Differences in epidemiological and clinical findings between localized and systemic osteoarticular infection caused by Sporothrix: a systematic review of individual participant data.
Max Carlos Ramírez-Soto, Alexandro Bonifaz, Andrés Tirado-Sánchez, Yang Song, Alejandro Llanos-Cuentas
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引用次数: 0
Abstract
Knowledge of the clinical recognition and management of osteoarticular sporotrichosis is derived from case reports and limited series. Our aim was to perform a systematic review to evaluate the differences in epidemiologic and clinical findings between localized and systemic forms of osteoarticular sporotrichosis. We searched MEDLINE/PubMed, SCOPUS, Web of Science (WoS), Ovid, SCiELO, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang Data, CQVIP and xueshu.baidu.com on 31 December 2023. The retrieved case data was divided into two groups: (1) localized osteoarticular infection and (2) systemic osteoarticular infection. We estimated differences between the two groups using generalized linear models with Poisson distribution for robust variances to estimate prevalence ratios (PRs) with 95% confidence intervals (95% CIs). A total of 111 cases of localized infection and 100 cases of systemic infection were included. Individuals with systemic infection were more likely to be from hyperendemic areas (adjusted prevalence ratio (aPR) = 1.64; 95% CI, 1.24-2.18; p = 0.001), have HIV infection (aPR = 2.33; 95% CI, 1.42-3.82; p = 0.001), and have cancer (aPR = 1.90; 95% CI, 1.09-3.31; p = 0.023). Arthritis (50.4%) and osteomyelitis (46.0%) were predominant in localized and systemic infections, respectively. Osteomyelitis in 2 or more bones was more common in individuals with a systemic infection (aPR = 10.3; 95% CI, 3.38-31.7; p < 0.0001). Most cases of localized infection were treated with combination antifungals and surgery (32.2%), combination antifungals (25.3%) and amphotericin B monotherapy (19.1%), and systemic infection with combination antifungals (49.4%). As for the outcome, there were better outcomes in localized than in systemic infection. Therefore, Sporothrix infection should be considered in the differential diagnosis of osteomyelitis or arthritis, especially in immunocompromised patients from hyperendemic areas.
期刊介绍:
Medical Mycology is a peer-reviewed international journal that focuses on original and innovative basic and applied studies, as well as learned reviews on all aspects of medical, veterinary and environmental mycology as related to disease. The objective is to present the highest quality scientific reports from throughout the world on divergent topics. These topics include the phylogeny of fungal pathogens, epidemiology and public health mycology themes, new approaches in the diagnosis and treatment of mycoses including clinical trials and guidelines, pharmacology and antifungal susceptibilities, changes in taxonomy, description of new or unusual fungi associated with human or animal disease, immunology of fungal infections, vaccinology for prevention of fungal infections, pathogenesis and virulence, and the molecular biology of pathogenic fungi in vitro and in vivo, including genomics, transcriptomics, metabolomics, and proteomics. Case reports are no longer accepted. In addition, studies of natural products showing inhibitory activity against pathogenic fungi are not accepted without chemical characterization and identification of the compounds responsible for the inhibitory activity.