Sporotrichosis co-infection with human immunodeficiency virus/acquired immunodeficiency syndrome.

Sporotrichosis is a subcutaneous mycosis caused by a dimorphic fungus belonging to the genus Sporothrix. This fungal infection can affect both humans and domestic animals, and in recent years, an increase in the geographic spread and prevalence of sporotrichosis has been observed globally. This systematic review aimed to examine the clinical-epidemiological and therapeutic aspects related to sporotrichosis co-infection with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). An extensive electronic search was conducted on databases including PubMed, Web of Science, Lilacs, Medline, Embase, Scopus and SciELO was performed to identify clinical cases of people living with HIV (PLWH) with sporotrichosis published until May 2023. As a result, we found that most co-infected patients were male, representing 71.76% (94/131) of cases. The most prevalent age group was 41-50 years, with a mean age of 36.98 years. The countries with the highest number of cases were Brazil (75.57%, 99/131) and the United States (16.03%, 21/131). The most frequent clinical presentation was systemic dissemination, accounting for 69.47% (91/131) of the cases, followed by cutaneous dissemination with 13% (17/131). The mean CD4+ cell count was 154.07 cells/µL, and most patients used amphotericin B with at least one azole, which represented 47.33% (62/131) of cases, followed by azole monotherapy in 17.56% (23/131) of cases. As for the outcome, 51.15% (67/131) of the patients remained alive, and 37.4% (49/131) died. Therefore, it was concluded that sporotrichosis in PLWH is a disease with a high prevalence in Brazil and may be associated with systemic clinical manifestations requiring longer periods of systemic antifungal therapy.

Onychomycosis Caused by Fusarium Species.

Onychomycosis is a nail fungal infection that produces nail discolouration, thickness, and separation from the nail bed. The species of the Fusarium genus that cause onychomycosis are emerging and the number of cases has increased throughout the years. Microscopic examination, as well as cultures, are required for the accurate diagnosis of onychomycosis. The goal of treatment is to eliminate the organism that causes the disease and restore the nail's normal appearance. Here, we provide an overview of the onychomycosis cases that have been reported in literature over the last 24 years, which have been caused by the Fusarium species. We performed a review on the onychomycosis cases caused by the Fusarium species from January 1997 to January 2021. Patients aged between 40 and 49 years made up 30.23% of the cases. The most common aetiologic species was Fusarium solani species complex (FSSC), which accounted for 44.11% of the cases, followed by F. fujikuroi species complex (FFSC), which accounted for 17.64%; 14.70% of the cases were due to F. dimerum species complex (FDSC) and 14.70% of the cases were due F. oxysporum species complex (FOSC). Europe accounted for 29.06% of the cases caused by FOSC, whereas Africa accounted for 46.67% of the cases due to FSSC. The clinical presentation of onychomycosis due to Fusarium spp. is commonly the distal-lateral pattern of onychomycosis. Identification of the infectious agent in onychomycosis cases due to Fusarium is crucial in deciding the proper treatment. Although antifungal susceptibility tests have only been performed in a few cases, susceptibility testing can help with patient management.