Resumo
A esporotricose é uma micose de difícil tratamento e tem os gatos como seu principal hospedeiro. Suas manifestações clínicas são caracterizadas, principalmente por lesões de continuidade ulcerativas na pele e subcutâneo, linfocutânea, disseminada, com presença de sinais extracutâneo e sistêmica fatal. Seu tratamento baseia-se na administração de antifúngicos sistêmicos e tópicos, porém causam danos expressivos ao organismo e ao ambiemte. Com poucas opções de tratamento, a ozonioterapia pode ser indicada para o tratamento de afecções infecciosas para esporotricose, devido a ação fungicida, analgésica e anti-inflamatória. Objetivou-se em descrever o caso clínico de um felino, macho, castrado de 1 ano e 8 meses, que apresentava lesões ulcerativas no membro pélvico esquerdo e coxim plantar, diagnosticado com esporotricose. Uma vez que não havia a regressão das lesões com o tratamento convencional, foi instituído a ozonioterapia pela técnica de insuflação de bag's. Após 12 sessões, as feridas estavam parcialmente cicatrizadas, manteve-se o tratamento convencional com a adição do uso de óleo de girassol ozonizado até a regressão total das lesões.
Sporotrichosis is a mycosis that is difficult to treat and has cats as main hosts. Its clinical manifestations are characterized mainly by ulcerative skin lesions and subcutaneous, lymphocutaneous, disseminated, with the presence of extracutaneous and fatal systemic signs. Its treatment is based on the administration of systemic and topical antifungals, but they cause significant damage to the organism and the environment. With few treatment options, ozone therapy can be indicated for the treatment of infectious conditions for sporotrichosis, due to its fungicidal, analgesic and anti-inflammatory action. The objective was to describe the clinical case of a feline, male, castrated 1 year and 8 months old, who had ulcerative lesions on the left pelvic limb and foot pad, diagnosed with sporotrichosis. Since there was no regression of the lesions with conventional treatment, ozone therapy was instituted using the bag inflation technique. After 12 sessions, the wounds were partially healed, the conventional treatment was maintained with the addition of the use of ozonated sunflower oil until the total regression of the lesions.
La esporotricosis es una micosis de difícil tratamiento que tiene al gato como uno de sus principales huéspedes. Sus manifestaciones clínicas se caracterizan principalmente por lesiones ulcerativas continuas en piel y subcutáneas, linfocutáneas, diseminadas, con presencia de signos extracutáneos y sistémicos fatales. Su tratamiento se basa en la administración de antifúngicos sistémicos y tópicos, pero provocan importantes daños al organismo y al medio ambiente. Con pocas opciones de tratamiento, la ozonoterapia puede estar indicada para el tratamiento de cuadros infecciosos por esporotricosis, debido a su acción fungicida, analgésica y antiinflamatoria. El objetivo fue describir el caso clínico de un felino, macho, castrado de 1 año y 8 meses de edad, que presentaba lesiones ulcerativas en miembro pélvico izquierdo y almohadilla plantar, diagnosticado de esporotricosis. Dado que no hubo regresión de las lesiones con el tratamiento convencional, se instauró ozonoterapia mediante la técnica de bolsa inflada. Después de 12 sesiones, las heridas cicatrizaron parcialmente, se mantuvo el tratamiento convencional con la adición del uso de aceite de girasol ozonizado hasta la regresión total de las lesiones.
Assuntos
Animais , Masculino , Gatos , Esporotricose/tratamento farmacológico , Sporothrix/isolamento & purificação , Itraconazol/administração & dosagem , Óleo de Girassol/análise , OzonioterapiaResumo
A esporotricose é uma micose zoonótica subcutânea causada por fungos do complexo Sporothrix sp., que vem se apresentando frequentemente devida a sua forma de transmissão através do gato e a fácil disseminação do agente. A doença teve relevância a partir das epidemias ocorridas no Rio de Janeiro no final do século 20 e apesar do seu reconhecimento pelos órgãos governamentais, ainda é considerada negligenciada e subdiagnosticada. O estudo de metanálise envolvendo 147 trabalhos publicados entre os anos de 2010 a 2020 revelou que o Brasil apresentou destaque na ocorrência da esporotricose, inclusive demonstrando maior produção científica global e figurando papel central na coordenação de ações para colaboração científica com outros países nesta área do conhecimento. Estas ações conjuntas têm resultado em campanhas nas mídias sociais, alertando os tutores dos gatos dos riscos e de como a doença se apresenta clinicamente. Apesar do seu bom prognóstico, a doença é um problema de saúde pública nas diversas regiões do Brasil. A observação dos sinais clínicos e do histórico associado aos meios de diagnóstico são fundamentais para o reconhecimento da esporotricose, sendo das formas de diagnóstico o cultivo e a citologia considerados padrão ouro para identificação do agente Sporothrix sp. O reconhecimento rápido da esporotricose é fundamental, portanto esta revisão tem por objetivo descrever os padrões clínicos-epidemiológicos da doença e ressaltar sua importância para a sociedade.
Sporotrichosis is a subcutaneous zoonotic Dermatophytosis caused by fungi from the complex Sporothrix sp., it's been frequently seen due to it's propagation by the cat and easy dissemination of the agent. The disease has been relevant since the epidemics taken place in Rio de Janeiro in the end of the 20th century, although it was recognized by the government agencies, still considered neglected and underdiagnosed. The meta-analysis study involving 147 works published between 2010 and 2020 revealed that Brazil was highlighted in the occurrence of sporotrichosis, including demonstrating greater global scientific production and figuring a central role in coordinating actions for scientific collaboration with other countries. These joint actions have resulted in social media campaigns, alerting cat guardians of the risks and how the disease presents clinically. Although its good prognosis, the disease has become a public health problem in the diverse regions of Brasil, affecting humans and cats. The observation of the clinical signs and history associated to the diagnostic means are essential to the identification of the Sporotrichosis, by the means of diagnosis, the growth and cytology considered golden standard to identify the agent Sporthrix sp. A quick identification of the sporotrichosis is essential, therefore this review has the porpouse of describing clinical and epidemological patterns of the desease and highlight its significance to society.
Assuntos
Animais , Gatos , Doenças do Gato , Esporotricose/veterinária , Micoses/veterinária , Sporothrix/patogenicidade , ZoonosesResumo
A esporotricose é uma micose zoonótica subcutânea causada por fungos do complexo Sporothrix sp., que vem se apresentando frequentemente devida a sua forma de transmissão através do gato e a fácil disseminação do agente. A doença teve relevância a partir das epidemias ocorridas no Rio de Janeiro no final do século 20 e apesar do seu reconhecimento pelos órgãos governamentais, ainda é considerada negligenciada e subdiagnosticada. O estudo de metanálise envolvendo 147 trabalhos publicados entre os anos de 2010 a 2020 revelou que o Brasil apresentou destaque na ocorrência da esporotricose, inclusive demonstrando maior produção científica global e figurando papel central na coordenação de ações para colaboração científica com outros países nesta área do conhecimento. Estas ações conjuntas têm resultado em campanhas nas mídias sociais, alertando os tutores dos gatos dos riscos e de como a doença se apresenta clinicamente. Apesar do seu bom prognóstico, a doença é um problema de saúde pública nas diversas regiões do Brasil. A observação dos sinais clínicos e do histórico associado aos meios de diagnóstico são fundamentais para o reconhecimento da esporotricose, sendo das formas de diagnóstico o cultivo e a citologia considerados padrão ouro para identificação do agente Sporothrix sp. O reconhecimento rápido da esporotricose é fundamental, portanto esta revisão tem por objetivo descrever os padrões clínicos-epidemiológicos da doença e ressaltar sua importância para a sociedade.(AU)
Sporotrichosis is a subcutaneous zoonotic Dermatophytosis caused by fungi from the complex Sporothrix sp., it's been frequently seen due to it's propagation by the cat and easy dissemination of the agent. The disease has been relevant since the epidemics taken place in Rio de Janeiro in the end of the 20th century, although it was recognized by the government agencies, still considered neglected and underdiagnosed. The meta-analysis study involving 147 works published between 2010 and 2020 revealed that Brazil was highlighted in the occurrence of sporotrichosis, including demonstrating greater global scientific production and figuring a central role in coordinating actions for scientific collaboration with other countries. These joint actions have resulted in social media campaigns, alerting cat guardians of the risks and how the disease presents clinically. Although its good prognosis, the disease has become a public health problem in the diverse regions of Brasil, affecting humans and cats. The observation of the clinical signs and history associated to the diagnostic means are essential to the identification of the Sporotrichosis, by the means of diagnosis, the growth and cytology considered golden standard to identify the agent Sporthrix sp. A quick identification of the sporotrichosis is essential, therefore this review has the porpouse of describing clinical and epidemological patterns of the desease and highlight its significance to society.(AU)
Assuntos
Animais , Gatos , Doenças do Gato , Esporotricose/veterinária , Zoonoses , Sporothrix/patogenicidade , Micoses/veterináriaResumo
Background: Sporotrichosis is a deep cutaneous mycosis caused by the Sporothrix species complex, dimorphic fungi of which at least five are of clinical importance: S. brasiliensis, S. globosa, S. luriei, S. mexicana, and S. schenckii sensu stricto. The disease affects humans and animals, especially cats, which can manifest a wide spectrum of clinical sings, from cutaneous-lymphatic involvement to disseminated form. Infection usually results from direct inoculation of the fungus into skin. Zoonotic transmission is associated with scratching or biting of sick cats. The aim of this work was to report an atypical case of bone sporotrichosis in a cat.Case: A 5-year-old, male, neutered, mongrel and indoor cat was present at the Veterinary Clinic Hospital, Federal University of Rio Grande do Sul (HCV-UFRGS), Porto Alegre, Brazil, with lameness and increased volume in the left hindlimb. The animal had been treated intermittently with itraconazole during the last three years due to another cutaneous lesion which was recurrent and undiagnosed. A firm and painful mass was found in tarsal region of left hindlimb, that had approximately 5 cm in diameter. Radiographic examination of the left tibial-tarsal joint revealed bone lysis in the fifth metatarsal calcaneus, in addition to periosteum proliferation in calcaneus, tibio-tarsal subluxation, presence of osteophytes in tarsal bones and increase in soft tissue volume. Histopathological analysis of the biopsied tissue showed piogranulomatous inflammation. No yeast-like structures were observed in cytopathological exam. Tissue fragments were plated and Sporothrix sp. complex growth in mycological culture (Sabouraud Cycloheximide Chloramphenicol Agar). Physiological tests (growth rate at different temperatures and assimilation of sucrose and raffinose) were conducted for the differentiation of the species of complex. Molecular identification was performed using panfungal primers (ITS3-F / ITS4-R)...
Assuntos
Animais , Gatos , Doenças Ósseas/veterinária , Esporotricose/veterinária , Osso e Ossos/lesões , Sporothrix , Reação em Cadeia da Polimerase/veterináriaResumo
Background: Sporotrichosis is a deep cutaneous mycosis caused by the Sporothrix species complex, dimorphic fungi of which at least five are of clinical importance: S. brasiliensis, S. globosa, S. luriei, S. mexicana, and S. schenckii sensu stricto. The disease affects humans and animals, especially cats, which can manifest a wide spectrum of clinical sings, from cutaneous-lymphatic involvement to disseminated form. Infection usually results from direct inoculation of the fungus into skin. Zoonotic transmission is associated with scratching or biting of sick cats. The aim of this work was to report an atypical case of bone sporotrichosis in a cat.Case: A 5-year-old, male, neutered, mongrel and indoor cat was present at the Veterinary Clinic Hospital, Federal University of Rio Grande do Sul (HCV-UFRGS), Porto Alegre, Brazil, with lameness and increased volume in the left hindlimb. The animal had been treated intermittently with itraconazole during the last three years due to another cutaneous lesion which was recurrent and undiagnosed. A firm and painful mass was found in tarsal region of left hindlimb, that had approximately 5 cm in diameter. Radiographic examination of the left tibial-tarsal joint revealed bone lysis in the fifth metatarsal calcaneus, in addition to periosteum proliferation in calcaneus, tibio-tarsal subluxation, presence of osteophytes in tarsal bones and increase in soft tissue volume. Histopathological analysis of the biopsied tissue showed piogranulomatous inflammation. No yeast-like structures were observed in cytopathological exam. Tissue fragments were plated and Sporothrix sp. complex growth in mycological culture (Sabouraud Cycloheximide Chloramphenicol Agar). Physiological tests (growth rate at different temperatures and assimilation of sucrose and raffinose) were conducted for the differentiation of the species of complex. Molecular identification was performed using panfungal primers (ITS3-F / ITS4-R)...(AU)
Assuntos
Animais , Gatos , Esporotricose/veterinária , Sporothrix , Doenças Ósseas/veterinária , Osso e Ossos/lesões , Reação em Cadeia da Polimerase/veterináriaResumo
As micoses subcutâneas são doenças causadas por uma ampla variedade de fungos que após implante traumático, invadem tecidos cutâneo e subcutâneo. A esporotricose é uma micose subcutânea, subaguda ou crônica, causada por diferentes espécies do gêneroSporothrix, que apresenta distribuição mundial. As lesões são frequentemente restritas à pele, tecido subcutâneo e vasos linfáticos adjacentes, mas há relatos de infecções pulmonares primárias, osteoarticulares e conjuntivas, bem como disseminadas. É adquirida pela manipulação de material contaminado como vegetação e, especialmente, pelo contato com gatos infectados. Ocorre em microrregiões do Sul, Sudeste e especialmente na cidade do Rio de Janeiro, onde a esporotricose é endêmica. Entretanto dados sobre casos de esporotricose nas áreas metropolitanas da região sul do país ainda são escassos. Desta forma, este estudo bouscou realizar um copilados dos dados disponíveis para a estimar a ocorrência de esporotricose humana, felina e zoonótica em algumas cidades da Região Metropolitana de Porto Alegre (RMPA). Com este objetivo foi realizado um levantamento retrospectivo da esporotricose felina diagnosticada em dois setores da Faculdade de Veterinária da UFRGS. Os dados de pacientes humanos foram obtidos através de consulta a laboratórios de Micologia de dois Hospitais localizados em Porto Alegre e a algumas Secretarias da Saúde de cidades da RMPA. Foram analisadas 256 amostras de felinos com lesões dermatológicas suspeitas de esporotricose e identificados 104 (40,6%) casos positivos, cujo diagnóstico foi realizado através das técnicas isoladas ou associadas de citologia, histopatologia e cultivo. O uso da PCR permitiu caracterizar 21 isolados como Sporothrix brasilensis, dados que corroboram outros trabalhos já descritos na literatura nacional. Trabalhos recentes descrevem novas espécies isoladas de casos clínicos em humanos e animais enfatizam que existem diferenças quanto à susceptibilidade e, provavelmente ao grau de patogenicidade das mesmas. No âmbito desse estudo, foi possível coligir dados de 44 casos de esporotricose humana e 29 de esporotricose zoonótica. É muito provável que, dentre os casos reportados como só acometendo humanos, em muitos deles a infecção tenha sido contraída de gatos contaminados. Em relação a esses dados sobre esporotricose em humanos, é preciso enfatizar que, por diversas razões, os mesmos podem ser considerados como subnotificados. É preciso envidar esforços para que haja uma coordenação estadual que elabore um questionário padrão a ser distribuído para todos serviços de saúde e de Hospitais para que esta micose subcutânea, mas que pode causar óbito em paciente imunodeprimido, seja considerada como doença de notificação compulsória no Rio Grande do Sul à semelhança do que já ocorre em alguns municípios e estados brasileiros.
Subcutaneous mycotic diseases are caused by a wide range of fungi, which may, after traumatic introduction, invade cutaneous and subcutaneous tissues. Sporotrichosis is an acute to chronic subcutaneous mycosis caused by species belonging to the genus Sporothrix, a dimorphic fungus worldwide distributed. Lesions are frequently restricted to the skin, subcutaneous tissue, and adjacent lymphatics, but primary pulmonary, bone-joint, and conjunctiva infections, as well as disseminated diseases have been reported. The infection is acquired by the manipulation of contaminated material, such as vegetation and, specially, by direct contact with infected cats. It occurs in restricted areas of the Southern and Southeast regions, but most notably in Rio de Janeiro city, wherein sporotrichosis is endemic. However, information regarding sporotrichosis cases in the metropolitan area of the Southern region is still lacking. Therefore, we compiled the available data of humans, cats, and zoonotic sporotrichosis occurrence in some cities of the Metropolitan Area of Porto Alegre city (RMPA). Considering this aim, we did a retrospective study of feline sporotrichosis diagnosed in two laboratories of the Faculdade de Veterinária from UFRGS. Human patients data were obtained through a consult to Mycology laboratories in two hospitals located in Porto Alegre city, as well as some Secretary for Health from cities of the RMPA. A total of 256 samples of cats with cutaneous lesions and a suspicious diagnosis of sporotrichosis were found, of which 104 (40.6%) were positive. In these cases, the diagnosis was obtained through cytology, histopathology, and/or culture. In addition, 21 isolates were characterized as Sporothrix brasilensis through PCR, which is similar to other studies reported nationally. Recent published data have described new isolated species from clinical cases in humans and animals, which emphasize that susceptibility and pathogenicity to these isolates may differ. Within the scope of this study, it was possible to collect 44 cases of human sporotrichosis and 29 cases of zoonotic sporotrichosis. In cases affecting only humans it is most likely that in many of these the infection was acquired from contaminated cats. With regards to the data of sporotrichosis in humans, it is necessary to emphasize that, for many reasons, these cases are probably underreported. It is, therefore, mandatory to undertake efforts so that the state health coordination develops a standardized survey form to be distributed to all health services and hospitals in order to consider subcutaneous mycosis an obligatory notification disease in Rio Grande do Sul state, as it may lead to death of immunocompromised patients, similarly to what already occurs in other Brazilian cities and states. Keywords: Subcutaneous Mycosis. Sporothrix sp. Retrospective Study. Zoonosis
Resumo
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 defi ned 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
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 defi ned 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
Resumo
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.
Assuntos
Humanos , Animais , Gatos , Esporotricose/diagnóstico , Esporotricose/etiologia , Esporotricose/prevenção & controle , Doenças do Gato/prevenção & controle , Contenção de Riscos Biológicos/veterinária , Zoonoses/transmissãoResumo
A esporotricose é uma micose subcutânea causada por espécies do complexo Sporothrix schenckii que acomete seres humanos e animais, principalmente os gatos. Desde 1998 o Instituto Nacional de Infectologia Evandro Chagas/Fiocruz no Rio de Janeiro vem acompanhando uma epidemia dessa doença envolvendo seres humanos, cães e gatos, onde as principais formas de transmissão são arranhadura, mordedura e/ou contato com o exsudato das lesões cutâneas de gatos doentes. O diagnóstico definitivo da esporotricose felina é obtido a partir do isolamento do Sporothrix sp. em meios de cultura, entretanto, o resultado desse exame pode demorar até quatro semanas, o que em algumas situações pode retardar o início do tratamento antifúngico. Os exames citopatológico, histológico e imuno-histoquímico são opções viáveis e mais rápidas para o diagnóstico dessa micose em gatos, principalmente em situações quando não é possível realizar o isolamento fúngico. O diagnóstico precoce da esporotricose felina é importante na implementação rápida do tratamento antifúngico, melhorando o prognóstico na maioria dos casos. O objetivo deste estudo foi avaliar e comparar as diferentes técnicas utilizadas no diagnóstico da esporotricose felina antes e durante o tratamento antifúngico. Na primeira etapa do estudo foram comparados os exames citopatológico (coloração pelo método panótico rápido), histológico (impregnação pela prata de Grocott) e imuno-histoquímico de 184 gatos no diagnóstico da esporotricose sem tratamento antifúngico prévio utilizando o cultivo fúngico como teste padrão de referência. Estruturas leveduriformes foram observadas em 160 (87,0%) casos no exame citopatológico, 168 (91,3%) na histopatologia e 163 (88,3%) na imunohistoquímica. A associação das três técnicas elevou a sensibilidade do diagnóstico para 98,3%, o que enfatiza a necessidade de sua implementação como ferramentas de rotina, sobretudo quando a cultura fúngica não está disponível. Na etapa seguinte, a carga parasitária e o isolamento de Sporothrix sp. das lesões cutâneas de 74 gatos foram avaliados mensalmente antes e durante o tratamento com itraconazol por um período de 12 semanas. A mediana da carga fúngica observada antes do início do tratamento antifúngico foi maior (pMW = 0,013) nos gatos nos quais foi observada a persistência da lesão (Med=98,6) em relação aqueles em que houve cicatrização (Med=15,0). A redução da carga fúngica ocorreu em todas as lesões estudadas, assim como a redução da positividade da cultura fúngica e do exame citopatológico. Estes resultados sugerem uma redução no potencial zoonótico dos gatos, enfatizando a importância do tratamento precoce como medida de controle. Adicionalmente, o isolamento do fungo e a presença de estruturas leveduriformes nas lesões de gatos com esporotricose podem ser fatores preditores da falência terapêutica, indicando a necessidade da implementação de alternativas terapêuticas.
Sporotrichosis is subcutaneous mycose caused by species of fungus from the Sporothrix schenckii complex and affects humans and animals, especially cats. Since 1998, the Instituto Nacional de Infectologia Evandro Chagas/Fiocruz in Rio de Janeiro has been describing in Rio de Janeiro an epidemic of sporotrichosis, involving humans, cats and dogs, with most of cases related to transmission through scratches, bites or contact with lesions from infected cats. The definitive diagnosis is based on the isolation of the fungus in culture; however, the results may take up to four weeks and postpone treatment outset. The cytopathology, histopathology and immunohistochemistry should be considered as rapid and accessible alternatives for the diagnosis in cats, especially when the fungal culture is not available. The early diagnosis of feline sporotrichosis is desirable for the prompt beginning of the antifungal treatment, improving the prognosis in most of the cases. The aim of this study was to evaluate and compare different techniques for the diagnosis of feline sporotrichosis before and during the treatment with itraconazol. In the first part of the study, cytopathological (Quick Panoptic), histopathological (Grocott silver stain) and immunohistochemical examinations were compared regarding the diagnosis of sporotrichosis in 184 cats without previous treatment, by using fungal culture as a reference standard. The yeast-like cells were observed in 160 (87.0%) cases by cytopathological examination, in 168 (91.3%) by histopathology and in 163 (88.3%) by immunohistochemistry. The combination of the three methods led to the diagnosis of 98.3% of cases, pointing to the need of their implementation as regular tools, notably when fungal culture is not available. In the second part of the study, the fungal burden and the isolation of Sporothrix sp. in cutaneous lesions of 74 cats were monthly evaluated before and during the treatment with itraconazole for twelve weeks. The median of the fungal load detected before the outse of the antifungal treatment was higher (pMW=0.013) in cats in which there was a persistence of the cutaneous lesion (Med=98.6) in comparison to those in which healing of the lesion was observed (Med=15.0). The decrease of the fungal burden occurred in all the lesions in this study as well as the reduction of the positivity of the fungal culture and the cytopathological examination. These results suggest a reduction in the zoonotic potential of cats and emphasize the importance of the early treatment as a control measure. In addition, the isolation of the fungus and the presence of yeast-like cells in lesions of cats with sporotrichosis during the treatment can be a predictor of treatment failure and should alert for the need of alternative therapeutic regimens.
Resumo
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 defi ned 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
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 defi ned 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