Clinical characteristics, diagnosis, and treatment of central nervous system sporotrichosis: Systematic review and meta-analysis.
Mycoses
; 67(2): e13697, 2024 Feb.
Article
in En
| MEDLINE
| ID: mdl-38374494
ABSTRACT
BACKGROUND:
The clinical features of central nervous system (CNS) sporotrichosis are derived from case reports and a limited series of cases. Our objective was to carry out a systematic review and meta-analysis of CNS sporotrichosis.METHODS:
We searched PubMed/MEDLINE, Embase, Scopus, and LILACS on 9 September 2023. Our inclusion criteria were documentation of Sporothrix and demonstrated CNS involvement. A metaproportion or metamean analysis was performed to estimate a summary proportion with 95% confidence intervals.RESULTS:
We included 52 cases of CNS sporotrichosis published from 1966 to 2023. Forty-six patients were male (88%, 95% CI 77-95), and the mean age was 39 years (95% CI 36-43). Close contact with cats was reported in 55% of cases (95% CI 37-72). Thirty-two (61.5%) patients were from Brazil, 18 patients from the United State of America (34.6%). Only two Sporothrix species were reported S. schenckii (26/41, 63%), and S. brasiliensis (15/41, 37%). The most common neurological symptom was headache. Meningitis was chronic in approximately 80% of cases. A significant majority of the patients were immunocompromised. HIV infection was the primary cause of immunosuppression (85%, 95% CI 61-95). Overall mortality was 56% (22/39). The comparison of Kaplan-Meier survival curve showed a higher mortality with a statistically significant difference in immunosuppressed patients (p = .019).CONCLUSION:
CNS sporotrichosis represents a notable cause of chronic meningitis, especially in individuals living in the Americas with HIV infection and concurrent skin lesions.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Sporotrichosis
/
Sporothrix
/
Antifungal Agents
Limits:
Adult
/
Animals
/
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
/
America do sul
/
Brasil
Language:
En
Year:
2024
Type:
Article