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- Title
Clinical characteristics, diagnosis, and treatment of central nervous system sporotrichosis: Systematic review and meta‐analysis.
- Authors
de Oliveira, Vítor Falcão; Petrucci, Júlia Figueiredo; Taborda, Mariane; Brener, Pedro Zanetta; Kremer, Pedro Guilherme De Barros Brito; Randi, Bruno Azevedo; Magri, Adriana Satie Gonçalves Kono; Magri, Marcello Mihailenko Chaves; Levin, Anna S.; Silva, Guilherme Diogo
- Abstract
Background: The clinical features of central nervous system (CNS) sporotrichosis are derived from case reports and a limited series of cases. Our objective was to carry out a systematic review and meta‐analysis of CNS sporotrichosis. Methods: We searched PubMed/MEDLINE, Embase, Scopus, and LILACS on 9 September 2023. Our inclusion criteria were documentation of Sporothrix and demonstrated CNS involvement. A metaproportion or metamean analysis was performed to estimate a summary proportion with 95% confidence intervals. Results: We included 52 cases of CNS sporotrichosis published from 1966 to 2023. Forty‐six patients were male (88%, 95% CI: 77–95), and the mean age was 39 years (95% CI: 36–43). Close contact with cats was reported in 55% of cases (95% CI: 37–72). Thirty‐two (61.5%) patients were from Brazil, 18 patients from the United State of America (34.6%). Only two Sporothrix species were reported: S. schenckii (26/41, 63%), and S. brasiliensis (15/41, 37%). The most common neurological symptom was headache. Meningitis was chronic in approximately 80% of cases. A significant majority of the patients were immunocompromised. HIV infection was the primary cause of immunosuppression (85%, 95% CI: 61–95). Overall mortality was 56% (22/39). The comparison of Kaplan–Meier survival curve showed a higher mortality with a statistically significant difference in immunosuppressed patients (p =.019). Conclusion: CNS sporotrichosis represents a notable cause of chronic meningitis, especially in individuals living in the Americas with HIV infection and concurrent skin lesions.
- Subjects
BRAZIL; CENTRAL nervous system; SPOROTRICHOSIS; HIV infections; IMMUNOCOMPROMISED patients; INFECTION
- Publication
Mycoses, 2024, Vol 67, Issue 2, p1
- ISSN
0933-7407
- Publication type
Case Study
- DOI
10.1111/myc.13697