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      A Case of Acute Granulomatous Conjunctivitis Caused by Cat-transmitted Sporothrix schenckii

      case-report
      1 , , 1 , 1 , 2 , 2 , 1
      ,
      Cureus
      Cureus
      sporothrix schenckii, conjunctiva, conjunctivitis, itraconazole, sporotrichosis

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          Abstract

          In human, sporotrichosis infection commonly manifests as skin lesions through direct inoculation. It is rarely associated with ocular manifestation via a zoonotic transmission. We describe a young lady who presented with acute left eye granulomatous conjunctivitis who had a history of exposure to her sick cat diagnosed with sporotrichosis infection. Sporothrix schenckii was isolated from the culture of the excised conjunctival tissue. The patient recovered fully after six months of oral anti-fungal treatment. Clinicians should be aware of this new zoonotic infection transmitted by infected felines as it is reversible with timely diagnosis and initiation of anti-fungal therapy.

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          Most cited references11

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          Sporothrix schenckii and Sporotrichosis.

          Sporotrichosis, which is caused by the dimorphic fungus Sporothrix schenckii, is currently distributed throughout the world, especially in tropical and subtropical zones. Infection generally occurs by traumatic inoculation of soil, plants, and organic matter contaminated with the fungus. Certain leisure and occupational activities, such as floriculture, agriculture, mining, and wood exploitation, are traditionally associated with the mycosis. Zoonotic transmission has been described in isolated cases or in small outbreaks. Since the end of the 1990s there has been an epidemic of sporotrichosis associated with transmission by cats in Rio de Janeiro, Brazil. More than 2,000 human cases and 3,000 animal cases have been reported. In humans, the lesions are usually restricted to the skin, subcutaneous cellular tissue, and adjacent lymphatic vessels. In cats, the disease can evolve with severe clinical manifestations and frequent systemic involvement. The gold standard for sporotrichosis diagnosis is culture. However, serological, histopathological, and molecular approaches have been recently adopted as auxiliary tools for the diagnosis of this mycotic infection. The first-choice treatment for both humans and cats is itraconazole.
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            Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America.

            Guidelines for the management of patients with sporotrichosis were prepared by an Expert Panel of the Infectious Diseases Society of America and replace the guidelines published in 2000. The guidelines are intended for use by internists, pediatricians, family practitioners, and dermatologists. They include evidence-based recommendations for the management of patients with lymphocutaneous, cutaneous, pulmonary, osteoarticular, meningeal, and disseminated sporotrichosis. Recommendations are also provided for the treatment of sporotrichosis in pregnant women and in children.
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              Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases.

              Sporotrichosis is the most common subcutaneous mycosis in South America. Classic infection is associated with traumatic inoculation of soil, vegetables, and organic matter contaminated with Sporothrix schenckii. Zoonotic transmission has been described in isolated cases or in small outbreaks. Since 1998, we have been observing an increasing number of cases of sporotrichosis in persons from the city of Rio de Janeiro, Brazil, and surroundings. From 1998 to 2001, 178 cases of culture-proven sporotrichosis had been diagnosed. Female patients predominated, and the median age was 39 years. The most frequent clinical presentation was lymphocutaneous disease. Of the 178 patients, 156 reported domiciliary or professional contact with cats with sporotrichosis, and 97 of these patients had a history of receipt of cat scratch or bite. The patients received itraconazole as first-line treatment. This study suggests that feline transmission of sporotrichosis was associated with a large and long-lasting outbreak of the disease in Rio de Janeiro.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                8 October 2018
                October 2018
                : 10
                : 10
                : e3428
                Affiliations
                [1 ] Ophthalmology, School of Medical Sciences/Universiti Sains Malaysia, Kota Bharu, MYS
                [2 ] Ophthalmology, Hospital Raja Perempuan Zainab, Kota Bharu, MYS
                Author notes
                Article
                10.7759/cureus.3428
                6289554
                63123a84-fbc3-49ab-ae25-672a1e81fb23
                Copyright © 2018, Ling et al.

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

                History
                : 17 September 2018
                : 8 October 2018
                Categories
                Ophthalmology

                sporothrix schenckii,conjunctiva,conjunctivitis,itraconazole,sporotrichosis

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