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2013, Número 1

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Rev Mex Patol Clin Med Lab 2013; 60 (1)


Nuevas observaciones sobre la ecología y epidemiología del Sporothrix schenckii y la esporotricosis
2. Nichos ecológicos de S. schenckii y brotes zoonóticos

Carrada-Bravo T, Olvera-Macías MI

Idioma: Ingles.
Referencias bibliográficas: 98
Paginas: 5-24
Archivo PDF: 1208.74 Kb.


RESUMEN

La esporotricosis es la micosis subcutánea más prevalente en las Américas, Japón, India y Sudáfrica. Clásicamente, la infección se asociaba con la inoculación traumática del suelo, vegetales, espinas, paja o zacates contaminados con S. schenckii. Esta publicación presenta la ecología del microorganismo y los factores de riesgo de la enfermedad, según los trabajos de investigación más recientes, referentes a la epidemiología y laboratorio. Del 2005 al 2008, se diagnosticaron 804 casos nuevos en el Instituto de Investigación Evandro Chagas (IPEC) en Río de Janeiro, Brasil. Las más atacadas fueron las mujeres de 40-49 años de edad, amas de casa procedentes de los estratos sociales más pobres. El contacto directo con los gatos se reportó en 91% de los casos humanos, el antecedente de mordeduras y arañazos fue recabado en 68% de los afectados. Además, en el IPEC se confirmaron más de 1,503 gatos y 64 perros infectados. La esporotricosis canina se comportó como enfermedad autolimitada. La enfermedad gatuna varió desde una infección subclínica, hasta la forma sistémica con diseminación hematógena de S. schenckii. El potencial zoonótico de los felinos se demostró por el aislamiento de S. schenckii a partir de las biopsias de piel y de las cavidades oronasal y de las uñas. De 1999 a 2009, hubo 21 enfermos VIH-positivos con esporotricosis, la serie más grande reportada hasta esta fecha. Once (52.4%) fueron tratados con itraconazol oral y ocho (38.1%) recibieron amfotericina B, con una tasa de curación excelente de 81%.


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