Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil.
<h4>Background</h4>Bone sporotrichosis is rare. The metropolitan region of Rio de Janeiro is hyperendemic for zoonotic sporotrichosis and the bone presentations are increasing.<h4>Methods</h4>We studied a retrospective cohort of 41 cases of bone sporotrichosis, diagnosed from...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-03-01
|
| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0009250 |
| _version_ | 1818937387868225536 |
|---|---|
| author | Vanessa Ramos Guis S-M Astacio Antonio C F do Valle Priscila M de Macedo Marcelo R Lyra Rodrigo Almeida-Paes Manoel M E Oliveira Rosely M Zancopé-Oliveira Luciana G P Brandão Marcel S B Quintana Maria Clara Gutierrez-Galhardo Dayvison F S Freitas |
| author_facet | Vanessa Ramos Guis S-M Astacio Antonio C F do Valle Priscila M de Macedo Marcelo R Lyra Rodrigo Almeida-Paes Manoel M E Oliveira Rosely M Zancopé-Oliveira Luciana G P Brandão Marcel S B Quintana Maria Clara Gutierrez-Galhardo Dayvison F S Freitas |
| author_sort | Vanessa Ramos |
| collection | DOAJ |
| description | <h4>Background</h4>Bone sporotrichosis is rare. The metropolitan region of Rio de Janeiro is hyperendemic for zoonotic sporotrichosis and the bone presentations are increasing.<h4>Methods</h4>We studied a retrospective cohort of 41 cases of bone sporotrichosis, diagnosed from 1999-2016. The inclusion criteria was fungal culture isolation from any clinical specimen associated to bone involvement (radiography and/or computed tomography) compatible with fungal osteomyelitis or histopathological findings of bone material compatible with sporotrichosis. Molecular identification was performed when possible.<h4>Results</h4>Male patients represented 58.5% of the cases, with a cohort median age of 43 years. Immunosuppressive conditions were present in 68.3% of the patients, mostly HIV coinfection (51.2%). Multifocal bone involvement (more than one anatomical segment) was diagnosed in 61% of the patients, while 39% presented unifocal involvement. The bones of the hands were the most affected (58.5%), followed by the feet (41.5%) and tibia (26.8%). Multifocal group was characterized by a higher proportion of males (p = 0.0045) with immunosuppressive conditions (p = 0.0014). Amphotericin B followed by oral itraconazole was the main treatment, with a median time of 16.7 months (1.5 to 99.2 months), and cure of 53.7% of the patients (84.6% of immunocompetent and 39.3% of immunocompromised patients). Sequelae occurred in 12.2% of the patients-amputations (7.3%) and ankylosis (4.9%), while 22% died in the course of the disease. Sporothrix brasiliensis was the causative agent in all the 9 (22%) performed cases.<h4>Conclusions</h4>Bone sporotrichosis is a chronic, challenging condition with prolonged treatment, often with poor results and sequelae. |
| first_indexed | 2024-12-20T05:51:09Z |
| format | Article |
| id | doaj.art-a08a637682ea431fa380284aaf2b462d |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-20T05:51:09Z |
| publishDate | 2021-03-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-a08a637682ea431fa380284aaf2b462d2022-12-21T19:51:09ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352021-03-01153e000925010.1371/journal.pntd.0009250Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil.Vanessa RamosGuis S-M AstacioAntonio C F do VallePriscila M de MacedoMarcelo R LyraRodrigo Almeida-PaesManoel M E OliveiraRosely M Zancopé-OliveiraLuciana G P BrandãoMarcel S B QuintanaMaria Clara Gutierrez-GalhardoDayvison F S Freitas<h4>Background</h4>Bone sporotrichosis is rare. The metropolitan region of Rio de Janeiro is hyperendemic for zoonotic sporotrichosis and the bone presentations are increasing.<h4>Methods</h4>We studied a retrospective cohort of 41 cases of bone sporotrichosis, diagnosed from 1999-2016. The inclusion criteria was fungal culture isolation from any clinical specimen associated to bone involvement (radiography and/or computed tomography) compatible with fungal osteomyelitis or histopathological findings of bone material compatible with sporotrichosis. Molecular identification was performed when possible.<h4>Results</h4>Male patients represented 58.5% of the cases, with a cohort median age of 43 years. Immunosuppressive conditions were present in 68.3% of the patients, mostly HIV coinfection (51.2%). Multifocal bone involvement (more than one anatomical segment) was diagnosed in 61% of the patients, while 39% presented unifocal involvement. The bones of the hands were the most affected (58.5%), followed by the feet (41.5%) and tibia (26.8%). Multifocal group was characterized by a higher proportion of males (p = 0.0045) with immunosuppressive conditions (p = 0.0014). Amphotericin B followed by oral itraconazole was the main treatment, with a median time of 16.7 months (1.5 to 99.2 months), and cure of 53.7% of the patients (84.6% of immunocompetent and 39.3% of immunocompromised patients). Sequelae occurred in 12.2% of the patients-amputations (7.3%) and ankylosis (4.9%), while 22% died in the course of the disease. Sporothrix brasiliensis was the causative agent in all the 9 (22%) performed cases.<h4>Conclusions</h4>Bone sporotrichosis is a chronic, challenging condition with prolonged treatment, often with poor results and sequelae.https://doi.org/10.1371/journal.pntd.0009250 |
| spellingShingle | Vanessa Ramos Guis S-M Astacio Antonio C F do Valle Priscila M de Macedo Marcelo R Lyra Rodrigo Almeida-Paes Manoel M E Oliveira Rosely M Zancopé-Oliveira Luciana G P Brandão Marcel S B Quintana Maria Clara Gutierrez-Galhardo Dayvison F S Freitas Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil. PLoS Neglected Tropical Diseases |
| title | Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil. |
| title_full | Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil. |
| title_fullStr | Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil. |
| title_full_unstemmed | Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil. |
| title_short | Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil. |
| title_sort | bone sporotrichosis 41 cases from a reference hospital in rio de janeiro brazil |
| url | https://doi.org/10.1371/journal.pntd.0009250 |
| work_keys_str_mv | AT vanessaramos bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT guissmastacio bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT antoniocfdovalle bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT priscilamdemacedo bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT marcelorlyra bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT rodrigoalmeidapaes bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT manoelmeoliveira bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT roselymzancopeoliveira bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT lucianagpbrandao bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT marcelsbquintana bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT mariaclaragutierrezgalhardo bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil AT dayvisonfsfreitas bonesporotrichosis41casesfromareferencehospitalinriodejaneirobrazil |