title: Sporotrichosis in HIV-infected patients: report of 21 cases of endemic sporotrichosis in Rio de Janeiro, Brazil.
abstract: Sporotrichosis is endemic in Rio de Janeiro, Brazil, and cases have been reported to be associated with HIV. This article describes the clinical manifestations and evolution of sporotrichosis in HIV-positive patients and constitutes the largest case series reported to date. There were 21 HIV-positive patients with sporotrichosis diagnosed by the recovery of the etiologic agent from 1999-2009. Sixteen patients (76.2%) were men and five (23.8%) were women, with a mean age of 41.2 years. Seven of these individuals were previously unaware of their HIV infection. Mean CD4 count was 346.4 cells/μl. The most frequent clinical presentations of sporotrichosis in these patients were the lymphocutaneous and disseminated form (seven patients each, 33.3%), followed by the widespread cutaneous form in five (23.8%), and fixed form in the remaining two (9.5%). In patients with the disseminated forms, clinical manifestations involved the skin in six, mucosa (nasal, oral, or conjunctival) in four, bone in two, and meninges in two. Eleven (52.4%) patients received itraconazole and eight (38.1%) amphotericin B contributing to an overall cure rate of 81%. Spontaneous cure was observed in one patient. The clinical forms of sporotrichosis varied according to the patients' immune status. The results demonstrate the importance of sporotrichosis as an opportunistic infection associated with AIDS in countries where the mycosis occurs.
authors.affiliation: Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. dayvison.freitas@ipec.fi ocruz.br
authors.forename: Dayvison Francis Saraiva
authors.initials: DF
authors.lastname: Freitas
authors.forename: Brenda
authors.initials: B
authors.lastname: de Siqueira Hoagland
authors.forename: Antonio Carlos Francesconi
authors.initials: AC
authors.lastname: do Valle
authors.forename: Beatriz Barros
authors.initials: BB
authors.lastname: Fraga
authors.forename: Mônica Bastos
authors.initials: MB
authors.lastname: de Barros
authors.forename: Armando
authors.initials: A
authors.lastname: de Oliveira Schubach
authors.forename: Rodrigo
authors.initials: R
authors.lastname: de Almeida-Paes
authors.forename: Tullia
authors.initials: T
authors.lastname: Cuzzi
authors.forename: Cláudia Maria Valete
authors.initials: CM
authors.lastname: Rosalino
authors.forename: Rosely Maria
authors.initials: RM
authors.lastname: Zancopé-Oliveira
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Gutierrez-Galhardo
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013174:Sporotrichosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B