{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:44:09Z","timestamp":1790117049847,"version":"4.0.1"},"reference-count":87,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico (PIBIC-CNPq-UFF, Brazil), Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior, Brazil","award":["001"],"award-info":[{"award-number":["001"]}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"crossref","award":["308986\/2022-9"],"award-info":[{"award-number":["308986\/2022-9"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"crossref","award":["302722\/2022-0"],"award-info":[{"award-number":["302722\/2022-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"crossref","award":["307421\/2022-8"],"award-info":[{"award-number":["307421\/2022-8"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>\u201cUnusual sporotrichosis\u201d, a concept proposed in this review, refers to severe, extracutaneous, or anatomically atypical manifestations of sporotrichosis occurring in immunocompetent hosts and represents an underrecognized clinical subset associated with important diagnostic and therapeutic challenges. This systematic review aimed to characterize unusual sporotrichosis worldwide and to clarify its epidemiological, clinical, diagnostic, and therapeutic patterns. Following a registered protocol and PRISMA guidelines, PubMed, Scopus, and BVS\/LILACS were searched up to November 2025 using a PICO-based strategy. Eligible studies included peer-reviewed case reports and case series with laboratory-confirmed sporotrichosis in patients without immunosuppression, diabetes mellitus, alcoholism, or other confounding comorbidities; classical lymphocutaneous and fixed cutaneous forms were excluded. From 922 records, 39 studies were included (13 case series and 26 case reports), yielding 55 cases reported between 1957 and 2024 across five world regions, mainly from the United States of America and Brazil. Adults aged 40\u201359 years (41.8%) and males (74.5%) predominated. Sapronotic transmission was most frequent (69.0%), although zoonotic transmission increased over time. Sporothrix schenckii\/Sporothrix schenckii sensu stricto was the predominant species (87.3%). Osteoarticular (30.9%) and systemic (27.2%) forms were the most common presentations. Although cure was achieved in most cases (58.1%), sequelae were frequent (21.8%), and the worst prognosis\u2014including most deaths\u2014was observed in osteoarticular sporotrichosis. Unusual sporotrichosis is globally distributed and clinically distinct; therefore, early recognition and multimodal diagnostic and therapeutic strategies are essential to improve outcome.<\/jats:p>","DOI":"10.3390\/jof12020155","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T08:58:21Z","timestamp":1771837101000},"page":"155","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual Sporotrichosis: A New Concept Proposal on the Unexpected Faces of Sporothrix spp. Infection"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4341-8154","authenticated-orcid":false,"given":"Jayne Ara\u00fajo","family":"da Silva","sequence":"first","affiliation":[{"name":"Graduate Program in Applied Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-150, RJ, Brazil"},{"name":"Center for Microorganisms\u2019 Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-141, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1352-6003","authenticated-orcid":false,"given":"Adriany Lucas dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Graduate Program in Applied Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-150, RJ, Brazil"},{"name":"Center for Microorganisms\u2019 Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-141, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00falia Andrade de Castro","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Center for Microorganisms\u2019 Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-141, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana de Paula","family":"Pires","sequence":"additional","affiliation":[{"name":"Center for Microorganisms\u2019 Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-141, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4221-2728","authenticated-orcid":false,"given":"Marcelo","family":"Cerilo-Filho","sequence":"additional","affiliation":[{"name":"Graduate Program in Applied Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-150, RJ, Brazil"},{"name":"Center for Microorganisms\u2019 Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-141, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-3602","authenticated-orcid":false,"given":"Gil","family":"Benard","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Mycology (LIM-53), Division of Clinical Dermatology, Institute of Tropical Medicine, Hospital das Cl\u00ednicas, Faculty of Medicine, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1918-7122","authenticated-orcid":false,"given":"Jos\u00e9 Rodrigo Santos","family":"Silva","sequence":"additional","affiliation":[{"name":"Graduate Program in Biology of Infectious and Parasitic Agents, Centre for Biological and Health Sciences, Federal University of Sergipe, S\u00e3o Crist\u00f3v\u00e3o 49100-000, SE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8955-3204","authenticated-orcid":false,"given":"Ricardo Luiz Dantas","family":"Machado","sequence":"additional","affiliation":[{"name":"Graduate Program in Applied Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-150, RJ, Brazil"},{"name":"Center for Microorganisms\u2019 Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-141, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9ssica Dornelas","family":"da Silva","sequence":"additional","affiliation":[{"name":"Clinical Research Unit of the Antonio Pedro Hospital, NanoOnco 3D, Fluminense Federal University, Niteroi 24033-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6973-0595","authenticated-orcid":false,"given":"H\u00e9ctor Manuel","family":"Mora-Montes","sequence":"additional","affiliation":[{"name":"Departamento de Biolog\u00eda, Divisi\u00f3n de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s\/n, col. Noria Alta, Guanajuato 36050, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0016-4809","authenticated-orcid":false,"given":"Gutemberg Gomes","family":"Alves","sequence":"additional","affiliation":[{"name":"Cell and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Niteroi 24210-201, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0461-7521","authenticated-orcid":false,"given":"Andr\u00e9a Regina de Souza","family":"Baptista","sequence":"additional","affiliation":[{"name":"Graduate Program in Applied Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-150, RJ, Brazil"},{"name":"Center for Microorganisms\u2019 Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niteroi 24020-141, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, August 31). 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