Medical mycology最新文献

{"title":"Diagnostic performance of IgG against multiplex Aspergillus antigens (mx4) for identifying chronic pulmonary aspergillosis.","authors":"Inderpaul Singh Sehgal, Ritesh Agarwal, Valliappan Muthu, Kuruswamy Thurai Prasad, Sahajal Dhooria, Mani Singh, Shivaprakash M Rudramurthy, Ashutosh Nath Aggarwal, Mandeep Garg, Arunaloke Chakrabarti","doi":"10.1093/mmy/myag071","DOIUrl":"10.1093/mmy/myag071","url":null,"abstract":"<p><p>Serum A. fumigatus-IgG is the cornerstone serological test for diagnosing chronic pulmonary aspergillosis (CPA), but its sensitivity is imperfect. A multiplex Aspergillus antigen preparation (mx4) incorporating extracts of A. fumigatus, A. flavus, A. niger, and A. terreus is commercially available. We aimed to compare the diagnostic performance of the serum mx4-IgG assay with the A. fumigatus-IgG assay for diagnosing CPA. We prospectively enrolled 332 consecutive adults with suspected CPA at a tertiary chest clinic between August 2022 and July 2025. Serum IgG against mx4, A. fumigatus, A. flavus, A. niger, and A. terreus was measured using a fluorescent enzyme immunoassay. Diagnostic performance was evaluated against a primary composite reference standard and two alternative serology-based definitions. Hierarchical diagnostic algorithms and a simplified cost analysis were performed. Of 332 participants, 230 had CPA, and 102 were diseased controls (patients with structural lung disease). Against the primary reference standard, the mx4-IgG assay achieved a sensitivity of 83.0% and specificity of 73.5%, compared with 95.2% and 88.2%, respectively, for the A. fumigatus-IgG assay. Similar findings were observed using alternative serology-based CPA definitions. In hierarchical testing, a sequential strategy of A. fumigatus-IgG and A. flavus-IgG identified 97.7% of CPA cases at the lowest cost (USD 24/patient) and outperformed strategies incorporating the mx4-IgG assay (mx4-IgG followed by A. fumigatus-IgG). The mx4-IgG assay was not superior to the A. fumigatus-IgG assay for diagnosing CPA. Sequential testing with A. fumigatus-IgG followed by A. flavus-IgG achieved the highest diagnostic yield at the lowest cost and warrants further evaluation.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryptococcus gattii complex infections in southern Brazil: Epidemiology, clinical features, management, and outcomes from a 33-year cohort.","authors":"Bruno Hassunuma Carneiro, Regielly Caroline Raimundo Cognialli, Giovanni Luis Breda, João Cesar Beenke França, Marcelo Abreu Ducroquet, Marisol Dominguez Muro, Flavio Queiroz-Telles","doi":"10.1093/mmy/myag068","DOIUrl":"10.1093/mmy/myag068","url":null,"abstract":"<p><p>Cryptococcus gattii complex has emerged as an important cause of invasive fungal disease in both immunocompetent and immunocompromised hosts, yet robust clinical and epidemiological data remain limited, particularly in Latin America. An observational study was conducted to describe and analyze the clinical characteristics and outcomes of all proven and probable cases of C. gattii complex infection managed at a tertiary referral center in southern Brazil from 1992 to 2025. A total of 39 cases were identified. The median age was 54 years, and 61.5% were male. Most patients (61.5%) were considered immunocompetent, although comorbidities were common. Headache (61.5%), altered mental status (33.3%), and fever (30.8%) were the most frequent symptoms overall. Pulmonary disease was the predominant clinical form (76.9%), but meningitis/meningoencephalitis was also common (69.2%). Nearly half (46.2%) had both pulmonary and neurological disease. Cryptococcomas were frequent (76.9%); the majority were managed without surgical intervention. Severe impairment of consciousness at presentation and cerebrospinal fluid protein levels above 92.15 mg/dl were significantly associated with mortality. Amphotericin B deoxycholate plus fluconazole was the most prescribed induction regimen, with a median duration of 3 weeks. The overall mortality was 20.5%. Immune reconstitution inflammatory syndrome occurred only among patients with cryptococcomas and was managed with glucocorticoids in most cases. The performance of the cryptococcal antigen (CrAg) test was excellent in both neurological and pulmonary diseases. This study highlights the clinical spectrum of C. gattii complex infection and supports the potential utility of shorter induction regimens (< 4 weeks), as well as the role of CrAg as a valuable diagnostic tool.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HAC1 contributes to stress adaptation and virulence in the emerging fungal pathogen Candida auris.","authors":"Sayoko Oiki, Masahiro Abe, Ai Hirasawa, Ami Koizumi, Amato Otani, Takayuki Shinohara, Yoshitsugu Miyazaki","doi":"10.1093/mmy/myag067","DOIUrl":"10.1093/mmy/myag067","url":null,"abstract":"<p><p>Candida auris (Candidozyma auris) is an emerging multidrug-resistant fungal pathogen that poses a significant global health threat. However, the molecular mechanisms underlying its virulence remain incompletely understood. In this study, we performed in vivo transcriptome analysis using an immunosuppressed mouse gastrointestinal infection model to identify genes associated with host adaptation and virulence during infection. By comparing fungal transcriptomes obtained from colonization and dissemination sites with those from in vitro cultures, we identified genes that were consistently upregulated during infection. Among these genes, the unfolded protein response regulator HAC1 was selected as a candidate virulence-associated gene for further analysis. Reverse transcription PCR and sequencing analyses revealed that HAC1 mRNA in C. auris undergoes an unconventional splicing event of 287 bp that is enhanced under endoplasmic reticulum stress conditions. The excised region spans the annotated open reading frame boundary, suggesting that the translated region of HAC1 may require re-evaluation. Notably, a proportion of HAC1 transcripts appeared to be spliced even under non-stress conditions, indicating a detectable basal level of the unfolded protein response. Differences in splicing dynamics were also observed among clade strains. Functional analyses demonstrated that deletion of HAC1 increased sensitivity to endoplasmic reticulum stress. The HAC1 deletion mutant also exhibited reduced virulence in both Galleria mellonella and immunosuppressed mouse infection models, as evidenced by delayed host mortality and decreased fungal burdens, respectively. These findings indicate that HAC1 contributes to endoplasmic reticulum stress adaptation and survival in the host environment and identify HAC1 as a virulence-associated gene in C. auris.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-reactivity of cryptococcal antigen lateral flow assay with basidiomycetous yeasts.","authors":"Sarah E Kidd, Catriona L Halliday","doi":"10.1093/mmy/myag070","DOIUrl":"10.1093/mmy/myag070","url":null,"abstract":"<p><p>The cryptococcal antigen lateral flow assay (CrAg LFA) is a widely available point-of-care test for the diagnosis of cryptococcal meningitis. Although there have been some reports of cross-reactivity with Trichosporon species, the extent of cross-reactivity among basidiomycetous yeasts has not been widely explored. We tested a range of basidiomycete yeast isolates using a CrAg LFA to examine potential cross-reactivity, with positive results for all isolates belonging to Trichosporon and Naganishia species, and for some isolates of Cutaneotrichosporon, Filobasidium and Ustilago species. While these species rarely cause invasive infection, the potential for cryptococcal antigen cross-reactivity should be considered.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coccidioidomycosis-related hydrocephalus: A case control study.","authors":"Pravarakhya Puppalla, Dara S Farhadi, Derek Smetanick, Sameena Rahman, Avantika Mitbander, Sohail Daulat, Jude Kolodisner, Nehaw Sarmey, Martin E Weinand, Julie G Pilitsis","doi":"10.1093/mmy/myag075","DOIUrl":"10.1093/mmy/myag075","url":null,"abstract":"<p><p>Coccidioidomycosis (Valley Fever) is a fungal infection endemic to the southwestern United States. Meningitis occurs in approximately 1% of cases and often results in hydrocephalus necessitating shunting and lifelong antifungal therapy. Prior studies lack comparison with contemporaneous controls. In this study, we compare radiographic, laboratory, and longitudinal shunt survival data until revision and reprogramming. The objective was to compare the 7-year outcomes between patients who underwent shunting with and without coccidioidomycosis meningitis (CM). We identified neurosurgical patients who underwent initial shunt placement for hydrocephalus over 7 years at the University of Arizona-Tucson. Demographics, shunt characteristics, failure rates, imaging findings, operative complications, revision etiology, reprogramming rates, and mortality were compared. Of 180 initial shunt placements, 19 (11.7%) had CM. No differences in revision rates, reprogramming rate, time to first revision, or mortality were observed with antisiphon use. CM patients had lower mean final shunt pressures (56.9 ± 24.1 mmH₂O in CM (95% CI, 45.3-68.5 mmH₂O) vs. 76.3 ± 40.2 mmH₂O in non-CM (95% CI, 70.3-83.3 mmH₂O), P = 0.04) at a mean follow-up of approximately 1.7-1.9 years. Two-year shunt survival was 65.5% in CM (95% CI, 38.4%-82.9%) vs. 70.4% in Non-Coccidioidomycosis (non-CM) (95% CI, 60.9%-78.0%) (P = 0.71); patient survival was 92.3% in CM (95% CI, 56.6%-98.9%) vs. 89.5% in non-CM (95% CI, 82.1%-93.8%) (P = 0.97). Anti-siphon valves were used in 78.9% of CM patients (95% CI, 54.4%-93.9%) vs 74.5% of non-CM patients (95% CI, 67.1%-81.1%) (P = 0.67). Despite similar valve types and revision etiologies, the data suggests CM-related hydrocephalus treatment requires lower shunt pressures over time and may indicate differences in intracranial compliance dynamics in CM patients.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical utility of bronchoalveolar lavage galactomannan result stewardship within a tertiary medical system.","authors":"Anna Apostolopoulou, Sarah P Hammond, Sarah E Turbett, Jay A Fishman","doi":"10.1093/mmy/myag069","DOIUrl":"10.1093/mmy/myag069","url":null,"abstract":"<p><p>Our Transplant Infectious Disease (TID) program implemented monitoring of all elevated bronchoalveolar lavage (BAL) galactomannan (GM) results as a quality improvement (QI) project. Twenty-four hours after a positive result, a standardized email is sent to the primary providers if the GM result is unaccounted for based on clinical documentation. We performed a real-world, retrospective study to examine the impact of this intervention over one year (2022-2023) as well as the impact of an elevated BAL GM result on clinical decision-making. We captured the number of positive GM results that triggered notification of the primary team, and the number of times a single positive galactomannan triggered initiation or change of systemic antifungal therapy. We included 55 cases of BAL GM >1.0. In seventeen cases (31%), a single positive BAL GM result triggered the initiation of antifungal therapy. Most of these cases met criteria for probable IPA. The TID team contacted the primary team for 14 cases (25%) of elevated BAL galactomannan antigens, which led to a new start or change in antifungal regimen. Voriconazole was the most common definitive antifungal agent chosen. Though elevated BAL GM results were impactful in introducing or changing antifungal regimens, we identified a possible knowledge gap in the interpretation of elevated galactomannan results among clinical staff. Our study suggests that there may be value in the diagnostic stewardship and monitoring of BAL galactomannan results by infectious disease clinicians.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suitability of the pre-nociceptive chicken embryo as a model for investigating Sporothrix spp. infection and inflammatory response.","authors":"Júlio Marcos Ribeiro Risso, Mariana Almeida Ferreira, Lara Reis Gomes, Simone Sommerfeld, Fabiana Oliveira Notário, Isabelle Ezequiel Pedrosa, Anna Luiza Filsner Dias Strack, Bianca de Jesus E Silva, Letícia Gonçalves de Oliveira, Gabrielle Silveira Vargas, Jandra Pacheco Dos Santos, Alessandra Aparecida Medeiros Ronchi, Adriana Freitas Neves, Belchiolina Beatriz Fonseca, Álvaro Ferreira Júnior","doi":"10.1093/mmy/myag072","DOIUrl":"10.1093/mmy/myag072","url":null,"abstract":"<p><p>The use of alternative in vivo models, such as chicken embryos (CEs), for studying Sporothrix spp. infection aligns with sustainable and ethical research practices but remains poorly explored. This study evaluated the suitability of the pre-nociceptive stage of the CE model for investigating Sporothrix brasiliensis and S. schenckii pathogenesis. S. schenckii, S. brasiliensis, and a feline field isolate of S. brasiliensis were inoculated on the chorioallantoic membrane at 8-day-old CE. Control groups included sterile saline and the probiotic Saccharomyces boulardii. By 3 days post-inoculation, mortality in Sporothrix-challenged groups ranged from 14.28% to 31.4%, with lesion frequencies between 9% and 18.2%. Primary macroscopic findings included greenish hepatic discoloration and hemorrhage. The combined incidence of morbidity and mortality was higher in the Sporothrix groups than in controls; this rate did not differentiate virulence levels among the tested fungal strains. Histopathological analysis of the liver showed no significant changes; however, cerebral inflammation was significantly more pronounced in both S. brasiliensis groups. Molecular analysis revealed no upregulation of interleukin (IL)-1β or IL-6, but an 11.8-fold increase in IL-8 transcripts was detected in embryos challenged with S. brasiliensis. These results demonstrate that Sporothrix brasiliensis, although not previously described as infecting chickens, infected and induced an inflammatory response in 11-day-old CE following experimental challenged with the yeast-like cells via the chorioallantoic membrane. Further studies using CE should be conducted to better understand the host-fungus relationship in experimental infection. Our findings reinforce the potential of the CE model for ethical, early-stage studies of sporotrichosis pathogenesis and the host immune response.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter study reveals alarming terbinafine resistance in Trichophyton indotineae isolates from Iran.","authors":"Shima Aboutalebian, Zahra Jahanshiri, Mahboobeh Kharazi, Mohammad Reza Shidfar, Shahla Shadzi, Mostafa Chadeganipour, Mahzad Erami, Hossein Mirhendi","doi":"10.1093/mmy/myag064","DOIUrl":"10.1093/mmy/myag064","url":null,"abstract":"<p><p>Trichophyton indotineae has recently emerged as a major etiological agent of treatment-resistant dermatophytosis, particularly in India and Iran. Resistance to terbinafine is predominantly associated with point mutations in the squalene epoxidase (SQLE) gene. This study investigated the antifungal susceptibility of clinical dermatophyte isolates from Iran and characterized SQLE mutations in terbinafine-resistant strains. Over a 6-month period, 176 clinical dermatophyte isolates comprising 134 T. indotineae and 42 non-indotineae species were collected and identified by internal transcribed spacer (ITS) sequencing. In vitro antifungal susceptibility testing to eight antifungal agents was assessed according to CLSI M38 guidelines. Minimum inhibitory concentration (MIC) ranges, MIC₅₀, MIC₉₀, and geometric mean MICs were calculated. SQLE gene sequencing was performed for isolates exhibiting reduced terbinafine susceptibility. Out of 176 dermatophyte isolates, 66 (37.5%) demonstrated terbinafine MICs ≥ 0.5 µg/ml. Among these 66 isolates, 64 were T. indotineae (out of 134 total T. indotineae isolates, 47.76%), and 2 were T. tonsurans (out of 21 total T. tonsurans isolates, 9.52%). High-level terbinafine resistance (MIC ≥ 16 µg/ml) was observed in 50% (32/64) of T. indotineae isolates. Among the 66 resistant isolates, only 3 were wild-type: one T. indotineae and two T. tonsurans. The most prevalent SQLE alterations were the double mutation Phe397Leu + Ala448Thr (34.38%) and the single mutation Leu393Ser (32.81%), followed by the 1192 C→A substitution (10.94%). Notably, Ala448Thr also occurred in phenotypically susceptible isolates, yet correlated with increased MICs of itraconazole and voriconazole. Fluconazole showed poor activity (geometric mean MIC: 43.5072 µg/ml), whereas posaconazole exhibited the highest in vitro activity. Terbinafine remained effective for non-T. indotineae species, but is ineffective for T. indotineae-associated dermatophytosis due to widespread resistance. None of the isolates identified as T. interdigitale/mentagrophytes, T. rubrum, Microsporum canis, and Trichophyton benhamiae were resistant to TRB. This multicenter survey reveals high terbinafine resistance in Iranian T. indotineae isolates, linked to SQLE mutations and azole cross-resistance. Routine antifungal susceptibility testing, molecular screening, and alternative therapies are essential, prioritizing non-terbinafine options for T. indotineae (while it remains effective against other dermatophytes). Continued surveillance, accurate species identification, and tailored management are critical to control recalcitrant dermatophytosis.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effects of cell-free supernatants from a kefir-derived microbial consortium against multidrug-resistant Candida glabrata associated with vulvovaginal candidiasis.","authors":"Angela Maione, Marianna Imparato, Lea Di Massa, Annalisa Buonanno, Luigi Cirillo, Marco Guida, Elisabetta de Alteriis, Emilia Galdiero","doi":"10.1093/mmy/myag073","DOIUrl":"10.1093/mmy/myag073","url":null,"abstract":"<p><p>Vulvovaginal candidiasis (VVC) caused by non-albicans Candida species, particularly Candida glabrata, is increasingly associated with treatment failure due to intrinsic or acquired resistance to antifungal drugs. In this study, we explored the anticandidal activity of a postbiotic cell-free supernatant (CFS) obtained from a microbial consortium isolated from homemade kefir (Lactococcus lactis subsp. hordniae, Lactococcus lactis subsp. lactis, and Pichia kudriavzevii) against one reference strain and two multidrug-resistant clinical isolates of C. glabrata. Antifungal susceptibility assays showed a fungistatic effect of CFS (Minimum Inhibitory Concentration [MIC] ≥ 500 µg/ml). Pre-treatment with sub-MIC concentrations (100 µg/ml) of CFS significantly reduced C. glabrata planktonic growth and cell surface hydrophobicity, as well as A-431 vaginal epithelial cell damage. Although total biofilm biomass of C. glabrata was not markedly affected by pre-treatment, metabolic activity was significantly decreased, together with downregulation of key virulence genes (ALS3, ERG11, and FKS1). Subsequently, we explored the effect of the CFS on the inhibition and eradication of biofilms derived from pretreated cells, showing a more marked effect compared to biofilms from untreated cells. Furthermore, in pre-treated fungal cells, the CFS almost completely abolished invasive capacity, reducing invasion in epithelial cell model and restored wound healing capacity following infection. Additionally, CFS modulated the host inflammatory response by reducing the expression of pro-inflammatory cytokines in A-431 cells. Overall, the kefir-derived postbiotic attenuated major virulence traits of C. glabrata and promoted epithelial protection, providing preliminary evidence supporting its potential as a complementary approach for VVC prevention and management.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular adnexal sporotrichosis: Case series from a hyperendemic region in southern Brazil.","authors":"Vanice Rodrigues Poester, Rossana Patricia Basso, Bianca Dos Santos Blan, Mariana Rodrigues Trápaga, Lívia Silveira Munhoz, Diulien Canary de Lima, Augusto Neuberger, Karine Ortiz Sanchotene, Monica Campos Dos Santos, Eliane Rosa Goedel, Melissa Orzechowski Xavier","doi":"10.1093/mmy/myag054","DOIUrl":"10.1093/mmy/myag054","url":null,"abstract":"<p><p>Sporotrichosis is an emerging subcutaneous disease that occurs in outbreaks in Brazil and other South American countries. Reports of extracutaneous cases caused by Sporothrix brasiliensis have been increasing in the literature. This study describes the first case series of ocular adnexal sporotrichosis in the state of Rio Grande do Sul (RS), southern Brazil. A retrospective analysis was conducted, including cases diagnosed over a 3-year period at a specialized reference service in RS, Brazil. Ocular sporotrichosis accounted for 25 cases, with a marked increase observed during the last 2 years of the study (2024-2025), reaching the highest proportion of approximately 16 cases per 100 appointments among all sporotrichosis cases. All patients presented with ocular adnexal involvement, including granulomatous conjunctivitis (56%; 14/25), Parinaud oculoglandular syndrome (40%; 10/25), and eyelid lesions with dacryocystitis in one case (4%). All cases were associated with zoonotic transmission of S. brasiliensis. Clinical cure was achieved using itraconazole (200 mg/day) for a mean treatment duration of 120 days. Our findings highlight the emergence of ocular sporotrichosis in southern Brazil, predominantly affecting adnexal structures, and emphasize the importance of early diagnosis, continuous educational efforts, and increased awareness of extracutaneous manifestations in hyperendemic areas.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}