03788nas a2200169 4500000000100000008004100001260003700042100001400079700001700093700001800110245004800128856010400176300001300280490000700293520330400300022001403604 2025 d bPublic Library of Science (PLoS)1 aMatute DR1 aTeixeira MDM1 aJabra-Rizk MA00aSporothrix is neglected among the neglected uhttps://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1012898&type=printable ae10128980 v213 a

Fungal diseases are a growing threat to human health. The last 50 years have seen an increase in the prevalence of fungal infections [1,2]. Annually, close to 1 billion people are affected by mycoses [1,3]. Close to 7 million of these infections are life-threatening, and approximately 2 million of them are fatal [3]. One of the fungal diseases that has increased in importance in the last 50 years is sporotrichosis, a mycosis that is caused by members of the genus Sporothrix, and that usually manifests as a subcutaneous granulomatous disease [4–9]. Transmission typically occurs transcutaneously after contact with contaminated materials, often during farming or gardening, which can introduce the fungus through skin punctures [6]. The clinical presentation of sporotrichosis varies based on the type of infection and the immune status of the host. The most common forms of sporotrichosis are fixed cutaneous and lymphocutaneous sporotrichosis. In fixed cutaneous sporotrichosis, characterized by initial lesions that resemble small nodules, which may ulcerate over time (sporotrichotic chancres). These lesions are typically painless and remain around the puncture site (fixed). If the lesions spread, they can lead to cutaneous lymphocutaneous sporotrichosis, in which the infection spreads along the lymphatic vessels, resulting in additional nodules and systemic symptoms, or might even develop into disseminated cutaneous sporotrichosis. Extracutaneous forms of sporotrichosis also exist, but they are less common. Ocular sporotrichosis mostly often affects the ocular adnexa, but in some rare instances can also infect intraocular tissues (reviewed in [10]). Pulmonary infection, caused by inhalation of conidia from the air, can be localized or multifocal and is relatively uncommon (~1,000 cases), although these numbers might be artificially low due to underreporting [11]. Finally, osteoarticular infection usually manifests with tenosynovitis, joint effusion, bursitis, and synovial cyst formation [12].

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