CAT-TRANSMITTED HUMAN SPOROTRICHOSIS AS A PUBLIC HEALTH EMERGENCY IN BRAZIL: INTEGRATIVE REVIEW OF THE EPIDEMIOLOGICAL TRANSITION, CLINICAL SPECTRUM, AND THERAPEUTIC MANAGEMENT

Abstract

Human sporotrichosis has undergone a profound eco-epidemiological transition in Brazil, shifting from a rural sapronotic mycosis to the largest global hyperendemic of feline-borne zoonotic transmission caused by Sporothrix brasiliensis. Objective: To critically analyze contemporary scientific evidence on the eco-epidemiological dynamics, physiopathogenesis, clinical spectrum, diagnostic accuracy, therapeutics, and One Health surveillance of human sporotrichosis in Brazil. Methodology: Integrative review structured via the PICo strategy and PRISMA 2020 guidelines across PubMed/MEDLINE, BVS/LILACS, and SciELO (January 2020 to November 2026). Out of 783 records identified, 46 studies comprised the final sample, graded according to Melnyk and Fineout-Overholt. Results: Marked dispersion from the Southeast to the South, Northeast, and Amazon regions (outbreaks in PE, MA, PA, and AM), genotypic hegemony of S. brasiliensis (65.4%–89.3%), and predominance of the lymphocutaneous form (51%–72.7%) were demonstrated, alongside rising ocular (sequelae up to 34.8%), immunoreactive (erythema nodosum and Sweet syndrome), osteoarticular, and systemic forms in immunocompromised hosts. Given the low sensitivity of direct microscopy and histopathology (10%–31%), culture remains the reference standard, supported by lateral flow assays (83% sensitivity) and PCR. Itraconazole (100–400 mg/day) achieved 85.8%–98.8% cure rates, while lipid amphotericin B is reserved for invasive disease and thermotherapy for pregnant patients. Conclusion: Zoonotic sporotrichosis requires enforcement of mandatory notification (Ordinance GM/MS No. 6,734/2025), diagnostic decentralization in the SUS, and One Health integration.