Sporotrichosis during pregnancy: A retrospective study of 58 cases in a reference center from 1998 to 2023.

Autor:	Freitas DFS; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Rio de Janeiro, Brazil., Cunha RP; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Pós-graduação em Pesquisa Clínica em Doenças Infecciosas, Rio de Janeiro, Brazil., de Oliveira RVC; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Epidemiologia Clínica, Rio de Janeiro, Brazil., de Macedo PM; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Rio de Janeiro, Brazil., do Valle ACF; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Rio de Janeiro, Brazil., Rezende APMB; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Serviço de Enfermagem, Coordenação de Atenção a Pacientes Externos, Rio de Janeiro, Brazil., Eiras RV; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Serviço de Enfermagem, Coordenação de Atenção a Pacientes Externos, Rio de Janeiro, Brazil., Curi ALL; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Oftalmologia Infecciosa, Rio de Janeiro, Brazil., Carvalho EM; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Oftalmologia Infecciosa, Rio de Janeiro, Brazil., de Moraes RL; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Serviço Médico, Hospital Dia, Rio de Janeiro, Brazil., Almeida-Paes R; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, Brazil., Zancopé-Oliveira RM; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, Brazil., Gutierrez-Galhardo MC; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Rio de Janeiro, Brazil.
Jazyk:	angličtina
Zdroj:	PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2024 Dec 20; Vol. 18 (12), pp. e0012670. Date of Electronic Publication: 2024 Dec 20 (Print Publication: 2024).
DOI:	10.1371/journal.pntd.0012670
Abstrakt:	Background: Pregnant women constitute a vulnerable population occasionally affected by zoonotic sporotrichosis. Treatment is challenging due to potentially teratogenic oral medications (itraconazole and saturated potassium iodide solution) or lack of clinical experience during pregnancy (terbinafine). Literature is scarce on sporotrichosis and pregnancy, mainly consisting of case reports. Methodology/principal Findings: This study consists of a cohort of 58 cases of pregnant women with sporotrichosis attended in a reference center in Rio de Janeiro from 1998 to 2023. The median age was 27 years old; the majority were black (64.4%); comorbidities prior to pregnancy were reported by 20.7% (including two people living with HIV/AIDS-PLHIV) and 6.8% developed conditions that are unique to pregnancy. In 75.9% of patients, they were pregnant when they acquired sporotrichosis, with a median gestational age of 17 weeks, and 24.1% became pregnant during treatment for sporotrichosis. The lymphocutaneous form occurred in 63.8% of patients, followed by the fixed form (19%), disseminated cutaneous form (12%) and extracutaneous/disseminated forms (5.2%). Thermotherapy was indicated for all (except 2) patients and cryosurgery was performed in 22 (37.9%). Amphotericin B was indicated for a patient with external ocular sporotrichosis and for the PLHIV with osteomyelitis in the right tibia. Cure occurred in 100% of those followed (n = 44) with the remainder lost to follow-up (n = 14). Conclusions: Pregnant women with cutaneous sporotrichosis in this study recovered following physical therapies, suggesting these therapies may be effective. In cases of extracutaneous and disseminated forms, amphotericin B was indicated due to its safety profile in this population. Management of sporotrichosis during pregnancy requires a delicate assessment of the balance between maternal benefit and fetal risks. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2024 Freitas 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.)
Databáze:	MEDLINE
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