Clinical characteristics, diagnosis, and treatment of central nervous system sporotrichosis: Systematic review and meta-analysis.
Mycoses
; 67(2): e13697, 2024 Feb.
Article
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| 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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Esporotricosis
/
Sporothrix
/
Antifúngicos
Límite:
Adult
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Animals
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Female
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Humans
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Male
País/Región como asunto:
America do norte
/
America do sul
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Brasil
Idioma:
En
Revista:
Mycoses
Asunto de la revista:
MICROBIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Brasil