternative transmission route elicited changes in strategies to control the epidemic. There was a progressive increase in the number of cases involving especially children and the elderly. In addition to becoming hyperendemic, uncommon clinical pictures like immunoreactive clinical presentations or severe systemic cases have emerged. New species were identified and classified through molecular tools using more virulent clinical isolates, like S. brasiliensis, compared to the environmental isolates. Likewise, different species of Sporothrix have been associated with different geographic regions. The serological and molecular techniques are used as an auxiliary tool for the diagnosis and/or for species identification, although the isolation and the identification of Sporothrix spp. in clinical specimen is still the gold standard. Currently sporotrichosis epidemics requires the knowledge of the epidemiological-molecular profile to control the disease and the specific treatment. Itraconazole, potassium iodide, terfinafine, and amphotericin B are the available drugs in Brazil to treat sporotrichosis. The drug of choice, its posology, and treatment duration vary according to the clinical presentation, the Sporothrix species, and host immune status. New treatment choices, including a vaccine, are being developed; nevertheless, more clinical trials are required to confirm its efficacy.
Asunto(s)
Esporotricosis , Animales , Diagnóstico Diferencial , Humanos , Pronóstico , Esporotricosis/diagnóstico , Esporotricosis/tratamiento farmacológico , Esporotricosis/epidemiología , Esporotricosis/etiologíaRESUMEN
Abstract: In the late 90's there was a change in both the route of transmission and the people at risk for sporotrichosis. This zoonotic cat-man alternative transmission route elicited changes in strategies to control the epidemic. There was a progressive increase in the number of cases involving especially children and the elderly. In addition to becoming hyperendemic, uncommon clinical pictures like immunoreactive clinical presentations or severe systemic cases have emerged. New species were identified and classified through molecular tools using more virulent clinical isolates, like S. brasiliensis, compared to the environmental isolates. Likewise, different species of Sporothrix have been associated with different geographic regions. The serological and molecular techniques are used as an auxiliary tool for the diagnosis and/or for species identification, although the isolation and the identification of Sporothrix spp. in clinical specimen is still the gold standard. Currently sporotrichosis epidemics requires the knowledge of the epidemiological-molecular profile to control the disease and the specific treatment. Itraconazole, potassium iodide, terfinafine, and amphotericin B are the available drugs in Brazil to treat sporotrichosis. The drug of choice, its posology, and treatment duration vary according to the clinical presentation, the Sporothrix species, and host immune status. New treatment choices, including a vaccine, are being developed; nevertheless, more clinical trials are required to confirm its efficacy.
Asunto(s)
Humanos , Animales , Esporotricosis/diagnóstico , Esporotricosis/etiología , Esporotricosis/tratamiento farmacológico , Esporotricosis/epidemiología , Pronóstico , Diagnóstico DiferencialRESUMEN
PURPOSE: In this article, the authors describe multifocal choroiditis related to disseminated sporotrichosis in patients with HIV/AIDS. METHODS: We conducted a retrospective observational study of three patients infected with HIV who presented with disseminated sporotrichosis characterized by cutaneous lesions, multifocal choroiditis, and other manifestations, including osteomyelitis and involvement of the bone marrow, larynx, pharynx, and nasal and oral mucosa. RESULTS: Five eyes of three patients with HIV/AIDS showed multifocal choroiditis related to disseminated sporotrichosis. The CD4 counts ranged from 25 to 53 mm. All patients were asymptomatic visually. The ocular disease was bilateral in two patients. The lesion size ranged from 1/3 to 2 disc diameters. None of the patients had vitritis. Of the 12 lesions, 9 were localized in the posterior pole (Zone 1) and 3 were localized in the mild periphery (Zone 2). CONCLUSION: Multifocal choroiditis due to disseminated sporotrichosis can occur in profoundly immunosuppressed patients with HIV/AIDS.
Asunto(s)
Coroiditis/microbiología , Infecciones Fúngicas del Ojo/microbiología , Infecciones por VIH/complicaciones , Esporotricosis/etiología , Adulto , Humanos , Masculino , Coroiditis Multifocal , Estudios Retrospectivos , Sporothrix/aislamiento & purificaciónRESUMEN
Sporotrichosis is a dermatozoonosis caused by fungi of the Sporothrix genus. It is classified as an implantation mycosis. This fungal infection, with anthropozoonotic and saprozoonotic characteristics and which has domestic felines, soil, and vegetables as main sources of infection, has been responsible for epizootic and epidemic outbreaks in southern and southeastern Brazil. This report presents the case of a feline diagnosed and treated for sporotrichosis at Dermatology Service of FMVZ/USP, after referral from the Dermatology Department of EPM/Unifesp, where the owners of the cat were being treated for human sporotrichosis.(AU)
A esporotricose é uma dermatozoonose que tem como agentes etiológicos fungos do gênero Sporothrix. É responsável por quadros micóticos ditos de implantação. Essa micose, de características antropo e saprozoonóticas e cujas principais fontes de infecção são os felinos domésticos, o solo e os vegetais, tem sido responsável por surtos epizoóticos e epidêmicos no sul e sudeste brasileiro. Este relato apresenta o caso de um felino diagnosticado e tratado para esporotricose pelo Serviço de Dermatologia do Hospital Veterinário da FMVZ/USP, após ter sido encaminhado pelo Departamento de Dermatologia da EPM/Unifesp, onde os proprietários do animal estavam sendo tratados para esporotricose humana.(AU)
Asunto(s)
Animales , Gatos , Transmisión de Enfermedad Infecciosa/veterinaria , Sporothrix , Esporotricosis/epidemiología , Esporotricosis/etiología , Zoonosis/transmisión , Brasil , Micosis/veterinariaRESUMEN
Sporotrichosis is a dermatozoonosis caused by fungi of the Sporothrix genus. It is classified as an implantation mycosis. This fungal infection, with anthropozoonotic and saprozoonotic characteristics and which has domestic felines, soil, and vegetables as main sources of infection, has been responsible for epizootic and epidemic outbreaks in southern and southeastern Brazil. This report presents the case of a feline diagnosed and treated for sporotrichosis at Dermatology Service of FMVZ/USP, after referral from the Dermatology Department of EPM/Unifesp, where the owners of the cat were being treated for human sporotrichosis.(AU)
A esporotricose é uma dermatozoonose que tem como agentes etiológicos fungos do gênero Sporothrix. É responsável por quadros micóticos ditos de implantação. Essa micose, de características antropo e saprozoonóticas e cujas principais fontes de infecção são os felinos domésticos, o solo e os vegetais, tem sido responsável por surtos epizoóticos e epidêmicos no sul e sudeste brasileiro. Este relato apresenta o caso de um felino diagnosticado e tratado para esporotricose pelo Serviço de Dermatologia do Hospital Veterinário da FMVZ/USP, após ter sido encaminhado pelo Departamento de Dermatologia da EPM/Unifesp, onde os proprietários do animal estavam sendo tratados para esporotricose humana.(AU)
Asunto(s)
Animales , Gatos , Transmisión de Enfermedad Infecciosa/veterinaria , Sporothrix , Esporotricosis/epidemiología , Esporotricosis/etiología , Zoonosis/transmisión , Brasil , Micosis/veterinariaRESUMEN
We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.
Asunto(s)
Adulto , Humanos , Masculino , Adulto Joven , Infecciones por VIH/complicaciones , Síndrome Inflamatorio de Reconstitución Inmune/complicaciones , Esporotricosis/etiología , Coinfección , Infecciones por VIH/inmunología , Síndrome Inflamatorio de Reconstitución Inmune/inmunología , Esporotricosis/inmunología , Carga ViralRESUMEN
We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.
Asunto(s)
Infecciones por VIH/complicaciones , Síndrome Inflamatorio de Reconstitución Inmune/complicaciones , Esporotricosis/etiología , Adulto , Recuento de Linfocito CD4 , Coinfección , Infecciones por VIH/inmunología , Humanos , Síndrome Inflamatorio de Reconstitución Inmune/inmunología , Masculino , Esporotricosis/inmunología , Carga Viral , Adulto JovenRESUMEN
In the scientific literature, sporotrichosis has traditionally been associated with agricultural work, since the causative agent is found naturally in the soil. However, cases have been reported recently in an urban area, related to zoonotic transmission. The current study aimed to contribute to knowledge on sporotrichosis in an urban area through an exploratory analysis of its socio-spatial distribution in Rio de Janeiro, Brazil, from 1997 to 2007, identifying the areas with the heaviest transmission. The database from the Health Surveillance Service at the Evandro Chagas Institute for Clinical Research, Oswaldo Cruz Foundation, was used to estimate incidence rates and spatial distribution. During the study period, 1,848 cases of sporotrichosis were reported, predominantly in adult women not currently in the labor market. The leading source of infection was wounds caused by domestic cats, which contributed to the spread of sporotrichosis in this urban area. Georeferencing of 1,681 cases showed a transmission belt along the border between the city of Rio de Janeiro and the adjacent municipalities in the Greater Metropolitan Area.
Asunto(s)
Esporotricosis/epidemiología , Zoonosis/epidemiología , Adolescente , Adulto , Animales , Antifúngicos/uso terapéutico , Brasil/epidemiología , Gatos , Niño , Ciudades/epidemiología , Femenino , Humanos , Itraconazol/uso terapéutico , Masculino , Factores Sexuales , Sporothrix , Esporotricosis/tratamiento farmacológico , Esporotricosis/etiología , Adulto Joven , Zoonosis/transmisiónRESUMEN
Na literatura científica, a esporotricose esteve associada por anos a profissionais que lidam com a terra, local onde o fungo causador habita. Recentemente, numa área urbana tem sido registrada a ocorrência relacionada à transmissão zoonótica. Este trabalho objetivou contribuir para o conhecimento sobre a esporotricose em área urbana, por intermédio da analise exploratória de sua distribuição socioespacial no Rio de Janeiro, Brasil, entre 1997 e 2007, identificando os espaços de transmissão mais intensos. Utilizando-se base de dados do Serviço de Vigilância em Saúde, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, foram realizadas análises de frequência da doença e sua distribuição espacial. No período estudado, foram registrados 1.848 casos de esporotricose, com predomínio em mulheres adultas fora do mercado de trabalho. A fonte de contaminação predominante foi ferimento causado pelo gato doméstico, o que contribuiu para a disseminação da esporotricose em área urbana. O georreferenciamento de 1.681 casos evidenciou um cinturão de transmissão ao longo da divisa entre a capital e os municípios da região metropolitana.
In the scientific literature, sporotrichosis has traditionally been associated with agricultural work, since the causative agent is found naturally in the soil. However, cases have been reported recently in an urban area, related to zoonotic transmission. The current study aimed to contribute to knowledge on sporotrichosis in an urban area through an exploratory analysis of its socio-spatial distribution in Rio de Janeiro, Brazil, from 1997 to 2007, identifying the areas with the heaviest transmission. The database from the Health Surveillance Service at the Evandro Chagas Institute for Clinical Research, Oswaldo Cruz Foundation, was used to estimate incidence rates and spatial distribution. During the study period, 1,848 cases of sporotrichosis were reported, predominantly in adult women not currently in the labor market. The leading source of infection was wounds caused by domestic cats, which contributed to the spread of sporotrichosis in this urban area. Georeferencing of 1,681 cases showed a transmission belt along the border between the city of Rio de Janeiro and the adjacent municipalities in the Greater Metropolitan Area.
Asunto(s)
Adolescente , Adulto , Animales , Gatos , Niño , Femenino , Humanos , Masculino , Adulto Joven , Esporotricosis/epidemiología , Zoonosis/epidemiología , Antifúngicos/uso terapéutico , Brasil/epidemiología , Ciudades/epidemiología , Itraconazol/uso terapéutico , Factores Sexuales , Sporothrix , Esporotricosis/tratamiento farmacológico , Esporotricosis/etiología , Zoonosis/transmisiónRESUMEN
Subcutaneous mycoses include diverse clinical syndromes, characterized by invasion of the skin and subcutaneous tissue by saprobic fungi. Individuals living in rural areas constantly suffer lesions or trauma; however, only a few of them develop disease. In this contribution, we describe recent advances in the understanding of the virulence of these organisms, focusing on the most prevalent infections, sporotrichosis, chromoblastomycosis, and mycetoma. Although these infectious diseases are considered neglected tropical diseases, modern molecular techniques have been able to identify the etiologic agents and observe variations in the former monolithic concept of the species, which was based mostly on morphologic characteristics. The complete genetic characterization of the causative agents, along with that of their host, will help in the understanding of the factors on which the development of these infections depends.
Asunto(s)
Antifúngicos/uso terapéutico , Enfermedades Transmisibles/tratamiento farmacológico , Factores Inmunológicos/uso terapéutico , Micosis/tratamiento farmacológico , Tejido Subcutáneo/microbiología , Cromoblastomicosis/tratamiento farmacológico , Cromoblastomicosis/etiología , Enfermedades Transmisibles/etiología , Humanos , Micetoma/tratamiento farmacológico , Micetoma/etiología , Micosis/etiología , Micosis/inmunología , Salud Rural , Esporotricosis/tratamiento farmacológico , Esporotricosis/etiología , Tejido Subcutáneo/inmunologíaRESUMEN
Background: Sporotrichosis is a fungal infection caused by Sporothrix schenckii species complex, which is distributed worldwide, especially in regions of tropical and subtropical climates. It can affect both humans and a great variety of animals, among which, the domestic dog and cat. Today is considered the subcutaneous mycosis more frequent in Brazil, due to the progressive increase of zoonotic transmission of the disease in the metropolitan region of Rio de Janeiro. Review: In the endemic region of zoonotic sporotrichosis in Rio de Janeiro,veterinarians, their assistants and owners of cats with sporotrichosis are considered risk groups for acquiring the infection. Of the human cases of sporotrichosis in this endemic region that were accompanied by the Clinical Research Institute Evandro Chagas (IPEC / Fiocruz) in the period from 1998 to 2001, 5% of the patients diagnosed for the disease were veterinarians, demonstrating the occurrence of the infection in this occupational group. Biosafety is defined as a condition of security achieved by a set of measures aimed at the prevention, control, reduction or elimination of risks involved in activities that could endanger the health of humans, animals, plants and the environment. However, small animal veterinary pratictioners from the endemic region of Rio de Janeiro usually do not follow biosafety measures, which increases the risk of acquisition of sporotrichosis. In most cases, the infection results from traumatic inoculation of the fungus in skin and in humans, clinical forms may be: fixed or localized cutaneous, lymphatic-cutaneous, spread-cutaneous, mucosal and extra-cutaneous or systemic. In the endemic form of this disease that occurs in Rio de Janeiro, the cat is seen as a source of infection. The zoonotic potential of the cat is characterized by the abundance of yeasts found in their skin lesions and proximity with humans. Cats acquire the disease after fights with other infected cats and the skin lesions more frequently found are nodules and ulcers, covered or not by crusts, which can progress to necrosis with exposure of bones and muscles. The presence of respiratory signs, especially sneezing, with or without lesions in the mucosal and in the nasal region is common. The azole itraconazole is considered the drug of choice for humans and cats. However, unlike humans, the treatment is considered difficult in cats. The definitive diagnosis of sporotrichosis is obtained by isolation of Sporothrix in culture. Nonetheless, in cats, due to the great quantity of yeasts in their lesions, cytopathological test is strongly indicated in the presumptive diagnosis because of the speed in processing, low cost and no requirement of sophisticated technical training or complex laboratory structure. Discussion: A zoonotic form of sporotrichosis has become endemic in the metropolitan region of Rio de Janeiro and the veterinarians are a high risk group for acquiring the disease as well as have a very important role in the application of measures for the prevention and control of sporotrichosis. Therefore, in this review, specific biosafety procedures to reduce risks during the handling of cats with suspected sporotrichosis by veterinarians, technicians, caretakers and owners of cats were described. The topics aproached were: clinical care of the cat (where were appointed the recommended personal protective equipment, animal restraint and good practices), decontamination of the environment, equipment and items used in the cat care and management of waste. Aspects related to the fungus and the disease itself were also discussed.
Asunto(s)
Humanos , Animales , Gatos , Esporotricosis/diagnóstico , Esporotricosis/etiología , Esporotricosis/prevención & control , Enfermedades de los Gatos/prevención & control , Contención de Riesgos Biológicos/veterinaria , Zoonosis/transmisiónRESUMEN
A esporotricose constitui-se em dermatopatia ergodermatósica, de características antropo ou saprozoonótica que temcomo principais fontes de infecção os felinos domésticos, vegetais e o solo. Tem ela como epônimos as denominaçõesde Enfermidade de Schenk, maladie de vacance, Enfermidade dos: veterinários, jardineiros e floristas. Detectam-se,vez por outra, surtos epidêmicos e epizoóticos, tal como o evidenciado, no final do Século XX, em felinos, caninos ehumanos, no sudeste brasileiro. Revisam-se aspectos de ocorrência, etiopatogenia, clínicos, de diagnose, prognose eterapia de pacientes animais (caninos, felinos e equinos).(AU)
Sporotrichosis is an ergodermatosic dermatopathy of anthropozoonotic or saprozoonotic characteristics, whose mainsources of infection are domestic cats, plants and soil. It is also known as Schenks illness, maladie de vacances, Illnessof veterinarians, gardeners and florists. Epidemic and epizootic outbreaks are occasionally evidenced, as that occurredin the late twentieth century in cats, dogs and humans in southeastern Brazil. Aspects of occurrence, etiopathogenesis,clinical signs, diagnosis, prognosis and therapy of dogs, cats and horses with sporotrichosis are reviewed.(AU)
Asunto(s)
Animales , Esporotricosis/etiología , Esporotricosis/historia , Esporotricosis/diagnóstico , Sporothrix/patogenicidadRESUMEN
A esporotricose constitui-se em dermatopatia ergodermatósica, de características antropo ou saprozoonótica que temcomo principais fontes de infecção os felinos domésticos, vegetais e o solo. Tem ela como epônimos as denominaçõesde Enfermidade de Schenk, maladie de vacance, Enfermidade dos: veterinários, jardineiros e floristas. Detectam-se,vez por outra, surtos epidêmicos e epizoóticos, tal como o evidenciado, no final do Século XX, em felinos, caninos ehumanos, no sudeste brasileiro. Revisam-se aspectos de ocorrência, etiopatogenia, clínicos, de diagnose, prognose eterapia de pacientes animais (caninos, felinos e equinos)
Sporotrichosis is an ergodermatosic dermatopathy of anthropozoonotic or saprozoonotic characteristics, whose mainsources of infection are domestic cats, plants and soil. It is also known as Schenks illness, maladie de vacances, Illnessof veterinarians, gardeners and florists. Epidemic and epizootic outbreaks are occasionally evidenced, as that occurredin the late twentieth century in cats, dogs and humans in southeastern Brazil. Aspects of occurrence, etiopathogenesis,clinical signs, diagnosis, prognosis and therapy of dogs, cats and horses with sporotrichosis are reviewed
Asunto(s)
Animales , Esporotricosis/diagnóstico , Esporotricosis/etiología , Esporotricosis/historia , Sporothrix/patogenicidadRESUMEN
La esporotricosis es una micosis de evolución crónica producida por el Sporothrixschenkii. La intensidad del compromiso cutáneo y/o sistémico, como así también su evolución, dependerán de la respuesta inmune del huésped y de la cantidad y calidad del inóculo. La esporotricosis cutánea fija es una forma clínica de reinfección, que se expresa en el lugar de la inoculación como una pápula eritematosa, que posteriormente se ulcera o adquiere aspecto verrugoso o psoriasiforme. El diagnóstico surge de la sospecha clínica, la epidemiología y la biopsi acutánea. El estudio histopatológico puede demostrar la presencia tisular del microorganismo o, más frecuentemente, los llamados cuerpos asteroides. Se documenta un paciente con la variedad fija de esporotricosis cutánea ulcerada en dorso, producto de la reinfección por el Sporothrix schenkii. La expresión de esta forma clínica está vinculada a la inmunidad desarrollada ante la primera infección, que ocurrió seis años antes en su brazo...
Sporotrichosis is a mycoses produced by Sporothrix schenckii and characterizedby a chronic course. The evolution and severity of this entity dependson the host´s immune response and the quantity and quality of the inoculate.Fixed cutaneous sporotrichosis is an expression of re-infection. It begins likean erythematous papule at the inoculation site, that may later either ulcerateor turn into a psoriasiform or warty plaque. Diagnosis can be made basedon the clinical aspect of the lesion, the epidemiology and biopsy. The histopathologicalstudy can reveal the presence of the fungus or more frequentlyasteroid bodies. We report a patient with a cutaneous fixed ulcerated sporotrichosison his back, due to re-infection by Sporothrix schenckii. The clinicalexpression of this variety is related to the immunity generated in a previousinfection in his arm that occurred 6 years before...
Asunto(s)
Masculino , Esporotricosis/etiología , Esporotricosis , Brazo , Biopsia , MicosisRESUMEN
Sporothrix schenckii é um fungo dimórfico, agente etiológico da esporotricose, uma micose subaguda ou crônica que pode eventualmente evoluir para complicações sistêmicas, principalmente em pacientes imunocomprometidos. O endotélio exerce um papel crucial durante infecções disseminadas já que, juntamente com as células epiteliais, representa uma barreira a ser ultrapassada por microorganismos invasores. Em estudos anteriores, observamos que S. schenckii transmigra preferencialmente pela rota paracelular (passagem entre células endoteliais adjacentes), interagindo em seguida com componenetes da matriz subendotelial. Também foram identificadas algumas vias de sinalização relacionadas à diferentes fases da interação de leveduras de S. schenckii com o endotélio in vitro (associação/endocitose, transmigração). No entanto, a correlação entre tais vias de sinalização e os mecanismos celulares da invasão do endotélio pelo fungo não foram efetivamente demonstrados. No presente trabalho, a análise do perfil de proteínas endoteliais totais fosforiladas em resíduos de tirosina mostrou que S. schenckii induz fosforilações em tempos curtos (< 15 minutos), em proteínas de massas moleculares 20, 13, 12 e 6KDa, enquanto alunas proteínas de mais alto peso molecular (83, 123, 136, 140 e 193 KDa) persistem fosforiladas em tempos mais longos durante a infecção (6 horas). As vias de transdução de sinais disparadas pela interação do fungo com o endotélio foram investigadas através do uso de inibidores da ativação de MAPKs p38 (SB 203580) e ERK (PD 98059), MLCK (W7) e de um quelante de Ca2+ intracelular (BAPTA). A transmigração de S. schenckii através de monocamadas de HUVECs por 6 horas mostrou ser dependente da ativação de ERK e p38, ions Ca2+ intracelular e MLCK. Estas vias estão também envolvidas nos rearranjos do citoesqueleto de actina que levam à contratilidade celular e aumento da permeabilidade endotelial. A interação do fungo com HUVECs induziu ativação de Src...
Sporothrix schenckii, a dimorphic fungus, is the causative agent of sporotrichosis, a cutaneous/subcutaneous mycosis which can eventually evolve to systemic complications, mainly in immunocompromised patients. The primary interaction of pathogenic fungi with endothelial cells (EC) is throught to be essential for the development of systemic infections. We have previously shown that S. schenckii cross endothelial monolayers through a paracellular pathway, in a process also modulated by the subendothelial matrix, and that the fungus is able to alter host signaling pathways. We observed that the interaction of S. schenckii with human umbilical vein endothelial cells (HUVECs) was regulated by tyrosine-phosphorylation of EC proteins. In the present work, we observed that S. schenckii stimulates the early increase (<15 minutes) in tyrosine-phorphorylation of 20, 13, 12 e 6 KDa endothelial proteins, whereas tyrosine-phosphorylation of higher molecular weight proteins (83, 123, 136, 140 e 193 KDa) persists up to 6 hours of endothelial infection. Selective signal transduction inhibitors (SB203580 and W7, for blocking p38 MAPK and MLCK activation, respectively) were able to inhibit transendothelial migration of S. schenckii. The process was also modulated by Ca++ions. These signaling pathways are crucial for the actin rearrangement associated to impairment of endothelial permeability. Long-term (3 hours) interaction of S. schenckii with HUVECs lead to increase of MLC2 phosphorylation and Src activation. Src was shown by others to be involved in the phosphorylation of VE-cadherin, thus provoking adherent junctions (AJs) disassembly. We found that S. schenckii induces tyrosine-phosphorylation of endothelial VE-cadherin up to 3 hours of interaction with endothelial cells. VE-cadherin phosphorylation can be triggered by the activation of E-selectin in endothelial cells. Since the time-course of the major signaling events correlated with the time needed...