Conclusion and Perspectives
In the last two decades, we have observed the return of infectious diseases as one of the major causes of human death and a reduced quality of life in patients (Fisher et al. 2012).
Factors that contribute to this situation include the presence of organisms more resistant to drugs, the emergence of new pathogens and/or reemerging pathogens, and the increased number of immunocompromised patients such as those with AIDS, cancer, or organ transplantation. For a long time, sporotrichosis was described as a disease of low incidence in Brazil; however, recent reports show that the number of cases has been increasing, and the incidence of more severe or atypical clinical forms of the disease is occurring more frequently (Rodrigues et al. 2014d).In general, zoonotic pathogens are twice as likely to be associated with emerging diseases than non-zoonotic pathogens (Taylor et al. 2001). Sporothrix brasiliensis appears as a new emerging pathogen in a highly susceptible feline population and has developed an effective transmission route to humans in densely populated urban areas (Rodrigues et al. 2013b, 2014d; Montenegro et al. 2014). Furthermore, S. brasiliensis is more virulent than other members of the clinical clade (Fernandes et al. 2013), a factor that intensifies the atypical clinical manifestations in humans and animals.
The diagnosis of sporotrichosis must be quick and precise, thus avoiding disease complications in animals and interrupting the transmission to humans, minimizing the effects on the population (Rodrigues et al. 2015a). The treatment should be carried out effectively with the administration of antifungals such as itraconazole, potassium iodide, or a combination of therapies (Gremiao et al. 2015).
Notably, outbreaks caused by the classical transmission route, in which S. schenckii and S. globosa are the typical etiological agents, require the removal of the fungus sources in nature such as decaying plant debris (Rodrigues et al. 2016b). The alternative transmission route, which involves epizootics caused by S. brasiliensis during horizontal animal transmission as well as during zoonotic transmission, requires different strategies for epidemic containment. Prevention measures, appropriate treatment, and castration of cats are extremely important in the management of sick animals and education of pet owners on the main aspects of fungal transmission, especially in hyperendemic areas. Infected dead animals should be cremated but never buried, thus preventing new S. brasiliensis foci in the soil and the perpetuation of the pathogen in nature.