Schubach Armando, Barros Mônica Bastos de Lima, Wanke Bodo
Serviço de Infectologia, Brasil bLaboratório de Micologia Médica, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Curr Opin Infect Dis. 2008 Apr;21(2):129-33. doi: 10.1097/QCO.0b013e3282f44c52.
Epidemic sporotrichosis is rare and has been related to an environmental source of infection. There were no reports of epizootics before a cat-transmitted epidemic was reported in Rio de Janeiro, Brazil. In the present paper we review the data published on this epidemic.
From 1998 to 2004, 759 humans, 64 dogs and 1503 cats were diagnosed with sporotrichosis in the Evandro Chagas Clinical Research Institute. Of them, 85% of dogs and 83.4% of patients were reported to have had contact with cats with sporotrichosis, and 55.8% of the latter reported cat bites or scratches. Unusual manifestations were diagnosed in humans. Canine sporotrichosis presented as a self-limited mycosis. Feline sporotrichosis varied from subclinical infection to severe systemic disease with hematogenous dissemination of Sporothrix schenckii. Sporotrichosis in cats always preceded its occurrence among their owners and their domiciliary canine contacts. The zoonotic potential of cats was demonstrated by the isolation of S. schenckii from skin lesion fragments, and from material collected from their nasal and oral cavities.
Thus far it is not known why sporotrichosis takes on the proportion of an emergent zoonosis in Rio de Janeiro. We alert physicians and veterinarians working outside the epidemic area to the diagnostic challenges involved with sporotrichosis.
流行性孢子丝菌病较为罕见，与环境感染源有关。在巴西里约热内卢报告猫传播的疫情之前，没有动物流行病的报告。在本文中，我们回顾了关于这一疫情已发表的数据。
1998年至2004年期间，埃万德罗·查加斯临床研究所诊断出759例人类、64例犬类和1503例猫类患有孢子丝菌病。其中，85%的犬类和83.4%的患者报告曾接触患有孢子丝菌病的猫，后者中有55.8%报告有猫咬或抓伤史。人类被诊断出有不寻常的表现。犬类孢子丝菌病表现为一种自限性真菌病。猫类孢子丝菌病从亚临床感染到严重的全身性疾病不等，申克孢子丝菌可经血行播散。猫类的孢子丝菌病总是先于其主人及其家养犬类接触者发病。从皮肤病变碎片以及从猫的鼻腔和口腔采集的材料中分离出申克孢子丝菌，证明了猫具有人畜共患病的潜力。
到目前为止，尚不清楚为什么孢子丝菌病在里约热内卢会成为一种新出现的人畜共患病。我们提醒疫区以外工作的医生和兽医注意孢子丝菌病所涉及的诊断挑战。
