School of Medicine Publications
Document Type
Article
Publication Date
2-2026
Abstract
Background: Sporotrichosis is a dimorphic fungal infection of increasing global relevance. Although usually cutaneous or lymphocutaneous, disseminated disease occurs in immunocompromised hosts. Large-scale data on its epidemiology, treatment and outcomes remain limited.
Objectives: To characterise the clinical features, comorbidities, antifungal prescribing patterns and one-year mortality associated with sporotrichosis, with emphasis on patients with HIV and other forms of immunosuppression.
Patients/methods: We performed a retrospective global cohort study using the TriNetX Research Network. Adults (≥ 18 years) diagnosed with sporotrichosis were identified using ICD-9/10 codes (1995-2024). Demographics, comorbidities, laboratory parameters and antifungal prescriptions were analysed. The primary outcome was all-cause mortality at 1 year. Secondary outcomes included hospitalisation and admission to the intensive care unit (ICU).
Results: Among 2124 adults, the mean age was 52 years, and 56.5% were female. Nearly half of the cases originated internationally, with the southeastern United States accounting for the majority of domestic cases. Neoplasms (25%) and diabetes (11%) were the most common comorbidities. Lymphocutaneous disease was uncommon (9%), and disseminated infection occurred in 1% of cases. One-year mortality was 17%, with a higher risk among older adults and those with neoplasms, lymphocutaneous or disseminated infection or hyperferritinemia. Seventeen patients (0.8%) had HIV and were more likely to have pulmonary or disseminated disease. Itraconazole was the most commonly prescribed antifungal (52%), while the use of amphotericin B remained low (< 2%).
Conclusions: Sporotrichosis causes substantial global mortality. Outcomes appear driven by host factors and gaps in guideline-based management. Earlier recognition, optimised antifungal therapy, and use of inflammatory markers to guide risk stratification may improve outcomes and inform prevention strategies.
Recommended Citation
Schapiro, S., Pulciano, N., Galindo-Ramirez, J., Rau, N., Tuells, J., Agudelo Higuita, N. I., Thompson, G. R., 3rd, Chastain, D. B., & Henao-Martínez, A. F. (2026). Epidemiology and Outcomes of Sporotrichosis: A Descriptive Real-World Analysis From a Global Cohort. Mycoses, 69(2), e70152. https://doi.org/10.1111/myc.70152
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
DOI
10.1111/myc.70152
Academic Level
resident
Mentor/PI Department
Internal Medicine
Comments
© 2026 The Author(s). Mycoses published by Wiley‐VCH GmbH.
This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.