VITOR FALCAO DE OLIVEIRA

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico

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Autor e Coautores FMUSP-HC Normalizados: ADRIANA SATIE GONCALVES KONO MAGRI × Revista / Livro: Mycoses ×

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  • article 0 Citação(ões) na Scopus
    Clinical characteristics, diagnosis, and treatment of central nervous system sporotrichosis: Systematic review and meta-analysis
    (2024) OLIVEIRA, Vitor Falcao de; PETRUCCI, Julia Figueiredo; TABORDA, Mariane; BRENER, Pedro Zanetta; KREMER, Pedro Guilherme De Barros Brito; RANDI, Bruno Azevedo; MAGRI, Adriana Satie Goncalves Kono; MAGRI, Marcello Mihailenko Chaves; LEVIN, Anna S.; SILVA, Guilherme Diogo
    BackgroundThe clinical features of central nervous system (CNS) sporotrichosis are derived from case reports and a limited series of cases. Our objective was to carry out a systematic review and meta-analysis of CNS sporotrichosis.MethodsWe searched PubMed/MEDLINE, Embase, Scopus, and LILACS on 9 September 2023. Our inclusion criteria were documentation of Sporothrix and demonstrated CNS involvement. A metaproportion or metamean analysis was performed to estimate a summary proportion with 95% confidence intervals.ResultsWe included 52 cases of CNS sporotrichosis published from 1966 to 2023. Forty-six patients were male (88%, 95% CI: 77-95), and the mean age was 39 years (95% CI: 36-43). Close contact with cats was reported in 55% of cases (95% CI: 37-72). Thirty-two (61.5%) patients were from Brazil, 18 patients from the United State of America (34.6%). Only two Sporothrix species were reported: S. schenckii (26/41, 63%), and S. brasiliensis (15/41, 37%). The most common neurological symptom was headache. Meningitis was chronic in approximately 80% of cases. A significant majority of the patients were immunocompromised. HIV infection was the primary cause of immunosuppression (85%, 95% CI: 61-95). Overall mortality was 56% (22/39). The comparison of Kaplan-Meier survival curve showed a higher mortality with a statistically significant difference in immunosuppressed patients (p = .019).ConclusionCNS sporotrichosis represents a notable cause of chronic meningitis, especially in individuals living in the Americas with HIV infection and concurrent skin lesions.