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猫孢子丝菌病:流行病学和临床方面

Feline sporotrichosis: epidemiological and clinical aspects.

作者信息

Gremião Isabella D F, Menezes Rodrigo C, Schubach Tânia M P, Figueiredo Anna B F, Cavalcanti Maíra C H, Pereira Sandro A

机构信息

Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

出版信息

Med Mycol. 2015 Jan;53(1):15-21. doi: 10.1093/mmy/myu061. Epub 2014 Dec 4.

Abstract

Feline sporotrichosis, which is caused by species of the Sporothrix schenckii complex, is endemic to Rio de Janeiro, Brazil. More than 4000 cases of the disease were diagnosed at Fundação Oswaldo Cruz, Brazil, between 1998 and 2012. Sporotrichosis in cats has been reported in several countries, but nowhere has an outbreak of animal sporotrichosis been as large as that seen in Brazil. The clinical manifestations of the disease range from an isolated skin lesion that can progress to multiple skin lesions and even fatal systemic involvement. Nodules and ulcers are the most common types of lesions, and respiratory signs and mucosa involvement are frequent. The definitive diagnosis depends on isolation of the etiologic agent in culture. Cytology, histopathology, and serology are useful tools for preliminary diagnosis. Severe pyogranulomatous inflammatory infiltrate, high fungal load, and extension of lesions to mucosa, cartilage, and bone in the nose of cats are indicative of an agent of high virulence in this endemic region. Itraconazole is the drug of choice, while, in refractory cases, amphotericin B or potassium iodide might be alternative treatments; however, recurrence after discharge may occur. Sporotrichosis persists as a neglected disease in Rio de Janeiro, and the treatment of cats remains a challenging and long-term endeavor.

摘要

由申克孢子丝菌复合体物种引起的猫孢子丝菌病在巴西里约热内卢呈地方性流行。1998年至2012年间,巴西奥斯瓦尔多·克鲁兹基金会诊断出4000多例该病病例。猫孢子丝菌病在多个国家都有报道,但动物孢子丝菌病的暴发规模没有一处像在巴西那样大。该病的临床表现从可进展为多个皮肤病变甚至致命性全身感染的孤立皮肤病变,到结节和溃疡是最常见的病变类型,且常有呼吸道症状和黏膜受累。确诊依赖于在培养物中分离出病原体。细胞学、组织病理学和血清学是初步诊断的有用工具。猫鼻部出现严重的脓性肉芽肿性炎性浸润、高真菌负荷以及病变扩展至黏膜、软骨和骨骼,表明在这个地方性流行地区存在高毒力病原体。伊曲康唑是首选药物,而对于难治性病例,两性霉素B或碘化钾可能是替代治疗方法;然而,出院后可能会复发。在里约热内卢,孢子丝菌病仍是一种被忽视的疾病,猫的治疗仍然是一项具有挑战性的长期工作。

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