Sporotrichosis in Rio de Janeiro, Brazil: <i>Sporothrix brasiliensis</i> Is Associated with Atypical Clinical Presentations

<div><p>Background</p><p>There have been several recent changes in the taxonomy of <i>Sporothrix schenckii</i> as well as new observations regarding the clinical aspects of sporotrichosis. In this study, we determined the identification of the <i>Sporothrix</i> species associated with both classic and unusual clinical aspects of sporotrichosis observed in the endemic area of sporotrichosis in Rio de Janeiro, Brazil.</p><p>Methodology/Principal Findings</p><p>To verify whether <i>S. brasiliensis</i> is associated with clinical manifestations of sporotrichosis, a cross-sectional study was performed in which <i>Sporothrix</i> isolates from 50 patients with different clinical manifestations were analyzed and their isolates were studied by phenotypic and genotypic methods. Data from these patients revealed a distinct clinical picture and therapeutic response in infections caused by <i>Sporothrix brasiliensis</i> (n = 45) compared to patients with <i>S. schenckii</i> sensu stricto (n = 5). <i>S. brasiliensis</i> was associated with disseminated cutaneous infection without underlying disease, hypersensitivity reactions, and mucosal infection, whereas patients with <i>S. schenckii</i> presented with less severe and more often localized disease, similar to the majority of previously described sporotrichosis cases. Interestingly, <i>S. brasiliensis</i>-infected patients overall required shorter durations of itraconazole (median 16 weeks) compared to the individuals with <i>S. schenckii</i> (median 24 weeks).</p><p>Conclusions/Significance</p><p>These findings suggest that <i>Sporothrix</i> species are linked to different clinical manifestations of sporotrichosis and that <i>S. brasiliensis</i> is effectively treated with oral itraconazole.</p>