Clinical Manifestations, Antifungal Drug Susceptibility, and Treatment Outcomes for Emerging Zoonotic Cutaneous Sporotrichosis, Thailand

Abstract

We analyzed clinical manifestations, antifungal susceptibility, and treatment outcomes of cutaneous sporotrichosis in Thailand during 2018–2022. The study included 49 patients whose mean age was 58.7 (SD 16.9) years; 65.3% were female and 34.7% male. A history of cat exposure was reported in 32 (65.3%) patients who had a significantly higher prevalence of upper extremity lesions than did those without cat contact (90.6% vs. 41.7%; adjusted odds ratio 18.9 [95% CI 3.2–92.9]). Among patients >60 years of age, lesions were more likely to be nonpustular than for patients <60 years of age (82.1% vs. 52.4%; p = 0.033). All 9 isolates tested for antifungal drug susceptibility exhibited an itraconazole MIC of <1 μg/mL. Oral itraconazole monotherapy was effective; the median time-to-cure was 180 days (interquartile range 141–240 days). Physicians should heighten their awareness of potential sporotrichosis causes, particularly when a history of animal contact exists.

Keywords

• sporotrichosis
• Sporothrix
• subcutaneous fungal infection
• drug susceptibility
• itraconazole
• fungi