Análise do Perfil Clínico e Epidemiológico de Pacientes com Esporotricose Humana na Ilha De São Luís, Maranhão

Abstract

Human sporotrichosis associated with transmission from domestic cats has become an emerging urban zoonosis in Brazil, particularly due to the spread of Sporothrix brasiliensis, a species linked to large outbreaks and substantial public health impact. In São Luís, Maranhão, the progressive identification of human cases since 2022 highlighted the need to characterize the local profile of the disease and to understand its clinical, epidemiological, and therapeutic features. This observational, descriptive, retrospective cohort study analyzed patients with human sporotrichosis treated in the municipality of São Luís between August 2022 and July 2025. Secondary data were obtained from medical records, outpatient follow-up, clinical and epidemiological forms, laboratory records, and histopathological reports. A total of 156 patients were included, with a predominance of adults, women, self-declared brown-skinned individuals, and residents of different urban neighborhoods, including both peripheral and central areas of the municipality. Most cases were defined by clinical and epidemiological criteria, underscoring the importance of targeted anamnesis, identification of exposure to sick cats, and early clinical recognition in settings of zoonotic transmission. The lymphocutaneous form was the predominant clinical presentation, accounting for 66.0% of cases, followed by fixed cutaneous disease in 24.4%, disseminated cutaneous disease in 6.4%, and ocular lesions in 2.6%. Lesions mainly affected the hands and arms, a pattern consistent with traumatic inoculation during direct contact with infected cats. Although most patients had no recorded comorbidities, more complex presentations were identified, including disseminated forms, ocular involvement, and relapse in an immunosuppressed patient, demonstrating the clinical heterogeneity of the disease. Itraconazole at doses ranging from 200 to 400 mg/day was the most frequently used therapeutic regimen, prescribed in nearly all cases, with an average treatment duration of 3 to 6 months, varying according to lesion extent, disease severity, and clinical response. The findings show that human sporotrichosis in São Luís follows a pattern consistent with the national expansion of this zoonosis, while also carrying particular local relevance because it represents a still poorly systematized scenario in Maranhão. This study contributes to the recognition of a previously unstratified clinical and epidemiological profile of the disease in the municipality and reinforces the need for integrated surveillance, early diagnosis, healthcare workforce training, proper management of infected cats, and intersectoral actions guided by the One Health perspective.