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Primary Conjunctival Sporotrichosis: Two Cases From a Zoonotic Epidemic in Rio de Janeiro, Brazil

Schubach, Armando MD, PhD*; Barros, Mônica Bastos de Lima MD, MSc†; Schubach, Tânia Maria Pacheco VMD, PhD*; Francesconi-do-Valle, Antônio Carlos MD, PhD‡; Gutierrez-Galhardo, Maria Clara MD, PhD‡; Sued, Márcio MD§; Salgueiro, Mariza de Matos MD*; Fialho-Monteiro, Paulo Cezar MD∥; Reis, Rosani Santos MSc∥; Marzochi, Keyla Belizia Feldman MD, PhD*; Wanke, Bodo MD, PhD∥; Conceição-Silva, Fátima MD, PhD¶

Case Reports

Purpose: To describe Sporothrix schenckii conjunctivitis in 2 owners of cats with sporotrichosis.

Methods: Small case series and literature review.

Results: Two women had been caring for their pet cats with sporotrichosis for 2 months but did not recall any traumatic injury such as scratches or bites. Each presented a conjunctival granulomatous lesion measuring 4 to 5 mm accompanied by local hyperemia, secretion, and edema, in addition to painful facial subcutaneous nodes and regional lymph node enlargement. Pyogenic material was collected from the conjunctival sac and from cutaneous lesions on the cats. In both the patients and their respective cats, fungal colonies were isolated and identified as S. schenckii. Treatment with oral itraconazole 100 mg/d for 3 months resulted in complete healing of lesions in both patients. Patients remained clinically cured 15 months after end of treatment.

Conclusion: Sporotrichosis is presently occurring as an emerging zoonosis in Rio de Janeiro, and some unusual clinical forms have been diagnosed in humans. The cases reported here suggest atraumatic exposure to cats infected by S. schenckii.

From *Serviço de Zoonoses, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; †Serviço de Infectologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; ‡Serviço de Dermatologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; §Serviço de Oftalmologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; ∥Serviço de Micologia Médica, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; and ¶Laboratório de Imunidade Celular e Humoral em Protozooses, Departamento de Imunologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brasil.

Received for publication February 26, 2004; revision received August 11, 2004; accepted August 16. 2004.

Supported in part by a grant from the Program to Support Strategic Research (PAPES 3), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.

Reprints: Armando Schubach, MD, PhD, Fundação Oswaldo Cruz, Instituto de Pesquisa Clínica Evandro Chagas, Serviço de Zoonoses. Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brazil (e-mail: armando@ipec.fiocruz.br).

© 2005 Lippincott Williams & Wilkins, Inc.