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Sporotrichosis in Children: Case series and Narrative Review
Purpose of Review Pediatric sporotrichosis has not been sufficiently studied; this review aims to evaluate the risk and prognostic factors related to the development of sporotrichosis associated to this age group. Also, we want to evaluate the causes of the increased number of cases of sporotrichosi...
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Published in: | Current fungal infection reports 2022, Vol.16 (2), p.33-46 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Purpose of Review
Pediatric sporotrichosis has not been sufficiently studied; this review aims to evaluate the risk and prognostic factors related to the development of sporotrichosis associated to this age group. Also, we want to evaluate the causes of the increased number of cases of sporotrichosis in the pediatric population such as environmental changes in endemic areas, the biodiversity, and virulence among the pathogenic clade causing sporotrichosis in different areas of the globe, and especially the progression of the zoonotic transmission of infections caused by
Sporothrix brasiliensis
infections, associated to zoonotic transmission in Brazil and other endemic sporotrichosis countries.
Recent Findings
After evaluating a case series of 40 patients, we found that pediatric sporotrichosis in Mexico is mainly caused by
Sporothrix schenckii
which prevails in rural areas and is mainly sapronotically transmitted. In Brazil, the longest and largest pediatric sporotrichosis outbreak is caused by
Sporothrix brasiliensis
, etiologically related to sick cats, directly from lesions containing a high yeast cell burden. When affecting children
S. schenckii
and
S. brasiliensis
may cause distinct clinical manifestations especially in the onset of the disease and affected anatomical site. In Mexico, most of the patients are successfully treated with potassium iodide, whereas in Brazil, all patients respond to itraconazole.
Summary
Sporothrix schenckii
is the major etiologic agent in Mexico, being sapronotically transmitted, while in Brazil,
Sporothrix brasiliensis
is only transmitted by cats. In Mexico, the disease prevails in male patients (60%) from rural areas; in Brazil, the disease is more frequent in females (60%) from an urban region. Due to the zoonotic sporotrichosis outbreak in Brazil, the time of evolution seems to be shorter in Brazilian patients than in Mexican patients. Most Brazilian patients presented with facial lesions, including ocular involvement, while in Mexico, most of the children presented upper limbs involvement. In Mexico, treatment with potassium iodide in children was observed to induce faster remission than itraconazole, but controlled studies are lacking to evaluate this versus itraconazole, due to the low number of cases. A comparative study should be designed to evaluate the best and safest antifungal therapy for pediatric sporotrichosis. |
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ISSN: | 1936-3761 1936-377X |
DOI: | 10.1007/s12281-022-00429-x |