Current Progress on Epidemiology, Diagnosis, and Treatment of Sporotrichosis and Their Future Trends

Sporotrichosis, a human and animal disease caused by Sporothrix species, is the most important implantation mycosis worldwide. Sporothrix taxonomy has improved in recent years, allowing important advances in diagnosis, epidemiology, and treatment. Molecular epidemiology reveals that S. brasiliensis remains highly prevalent during the cat-transmitted sporotrichosis outbreaks in South America and that the spread of S. brasiliensis occurs through founder effects. Sporothrix globosa and S. schenckii are cosmopolitan on the move, causing major sapronoses in Asia and the Americas, respectively. In this emerging scenario, one-health approaches are required to develop a creative, effective, and sustainable response to tackle the spread of sporotrichosis. In the 21st century, it has become vital to speciate Sporothrix, and PCR is the main pillar of molecular diagnosis, aiming at the detection of the pathogen DNA from clinical samples through multiplex assays, whose sensitivity reaches remarkably three copies of the target. The treatment of sporotrichosis can be challenging, especially after the emergence of resistance to azoles and polyenes. Alternative drugs arising from discoveries or repositioning have entered the radar of basic research over the last decade and point to several molecules with antifungal potential, especially the hydrazone derivatives with great in vitro and in vivo activities. There are many promising developments for the near future, and in this review, we discuss how these trends can be applied to the Sporothrix-sporotrichosis system to mitigate the advance of an emerging and re-emerging disease.

Automated summary

Sporotrichosis, caused by Sporothrix species, is a significant implantation mycosis. Recent advancements in Sporothrix taxonomy have improved diagnosis, epidemiology, and treatment. Molecular epidemiology reveals the prevalence of S. brasiliensis in cat-transmitted outbreaks in South America, while S. globosa and S. schenckii cause major infections in Asia and the Americas, respectively. One-health approaches are necessary to address the spread of sporotrichosis. Speciating Sporothrix is vital in the 21st century, with PCR being the main method for molecular diagnosis. Treatment can be challenging due to resistance, but alternative drugs hold promise. This review explores these trends to mitigate the emerging and re-emerging disease.