ABSTRACT Zoonotic sporotrichosis has expanded in Brazil as an urban, cat-associated mycosis, but its human clinical-epidemiological profile remains poorly characterized in Maranhao State, Brazil. This study describes a hospital-based cohort from Greater Sao Luis and defines a regional profile not previously established in the state. We conducted an observational study combining retrospective and prospective data from 2022 to 2025 at a reference hospital for infectious diseases in Sao Luis municipality, Maranhao State, Brazil. Confirmed cases were defined by culture and/or compatible histopathological findings supported by clinical-epidemiological criteria. Demographic, exposure, clinical, laboratory, therapeutic, and outcome variables were analyzed using descriptive statistics and appropriate statistical tests. A total of 189 confirmed cases were analyzed. Cases increased sharply after 2022 and peaked in 2024, with 82 cases. Most patients lived in Sao Luis municipality (84.7%), were female (67.2%), and were aged 30-59 years (47.1%). Feline-associated exposure predominated: 70.9% reported having household cats and 81.5% reported scratches or contact with feline lesions or secretions. The lymphocutaneous form was the main presentation (61.9%), followed by fixed cutaneous disease (29.1%); upper limbs were the most frequently affected sites (73.0%). Culture was positive for Sporothrix spp. in 62.2% of tested samples, and suppurative granulomas were frequent findings on histopathological examination. Itraconazole was the first-line therapy in 92.0% of treated patients. Greater Sao Luis shows the profile of an emerging urban epidemic of zoonotic sporotrichosis of feline origin. These findings provide local evidence to guide surveillance, early diagnosis, integration between human and veterinary health services, and One Health-based control strategies in Maranhao State.
Mycoplasma genitalium is an emerging sexually transmitted pathogen with increasing antimicrobial resistance worldwide. In Brazil, molecular testing for M. genitalium and resistance-associated mutations is not routinely available, and national data remain scarce. We analyzed 118 M. genitalium-positive urethral and vaginal swab samples collected between 2018 and 2023 from sites across all five Brazilian geographic regions. PCR amplification and sequencing of 23S rRNA, parC, and gyrA identified macrolide and fluoroquinolone resistance-associated mutations. Among 79 samples successfully sequenced for 23S rRNA, 40.5% harbored macrolide resistance-associated mutations (A2058G, A2059G, or A2058T) detected in samples from all five regions at different frequencies. A total of 6.1% of sequenced samples presented parC mutations, including two with combined 23S rRNA and parC mutations. No resistance-associated mutations were detected in gyrA. While resistance-associated mutations occurred in both symptomatic men and pregnant women, these findings are not representative estimates for the Brazilian population since the study used convenience samples from two distinct surveillance populations. Nonetheless, they provide multicenter molecular data that may inform future surveillance, diagnostic strategies, antimicrobial stewardship, and resistance-guided management of M. genitalium in Brazil.
Flooding can disrupt sanitation, contaminate water sources, and alter patterns of infectious disease; however, causal attribution of an individual febrile illness episode to flood exposure is difficult in retrospective hospital-based data. This study described hospitalized patients with acute febrile illness during a post-flood period in northern Vietnam, exploring associations with adverse short-term outcomes. This multicenter retrospective observational cohort included 237 consecutive patients admitted in Thai Nguyen province from October to November 2025. Demographic, documented environmental, clinical, laboratory, etiologic, and treatment data were obtained from medical records. Severe disease occurred in 8.4% and treatment non-response in 6.8% of patients. At admission, mean high-sensitivity C-reactive protein (hs-CRP) was 103.3 +/- 98.3 mg/L, procalcitonin (PCT) was 6.7 +/- 11.6 ng/mL, AST was 55.6 +/- 61.4 U/L, ALT was 42.5 +/- 46.2 U/L, and GGT was 79.9 +/- 70.7 U/L. Recorded etiologic diagnoses most commonly included Escherichia coli (33.3%), Vibrio cholerae (18.1%), influenza viruses (13.5%), Leptospira species (11.0%), and Streptococcus pneumoniae (11.0%). Ceftriaxone was administered to 61.5% of patients. Separate univariable exploratory analyses associated severeflood residence, non-clean water use, chronic disease history, hs-CRP > 100 mg/L, PCT > 2 ng/mL, and fever duration >= 3 days with adverse outcomes. These findings represent within-cohort associations among patients from flood-affected communities and do not indicate that flooding caused the illness episodes or outcomes. Most patients exhibited favorable short-term outcomes.
After the recertification of measles elimination in Brazil, outbreaks associated with imported cases may occur in pockets of susceptible individuals, including communities with low vaccination coverage. This study describes an outbreak investigation conducted in 2025 in Campos Lindos, Tocantins State, Brazil. In total, 25 cases were confirmed, mostly among unvaccinated Old Believers (a traditional community of Russian origin) following viral introduction linked to international travel, with transmission occurring predominantly within the community. Outbreak response measures, including ring vaccination and active case finding, interrupted transmission after 12 weeks with no new cases. The rapid response was effective and reinforces the importance of identifying susceptibility pockets in the population to prevent measles reintroduction.
The Amapa State, Brazil, in the Amazon region and bordering French Guiana, is a strategic sentinel location for infectious disease surveillance. Ecological pressures such as deforestation, artisanal gold mining, and high human mobility contribute to complex transmission dynamics of arboviruses, bacterial infections, and other pathogens. This study aims to characterize the etiologies of acute febrile illness (AFI) reported in Amapa State in 2018-2020, focusing on arbovirus circulation, bacterial contributions, and emerging pathogens. A retrospective analysis was carried out with 727 AFI cases. Laboratory diagnoses were established using molecular and serological assays, with systematic testing for different pathogens. Definitive diagnoses were obtained in 185 individuals (25.4%), yielding 209 positive results and including 23 cases of co-infection. Dengue virus was the predominant etiological agent (n=109, 52%), followed by leptospirosis (n=20, 9.5%), chikungunya virus (n=16, 7.6%), parvovirus B19 (n=16, 7.6%), measles (n=15, 7.1%), zika virus (n=10, 4.8%), mayaro virus (n=1,0.5%), and other bacterial infections (n=5, 2.4%). Isolated cases of hepatitis A and B, malaria, SARS-CoV-2, enterovirus, and acute Chagas disease were also identified. No hepatitis E virus or oropouche cases were detected. Dengue virus was the leading cause of AFI. Leptospirosis, chikungunya virus, and parvovirus B19 were other prevalent and often underrecognized contributors. The detection of additional viruses highlights Amapa State as a potential zone of "silent expansion" for emerging arboviruses. Co-detection of multiple pathogens underscores diagnostic complexity in regions with overlapping transmission. Strengthening surveillance, expanding laboratory capacity, and prioritizing differential diagnostics are essential to capture epidemiological dynamics and guide public health interventions.
