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      An Immune-Based Therapeutical Approach in an Elderly Patient With Fixed Cutaneous Sporotrichosis

      case-report

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          Abstract

          Sporotrichosis is a subcutaneous fungal infection caused by thermally dimorphic fungi from the Sporothrix genus, primarily prevalent in tropical regions of Latin America, Africa, and Asia. Mexico’s Jalisco state is an endemic hotspot with a remarkable prevalence rate of 54.4%. Clinical presentation varies based on immune status and virulence. The most common form is cutaneous-lymphangitic (67%), with fixed cutaneous cases accounting for 28%. This case study explores a traditional therapeutic approach for fixed cutaneous sporotrichosis but introduces a distinct immunological perspective.

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          Neutrophils sense microbial size and selectively release neutrophil extracellular traps in response to large pathogens

          Nora Branzk, Aleksandra Lubojemska, Sarah Hardison … (2014)
          Neutrophils are critical for antifungal defense, but the mechanisms that clear hyphae and other pathogens that are too large to be phagocytosed remain unknown. We show that neutrophils sense microbial size and selectively release neutrophil extracellular traps (NETs) in response to large pathogens, such as Candida albicans hyphae and extracellular Mycobacterium bovis aggregates, but not small yeast and single bacteria. NETs are fundamental in countering large pathogens in vivo. Phagocytosis via dectin-1, acts as a sensor for microbial size preventing NETosis by downregulating neutrophil elastase (NE) translocation to the nucleus. Dectin-1 deficiency leads to aberrant NETosis and NET-mediated tissue damage during infection. Size-tailored neutrophil responses clear large microbes and minimize pathology when microbes are small enough to be phagocytosed.
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            Neutrophils and NETs in modulating acute and chronic inflammation

            Fernanda Castanheira, Paul Kubes (2019)
            Neutrophils are an absolutely essential part of the innate immune system, playing an essential role in the control of infectious diseases but more recently are also being viewed as important players in tissue repair. Neutrophils are able to counteract an infection through phagocytosis and/or the release of neutrophil extracellular traps (NETs). By contrast, neutrophils help repair damaged tissues, limiting NET production but still phagocytosing debris. However, when inflammation is recurrent, or the inciting agent persists, neutrophils through a frustrated inability to resolve the problem can release NETs to exacerbate tissue damage during inappropriate inflammation. In this review, we discuss the mechanisms of NET formation, as well as the apparent paradoxical role of neutrophils and NETs in host defense, chronic inflammation, and tissue disrepair.
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              Global epidemiology of sporotrichosis.

              Arunaloke Chakrabarti, Alexandro Bonifaz, Maria Gutierrez-Galhardo … (2015)
              Sporotrichosis is an endemic mycosis caused by the dimorphic fungus Sporothrix schenckii sensu lato. It has gained importance in recent years due to its worldwide prevalence, recognition of multiple cryptic species within the originally described species, and its distinctive ecology, distribution, and epidemiology across the globe. In this review, we describe the current knowledge of the taxonomy, ecology, prevalence, molecular epidemiology, and outbreaks due to S. schenckii sensu lato. Despite its omnipresence in the environment, this fungus has remarkably diverse modes of infection and distribution patterns across the world. We have delved into the nuances of how sporotrichosis is intimately linked to different forms of human activities, habitats, lifestyles, and environmental and zoonotic interactions. The purpose of this review is to stimulate discussion about the peculiarities of this unique fungal pathogen and increase the awareness of clinicians and microbiologists, especially in regions of high endemicity, to its emergence and evolving presentations and to kindle further research into understanding the unorthodox mechanisms by which this fungus afflicts different human populations.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 29 January 2024
                Publication date (Electronic, collection): January 2024
                Volume: 16
                Issue: 1
                Electronic Location Identifier: e53192
                Affiliations
                [1 ] Dermatology, Dermatological Institute of Jalisco, “Dr. José Barba Rubio”, Jalisco, MEX
                [2 ] Internal Medicine, XXI Century National Medical Center, Mexico City, MEX
                [3 ] Medical Benefits, Mexican Institute of Social Security, Campeche, MEX
                Author notes
                Jesús Iván Martínez-Ortega jipirayno@ 123456gmail.com
                Article
                DOI: 10.7759/cureus.53192
                PMC ID: 10901695
                PubMed ID: 38425596
                SO-VID: 26eb468d-cec4-451c-af25-6117c76aa795
                Copyright © Copyright © 2024, Martínez-Ortega et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 28 January 2024
                Categories
                Subject: Internal Medicine
                Subject: Dermatology
                Subject: Infectious Disease

                Keywords: thermally dimorphic fungi,fixed cutaneous,fungal infection,sporothrix schenckii species,cutaneous sporotrichosis
                Data availability:
                Keywords: thermally dimorphic fungi, fixed cutaneous, fungal infection, sporothrix schenckii species, cutaneous sporotrichosis

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