Is terbinafine an effective treatment for feline sporotrichosis?

BACKGROUND: Terbinafine has been successfully used in the treatment of human sporotrichosis; however, its effectiveness in the treatment of feline sporotrichosis is unknown. Therefore, this study aimed to describe the use of terbinafine in the treatment of feline sporotrichosis. METHODS: A cohort study was conducted in cats with sporotrichosis to assess the effectiveness and safety of terbinafine (30‒60 mg/kg/day). Clinical examination and analysis of laboratory parameters were performed monthly until clinical signs resolved or terbinafine treatment was discontinued. RESULTS: Of the 54 cats with sporotrichosis included in the study, 19 were lost during follow-up and five were withdrawn from the study due to switching to treatment with another prescription drug. Of the remaining 30 cats, 10 achieved clinical cure, with a median treatment time of 18.5 weeks. Treatment failed in 18 cases, and two cats died. Twenty-two cats had adverse reactions to terbinafine treatment, and 10 cats showed elevation of serum transaminases. LIMITATION: Loss during follow-up was high, which makes it difficult to draw accurate conclusions regarding clinical outcomes. CONCLUSION: The low rate of clinical cure observed suggests that terbinafine does not represent an effective treatment option for cases of feline sporotrichosis.

PARK7/DJ-1 deficiency impairs microglial activation in response to LPS-induced inflammation.

BACKGROUND: Specific microglia responses are thought to contribute to the development and progression of neurodegenerative diseases, including Parkinson's disease (PD). However, the phenotypic acquisition of microglial cells and their role during the underlying neuroinflammatory processes remain largely elusive. Here, according to the multiple-hit hypothesis, which stipulates that PD etiology is determined by a combination of genetics and various environmental risk factors, we investigate microglial transcriptional programs and morphological adaptations under PARK7/DJ-1 deficiency, a genetic cause of PD, during lipopolysaccharide (LPS)-induced inflammation. METHODS: Using a combination of single-cell RNA-sequencing, bulk RNA-sequencing, multicolor flow cytometry and immunofluorescence analyses, we comprehensively compared microglial cell phenotypic characteristics in PARK7/DJ-1 knock-out (KO) with wildtype littermate mice following 6- or 24-h intraperitoneal injection with LPS. For translational perspectives, we conducted corresponding analyses in human PARK7/DJ-1 mutant induced pluripotent stem cell (iPSC)-derived microglia and murine bone marrow-derived macrophages (BMDMs). RESULTS: By excluding the contribution of other immune brain resident and peripheral cells, we show that microglia acutely isolated from PARK7/DJ-1 KO mice display a distinct phenotype, specially related to type II interferon and DNA damage response signaling, when compared with wildtype microglia, in response to LPS. We also detected discrete signatures in human PARK7/DJ-1 mutant iPSC-derived microglia and BMDMs from PARK7/DJ-1 KO mice. These specific transcriptional signatures were reflected at the morphological level, with microglia in LPS-treated PARK7/DJ-1 KO mice showing a less amoeboid cell shape compared to wildtype mice, both at 6 and 24 h after acute inflammation, as also observed in BMDMs. CONCLUSIONS: Taken together, our results show that, under inflammatory conditions, PARK7/DJ-1 deficiency skews microglia towards a distinct phenotype characterized by downregulation of genes involved in type II interferon signaling and a less prominent amoeboid morphology compared to wildtype microglia. These findings suggest that the underlying oxidative stress associated with the lack of PARK7/DJ-1 affects microglia neuroinflammatory responses, which may play a causative role in PD onset and progression.

Plasma itraconazole concentrations during treatment of feline sporotrichosis.

Itraconazole (ITZ) is the most used drug to treat feline sporotrichosis; however, little is known about its pharmacokinetics in cats with this mycosis. The aim of this study was to determine plasma ITZ concentrations in cats with sporotrichosis treated with ITZ as monotherapy or in combination with potassium iodide (KI). Cats diagnosed with sporotrichosis received orally ITZ (100 mg/cat/day) or combination therapy with ITZ (100 mg/cat/day) and KI (2.5-5 mg/kg/day) in the case of worsening or stagnation of the clinical condition. At each monthly visit, blood samples were collected at an interval of 4 h for analysis of trough and peak plasma ITZ concentrations by HPLC. Clinical features and laboratory parameters were evaluated during follow-up. Sixteen cats were included in the study. The median plasma ITZ concentration of all cats was 0.75 µg/mL. The median plasma ITZ concentration was 0.5 µg/mL in cats that received ITZ monotherapy (n = 12) and 1.0 µg/mL in those treated with ITZ + KI (n = 4). The clinical cure rate was 56.3% (n = 9) and the median treatment duration was 8 weeks. Nine cats (56.3%) developed adverse clinical reactions, and hyporexia was the most frequent (n = 8; 88.9%). Serum alanine aminotransferase was elevated in four cats (25%). The median plasma ITZ concentration detected in cats was considered to be therapeutic (>0.5 µg/mL) and was reached after 4 weeks of treatment. Plasma ITZ concentrations were higher in cats that received ITZ + KI compared to those treated only with ITZ, suggesting pharmacokinetic synergism between these drugs.

Itraconazole is the most common therapy for feline sporotrichosis, and combination therapy with potassium iodide is used in nonresponsive cases. Our study showed that all cats achieved a therapeutic plasma concentration of itraconazole, with higher levels in cats treated with the combination therapy.

Neutrophil Oxidative Burst Profile Is Related to a Satisfactory Response to Itraconazole and Clinical Cure in Feline Sporotrichosis.

Despite the central role of cats in the transmission and amplification of Sporothrix, studies regarding immune response in feline sporotrichosis are scarce. In cats with sporotrichosis, neutrophil-rich lesions are usually associated to good general condition and lower fungal burden. However, the role of neutrophils in anti-Sporothrix immunity has been little explored in cats. Thus, the aim of this study was to evaluate the neutrophil oxidative burst in the blood of cats with sporotrichosis. Cats with sporotrichosis included in the study were treated with itraconazole (ITZ) alone or combined with potassium iodide (KI). The neutrophil oxidative burst was evaluated through a flow-cytometry-based assay using dihydrorhodamine 123 (background) and stimulation with Zymosan and heat-killed Sporothrix yeasts. The cure rate was 50.0% in cats under treatment with ITZ monotherapy and 90.9% in cats treated with ITZ + KI (p = 0.014), endorsing the combination therapy as an excellent alternative for the treatment of feline sporotrichosis. Higher percentages of Sporothrix-stimulated neutrophils were associated with good general condition (p = 0.003). Higher percentages of Sporothrix- (p = 0.05) and Zymosan-activated (p = 0.014) neutrophils before and early in the treatment were related to clinical cure in ITZ-treated cats. The correlation between oxidative burst and successful use of KI could not be properly assessed given the low number of failures (n = 2) in this treatment group. Nasal mucosa involvement, typically linked to treatment failure, was related to lower percentages of activated neutrophils in the background at the treatment outcome (p = 0.02). Our results suggest a beneficial role of neutrophils in feline sporotrichosis and a positive correlation between neutrophil activation and the cure process in ITZ-treated cats.

Comparative Study of Colorimetric In Situ Hybridization and Quantitative Real-Time Polymerase Chain Reaction for Diagnosis of Infection by Leishmania infantum in Dogs in Formalin-Fixed and Paraffin-Embedded Skin.

The zoonotic visceral leishmaniasis is caused by the protozoan Leishmania infantum and dogs are reservoirs for this parasite. For the diagnosis of Leishmania at the species level in dogs in formalin-fixed, paraffin-embedded skin (FFPES) samples, colorimetric in situ hybridization (CISH) and quantitative real-time polymerase chain reaction (qPCR) are options, but their sensitivities are not well established. Therefore, the aim of this study was to determine the sensitivity of these two techniques in FFPES for the diagnosis of the L. infantum infection in dogs using culture as the reference standard. The FFPES of 48 dogs with cutaneous infection by L. infantum confirmed by culture and by multilocus enzyme electrophoresis were examined by CISH and qPCR using specific probes for L. infantum. The sensitivities of qPCR, CISH and their combination were, respectively, 77.0%, 58.0% and 83.3%. The sensitivities of qPCR in dogs with and without clinical signs were, respectively, 74.2% and 82.4%. The sensitivities of CISH in dogs with and without clinical signs were, respectively, 61.3% and 52.9%. The CISH and qPCR showed satisfactory sensitivities for the diagnosis of L. infantum in the FFPES of dogs, even in dogs without clinical signs, and their combination increases the sensitivity for this diagnosis.

Combination therapy of itraconazole and an acylhydrazone derivative (D13) for the treatment of sporotrichosis in cats.

Acylhydrazone (AH) derivatives represent a novel category of anti-fungal medications that exhibit potent activity against Sporothrix sp., both in vitro and in a murine model of sporotrichosis. In this study, we demonstrated the anti-fungal efficacy of the AH derivative D13 [4-bromo-N'-(3,5-dibromo-2-hydroxybenzylidene)-benzohydrazide] against both planktonic cells and biofilms formed by Sporothrix brasiliensis. In a clinical study, the effect of D13 was then tested in combination with itraconazole (ITC), with or without potassium iodide, in 10 cats with sporotrichosis refractory to the treatment of standard of care with ITC. Improvement or total clinical cure was achieved in five cases after 12 weeks of treatment. Minimal abnormal laboratory findings, e.g., elevation of alanine aminotransferase, were observed in four cats during the combination treatment and returned to normal level within a week after the treatment was ended. Although highly encouraging, a larger and randomized controlled study is required to evaluate the effectiveness and the safety of this new and exciting drug combination using ITC and D13 for the treatment of feline sporotrichosis. IMPORTANCE: This paper reports the first veterinary clinical study of an acylhydrazone anti-fungal (D13) combined with itraconazole against a dimorphic fungal infection, sporotrichosis, which is highly endemic in South America in animals and humans. Overall, the results show that the combination treatment was efficacious in ~50% of the infected animals. In addition, D13 was well tolerated during the course of the study. Thus, these results warrant the continuation of the research and development of this new class of anti-fungals.

A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis.

Feline sporotrichosis is an endemic disease with high occurrence in Brazil. Itraconazole (ITZ) remains the drug of choice for treating this disease in cats, despite the increasing reports of therapeutic failure. A controlled, randomized clinical trial was performed on 166 naive cats with sporotrichosis to assess the effectiveness and safety of the combination therapy with ITZ and potassium iodide (KI) compared with ITZ monotherapy. Cats were randomly allocated into two treatment groups: G1-ITZ 100 mg/cat/day-and G2-ITZ 100 mg/cat/day + KI 2.5-20 mg/kg/day. Cats treated in G2 presented 77% more risk of reaching a clinical cure (a positive effect) than those treated in G1, even when controlled by negative predictors. The survival curves of the two treatment protocols indicate that a clinical cure was achieved faster in G2. An increase in the KI dose was necessary in 28 cats due to the persistence of clinical signs. Adverse reactions were equally frequent in both groups and manageable with a temporary drug suspension and/or a hepatoprotective therapy. The combination therapy was associated with a higher cure rate and a shorter treatment time, suggesting that ITZ+KI arises as a better option for treating feline sporotrichosis and should be considered the first-line treatment, especially in the presence of negative predictors.

First report of Leishmania (Mundinia) martiniquensis in South American territory and confirmation of Leishbunyavirus infecting this parasite in a mare

BACKGROUND Epidemiological data related to leishmaniases or Leishmania infection in horses are scarce. However, studies carried out in different regions in the world showed equids parasitised by Leishmania braziliensis, L. infantum and L. martiniquensis. OBJECTIVES Identify the Leishmania species causing cutaneous leishmaniasis in a mare, living in Rio de Janeiro State (Brazil), and search the presence of Leishmania viruses in the isolated parasite. METHODS Isoenzymes and polymerase chain reaction (PCR) targeting ITSrDNA region followed by sequencing were conducted for typing the isolated parasite. A search for Leishmania virus infection was also performed. FINDINGS The mare presented skin nodules and ulcers in the left pinna caused by Leishmania spp. that was detected by culture and PCR. The parasite was identified as Leishmania (Mundinia) martiniquensis, infected by Leishbunyavirus (LBV), representing the first description of this species in South America. The animal travelled to different Brazilian regions, but not to outside the country. MAIN CONCLUSIONS The worldwide distribution of L. martiniquensis and its infection by LBV were confirmed in this study, indicating the autochthonous transmission cycle in Brazil. The clinical profile of the disease in the mare, showing fast spontaneous healing of cutaneous lesions, may indicate that skin lesions related to L. martiniquensis infection in horses might be underdiagnosed.

Cuidado ao paciente clínico com sintomas psiquiátricos: percepções dos enfermeiros / Care for clinical patients with psychiatric symptoms: nurses' perceptions / El cuidado de los pacientes clínicos con síntomas psiquiátricos: percepciones de las enfermeras

Objetivo: Analisar os desafios e sugestões no cuidado ao paciente clínico com sintomas psiquiátricos na percepção dos enfermeiros em unidades de internação clínica de um hospital geral. Método: Estudo qualitativo, do tipo exploratório-descritivo. A coleta dos dados ocorreu nos meses de agosto a setembro de 2019, por meio de entrevista semiestruturada com 13 enfermeiros. Resultados: Os entrevistados apontaram como desafios para a execução do cuidado: o despreparo do atendimento em decorrência da baixa carga horária dos cursos de graduação e a dificuldade de acesso à consultoria psiquiátrica. Em relação às sugestões, os enfermeiros entendem a necessidade de qualificar o cuidado através de capacitações, conhecimento da unidade de internação psiquiátrica do hospital e melhor dimensionamento de pessoal. Considerações finais: É imprescindível que sejam suscitadas reflexões a respeito da assistência a essas pessoas em outras áreas, contribuindo para a inclusão da subjetividade no cuidado integral no campo da saúde mental. (AU)

Objective: To analyze the challenges and suggestions in the care of clinical patients with psychiatric symptoms in the perception of nurses in clinical inpatient units of a general hospital. Methods: Qualitative, exploratory-descriptive study. Data collection took place from August to September 2019, through semi-structured interviews with 13 nurses. Results: The interviewees pointed out as challenges for the execution of the care: the unpreparedness of the care due to the low workload of the undergraduate courses and the difficulty of access to psychiatric consultancy. Regarding the suggestions, nurses understand the need to qualify care through training, knowledge of the hospital's psychiatric inpatient unit and better staffing. Conclusion: It is essential that reflections are raised regarding assistance to these people in other areas, contributing to the inclusion of subjectivity in comprehensive care in the field of mental health. (AU)

Objetivo: Analizar los desafíos y sugerencias en la atención de pacientes clínicos con síntomas psiquiátricos en la percepción de enfermeras en unidades de internación clínica de un hospital general. Métodos: Estudio cualitativo, exploratorio-descriptivo. La recolección de datos se realizó de agosto a septiembre de 2019, a través de entrevistas semiestructuradas con 13 enfermeras. Resultados: Los entrevistados señalaron como desafíos para la ejecución de la atención: la falta de preparación de la atención debido a la baja carga de trabajo de los cursos de pregrado y la dificultad de acceso a la consultoría psiquiátrica. Respecto a las sugerencias, los enfermeros comprenden la necesidad de calificar la atención a través de la capacitación, el conocimiento de la unidad de internación psiquiátrica del hospital y una mejor dotación de personal. Conclusion: Es fundamental que se planteen reflexiones sobre la atención a estas personas en otros ámbitos, contribuyendo a la inclusión de la subjetividad en la atención integral en el campo de la salud mental. (AU)

Feline sporotrichosis: associations between clinical-epidemiological profiles and phenotypic-genotypic characteristics of the etiological agents in the Rio de Janeiro epizootic area

BACKGROUND Sporotrichosis is caused by species of the genus Sporothrix. From 1998 to 2015, 4,703 cats were diagnosed at the Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. Even after the description of the Sporothrix species, the characterisation of feline isolates is not performed routinely. OBJECTIVES To characterise the clinical isolates from cats at the species level and correlate them with the clinical and epidemiological characteristics of the cats. METHODS Forty seven Sporothrix spp. isolates from cats assisted at Fiocruz from 2010 to 2011 were included. Medical records were consulted to obtain the clinical and epidemiological data. The isolates were identified through their morphological and physiological characteristics. T3B polymerase chain reaction (PCR) fingerprinting was used for molecular identification of the species. FINDINGS In phenotypic tests, 34 isolates were characterised as S. brasiliensis, one as S. schenckii and 12 as Sporothrix spp. PCR identified all isolates as S. brasiliensis. MAIN CONCLUSIONS S. brasiliensis is the only etiological agent of feline sporotrichosis in Rio de Janeiro to date. None association was found between the isolates and the clinical and epidemiological data. In addition, we strongly recommend the use of molecular techniques for the identification of isolates of Sporothrix spp.

Alterações fisiológicas e motivação da prática física do boxe: o virtual é viável? / Acute physiological changes and motivation to exercise boxing: Is the "virtual" boxing feasible?

Este estudo analisou alterações metabólicas, cardiovasculares e motivacionais de adultos jovens submetidos a uma sessão de boxe real e virtual, utilizando o console Xbox360 com Kinect. Em um estudo experimental cruzado, 10 adultos jovens saudáveis, de ambos os sexos, eutróficos (idade: 21±1 anos; índice de massa corporal: 23±1kg/m2 ; consumo de oxigênio pico: 25,5±5,9mL/kg/min) foram submetidos aleatoriamente a sessões de boxe real (saco de areia) e virtual (Kinect Sports Boxing) com duração de 15 minutos cada, com intervalo de 24h entre as sessões. A frequência cardíaca foi registrada durante todas as sessões e pressão arterial sistólica e diastólica antes e após as sessões. O gasto energético e o consumo de oxigênio foram estimados a partir da intensidade e duração das sessões. Ao final de cada sessão, registraram-se a percepção subjetiva de esforço e o grau de satisfação/motivação. A sessão de boxe real apresentou maior gasto energético, consumo de oxigênio, frequência cardíaca média e percepção subjetiva de esforço comparada à sessão virtual (P<0,05). Contudo, frequência cardíaca máxima, pressão arterial sistólica e diastólica e motivação/satisfação foram similares entre as sessões (P>0,05). Conclui-se que apesar de as alterações fisiológicas terem sido maiores na sessão real, caso o praticante não tenha a opção de sair de casa para treinar o boxe real ou apresente condições clínicas específicas, o virtual apresenta-se viável. Além disso, em virtude de a pressão arterial, frequência cardíaca máxima e motivação à prática apresentarem-se semelhantes à sessão real, indica-se o boxe virtual como uma prática de variabilidade ao treino dos praticantes de boxe....(AU)

This study analyzed metabolic, cardiovascular and motivational changes of young adults who underwent real and virtual boxing sessions, using the active video games in Xbox360 with Kinect. In a crossover study, 10 young adults, both sexes, eutrophics (age: 21±1 years; body mass index: 23±1kg/m2; oxygen consumption-peak: 25.5±5.9mL/kg/min) underwent real (sandbag) and virtual (Kinect Sports Boxing) randomized boxing sessions, lasting 15 minutes each, separated by 24 hours. Average and maximum heart rate were recorded during the sessions and systolic and diastolic blood pressure before and after sessions. Caloric expenditure and oxygen consumption were estimated from the session's intensity and duration. At the end of each session, perceived exertion and satisfaction/motivation scores were recorded. Real boxing session showed caloric expenditure, oxygen consumption, average heart rate and perceived exertion higher compared to the virtual session (P<0.05). However, maximum heart rate, systolic and diastolic blood pressure and motivation/satisfaction were similar between sessions (P>0.05). In conclusion, although metabolic changes had been higher in the real session, the virtual shows feasible, considering the subject not have the option of leaving home to train boxing or presents specific clinical conditions. Moreover, due to blood pressure, maximum heart rate and motivation to practice showed similar to the real session, virtual boxing is indicated as an alternative training to boxing practitioners....(AU)

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

BACKGROUND Sporothrix brasiliensis is the most virulent sporotrichosis agent. This species usually responds to antifungal drugs, but therapeutic failure can occur in some patients. Antifungal susceptibility tests have been performed on this species, but no clinical breakpoints (CBPs) are available. In this situation, minimal inhibitory concentration (MIC) distributions and epidemiological cutoff values (ECVs) support the detection of identification of resistant strains. OBJECTIVES To study the MIC distributions of five antifungal drugs against S. brasiliensis and to propose tentative ECVs. METHODS MICs of amphotericin B (AMB), itraconazole (ITR), ketoconazole (KET), posaconazole (POS), and terbinafine (TRB) against 335 S. brasiliensis strains were determined by the Clinical and Laboratory Standards Institute broth microdilution method. FINDINGS The proposed ECV, in µg/mL, for AMB, ITR, KET, POS, and TRB were 4.0, 2.0, 1.0, 2.0, and 0.25, respectively. Percentages of wild-type strains in our population for the above antifungal drugs were 98.48, 95.22, 95.33, 100, and 97.67%, respectively. MAIN CONCLUSIONS These ECVs will be useful to detect strains with resistance, to define CBPs, and to elaborate specific therapeutic guidelines for S. brasiliensis. Rational use of antifungals is strongly recommended to avoid the emergence of resistant strains and ensure the therapeutic effectiveness of sporotrichosis.

MOLECULAR IDENTIFICATION OF Bartonella henselae IN A SERONEGATIVE CAT SCRATCH DISEASE PATIENT WITH AIDS IN RIO DE JANEIRO, BRAZIL / Identificação molecular de Bartonella henselae em paciente com SIDA soronegativo para doença da arranhadura do gato no Rio de Janeiro, Brasil

Bartonella henselae is associated with a wide spectrum of clinical manifestations, including cat scratch disease, endocarditis and meningoencephalitis, in immunocompetent and immunocompromised patients. We report the first molecularly confirmed case of B. henselae infection in an AIDS patient in state of Rio de Janeiro, Brazil. Although DNA sequence of B. henselae has been detected by polymerase chain reaction in a lymph node biopsy, acute and convalescent sera were nonreactive.

Bartonella henselae está associada a um amplo espectro de manifestações clínicas, incluindo a doença da arranhadura de gato, endocardite, e meningoencefalite, em pacientes imunocompetentes e imunocomprometidos. Relatamos o primeiro caso confirmado por método molecular de B. henselae em um paciente com SIDA no estado do Rio de Janeiro, Brasil. Apesar da sequência de DNA de B. henselae ser detectada pela reação em cadeia da polimerase em uma biópsia do linfonodo, soros das fases aguda e convalescente foram não reativos.

Immune response after rabies oral immunization in mice

The objective of this study was to formulate an anti-rabies oral vaccine from the cell culture vaccine PV TECPAR to elicit the production of antibodies against the rabies in mice. A vaccine was developed using 10(7.5) DL50/0.03 ml viral antigens homogenised in lanovaseline to facilitate oral administration. Mice were vaccinated two times for seroconversion. Sera of the vaccinated mice showed a higher level of antibody production than the control group. These results could be used to direct the development of an anti-rabies oral vaccine.

Percepções de estudantes de Medicina Veterinária do Rio de Janeiro relacionadas à biossegurança esporotricose / Perceptions of veterinary students from Rio de Janeiro related to biosafety and sporotrichosis

A esporotricose acomete seres humanos e animais e é causada pelo fungo Sporothrix schenckii. Há 13 anos vem sendo descrita uma epidemia envolvendo seres humanos, cães e gatos no Estado do Rio de Janeiro. O médico veterinário insere-se neste contexto como grupo ocupacional de risco e como agente promotor de saúde e para isso necessita estar atualizado com relação à doença em si e aos procedimentos de Biossegurança.

Sporotrichosis affects humans and animals and is caused by the fungus Sporothrix schenckii. An epidemic of this disease involving human beings, dogs and cats has been described since 1998 in the state of Rio de Janeiro. Veterinarian !ts into this context as occupational risk group as well as a public health agent and thus needs to be well informed and updated about the disease and biosafety procedures.

Relato de caso autóctone de leishmaniose visceral canina na zona sul do município do Rio de Janeiro / Report on an autochthonous case of canine visceral leishmaniasis in the southern zone of the municipality of Rio de Janeiro

O Brasil enfrenta uma expansão e urbanização da leishmaniose visceral americana com casos humanos e caninos em várias cidades de grande porte. O presente relato descreve um caso de leishmaniose visceral canina autóctone em uma área não endêmica no município de Rio de Janeiro.

Brazil is facing expansion and urbanization of American visceral leishmaniasis, with human and canine cases in several large-sized cities. This report describes an autochthonous case of canine visceral leishmaniasis in a nonendemic area in the municipality of Rio de Janeiro.

Esporotricose felina estudo terapêutico no Rio de Janeiro / Feline sporotrichosis therapeutic study in Rio de Janeiro

A esporotricose é causada pelo fungo dimórfico Sporothrix schenckii que acomete humanos e animais. O gato é a espécie animal com o maior número de casos relatados até o momento. É uma doença freqüente no Rio de Janeiro e a transmissão zoonótica relacionada a gatos infectados vem aumentando na última década. A esporotricose felina possui variadas apresentações clínicas e o tratamento representa um desafio para o médico veterinário. Os esquemas terapêuticos recomendados para o tratamento da esporotricose felina estão baseados em relatos de casos isolados ou em estudo de série de casos, não tendo sido ainda executados estudos prospectivos controlados. O itraconazol e o cetoconazol são os antifúngicos mais utilizados, sendo o primeiro o fármaco de eleição...

Os iodetos, a terbinafina, a termoterapia local, a anfotericina B e a remoção cirúrgica das lesões cutâneas são outras opções de tratamento. Através de um estudo retrospectivo, realizado no Instituto de Pesquisa Clínica Evandro Chagas/FIOCRUZ no período de 2002-2005, comparou-se a efetividade e a segurança do cetoconazol e itraconazol no tratamento da esporotricose felina. Quinhentos e noventa e oito gatos receberamcetoconazol e 175 itraconazol. Foram curados 238 gatos (30,8%), 28,6 % dos que receberam cetoconazol 50-100 mg/gato (13,5-27,0 mg/kg/dia) e 38,3% dos tratados com itraconazol 30-100 mg/gato (8,3-27,7 mg/kg/dia)Efeitos adversos ocorreram em 39,6% dos gatos incluídos, 13,6 % vi vieram a óbito por diferentes causas e 55,6 % abandonaram ou ainda encontravam-se em tratamento. Estes resultados sugeriram que o itraconazol foi mais efetivo e seguro que o cetoconazol. Foi delineado um ensaio clínico controlado, randomizado e duplo-cego com objetivo de avaliar futuramente a eficácia e a segurança de diferentes doses de cetoconazol e itraconazol no tratamento da esporotricose felina...

Utilidade do coágulo sangüíneo para o isolamento de Sporothrix schenckii de gatos naturalmente infectados / Sporothrix schenckii isolation from blood clot of naturally infected cats

O diagnóstico de esporotricose disseminada costuma ser obtido através da necrópsia e o isolamento de Sporothrix schenckii do sangue é raro. Fungemia foi demonstrada in vivo através do isolamento do S. schenckii do sangue periférico de 13 (n=38; 34,2%) gatos com esporotricose naturalmente adquirida. A coinfecção com FIV e com FeLV encontradas, respectivamente, em 6 (n=34; 17,6%) casos e 1 (n=34; 2,9%), aparentemente não alterou a freqüência do isolamento de S. schenckii do sangue periférico. Comparando estes resultados aos dos hemocultivos realizados simultaneamente houve concordância de 84,2%. Assim, propomos o cultivo do coágulo como um método alternativo prático, eficiente e econômico para o diagnóstico de esporotricose disseminada em gatos in vivo.