Osteoarticular Sporotrichosis in a Brazilian Endemic Setting: Associated Factors and Outcomes

Authors:
Open Access
Publisher website
Google Scholar
Abstract
Background: Osteoarticular infection is an emerging complication of sporotrichosis, often leading to a significant increase in morbidity and longer treatment. Methods: We conducted a retrospective cohort study of osteoarticular sporotrichosis (OS) in southeastern Brazil (2014–2024) using clinical, epidemiological, and molecular data. Results: Among 252 patients, 20 (7.9%) had OS, including 10 (4%) with osteomyelitis. The median age of patients with OS was 58 years (IQR 39–64; range 18–83) and 55% were male. Hypertension (45%), diabetes (40%), alcohol use (40%), smoking (40%), and HIV infection (15%) were the most frequent conditions identified. Cutaneous lesions occurred in 95% of cases, and 90% of patients presented with arthralgia and edema. Multifocal OS was observed in 50% of cases, most commonly affecting the knees, fingers, and wrists. The mean time to diagnosis was 14.2 months. Most patients were treated with itraconazole combined with amphotericin B; 13 required surgical intervention, including 2 amputations. The mean treatment duration was 21 months. Multisystem involvement due to sporotrichosis was observed in 45% of cases, including pulmonary involvement. Mortality was 15%. Diabetes (OR = 4.11; 95% CI, 1.50–11.38; p = 0.006) was independently associated with OS. Conclusions: OS is associated with substantial morbidity and prolonged treatment. Diabetes may increase the risk of OS, while delayed diagnosis jeopardizes outcomes, underscoring the need for early management.
Funding Information
  • Fundação de Amparo à Pesquisa do Estado de Minas Gerais (APQ‐05368‐26)
  • Fundação de Amparo à Pesquisa do Estado de Minas Gerais (BPG‐00113‐23)
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (402200/2021‐7)
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (408540/2022‐2)
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (303762/2020‐9)
  • Ministério da Saúde (440010/2018‐7)
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

This publication has 33 references indexed in Scilit: