Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Aug 28;8(8):e3110.
doi: 10.1371/journal.pntd.0003110. eCollection 2014 Aug.

Sporotrichosis: An Emerging Neglected Opportunistic Infection in HIV-infected Patients in Rio De Janeiro, Brazil

Affiliations
Free PMC article

Sporotrichosis: An Emerging Neglected Opportunistic Infection in HIV-infected Patients in Rio De Janeiro, Brazil

Dayvison Francis Saraiva Freitas et al. PLoS Negl Trop Dis. .
Free PMC article

Abstract

Sporotrichosis associated with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil, affecting a large at-risk population, which includes HIV-infected individuals. We assessed patients co-infected by Sporothrix spp. and HIV over time in the context of an unabated sporotrichosis epidemic. A retrospective cohort retrieved information from a National reference institute for infectious diseases regarding 48 patients with sporotrichosis-HIV co-infection (group 1) as well as 3,570 patients with sporotrichosis (group 2), from 1987 through March 2013. Most patients from group 1 were male (68.8%), whereas women were predominant in group 2 (69.1%; p<0.0001). Patients from group 1 were younger than those from group 2 (μ = 38.38±10.17 vs. 46.34±15.85; p<0.001) and differed from group 2 in terms of their race/ethnic background, with 70.8% non-white patients in group 1 vs. 38.6% from group 2 (p<0.0001). Close to half (∼44%) of the patients from group 1 were hospitalized due to sporotrichosis over time, whereas hospitalization was very unlikely in group 2, among whom approximately 1% were hospitalized over time. Dissemination of sporotrichosis was the main cause of hospitalization in both groups, although it was more common among hospitalized patients from group 1 (19/21 [90.5%] vs. 16/37 [43.2%]; p<0.001). Over the period under analysis, eight patients died due to sporotrichosis (3/48 vs. 5/3,570). The diagnosis of sporotrichosis elicited HIV testing and subsequent diagnosis in 19/48 patients, whereas 23/48 patients were simultaneously diagnosed with the two infections. HIV infection aggravates sporotrichosis, with a higher incidence of severe disseminated cases and a higher number of hospitalizations and deaths. Underserved populations, among whom sporotrichosis has been propagated, have been affected by different transmissible (e.g., HIV) and non-transmissible diseases. These populations should be targeted by community development programs and entitled to integrated management and care of their superimposed burdens.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Annual number of patients with sporotrichosis at IPEC from 1987 through March 2013.
A) Sporotrichosis and HIV (group 1) and B) annual proportion of patients diagnosed with sporotrichosis among all patients diagnosed at IPEC.

Similar articles

See all similar articles

Cited by 18 articles

See all "Cited by" articles

References

    1. Barros MB, de Almeida-Paes R, Schubach AO (2011) Sporothrix schenckii and Sporotrichosis. Clin Microbiol Rev 24 (4) 633–654 10.1128/CMR.00007-11 - DOI - PMC - PubMed
    1. Marimon R, Cano J, Gené J, Sutton DA, Kawasaki M, et al. (2007) Sporothrix brasiliensis, S. globosa, and S. mexicana, three new Sporothrix species of clinical interest. J Clin Microbiol 45: 3198–3206 10.1128/JCM.00808-07 - DOI - PMC - PubMed
    1. Madrid H, Cano J, Gene J, Bonifaz A, Toriello C, et al. (2009) Sporothrix globosa, a pathogenic fungus with widespread geographical distribution. Rev Iberoam Micol 26: 218–222 10.1016/j.riam.2009.02.005 - DOI - PubMed
    1. Oliveira MM, Almeida-Paes R, Muniz MM, Gutierrez-Galhardo MC, Zancope-Oliveira RM (2011) Phenotypic and molecular identification of Sporothrix isolates from an epidemic area of sporotrichosis in Brazil. Mycopathologia 172: 257–267 10.1007/s11046-011-9437-3 - DOI - PubMed
    1. Rodrigues AM, de Hoog S, de Camargo ZP (2013) Emergence of pathogenicity in the Sporothrix schenckii complex. Med Mycol 51: 405–412 10.3109/13693786.2012.719648 - DOI - PubMed

Grant support

Financial support was received from FAPERJ/Rio de Janeiro, Brazil (grant proc. E-26/110.619/2012) and PAPES VI – CNPq/Fiocruz (grant proc. 407693/2012-2). DFSF received financial support from CNPq and CAPES. RMZO was supported in part by CNPq (350338/2000-0) and FAPERJ (E-26/103.157/2011). MCGG received partial funding from the Brazilian National STD/AIDS Program, Ministry of Health (46/CV079/2006). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Feedback