From neglected to notable: A growing public health challenge driven by hospitalization for sporotrichosis in Pernambuco, Northeast Brazil (2016–2024)

Opportunistic and endemic mycoses represent a significant global health concern, particularly in Brazil. In the northeastern state of Pernambuco (PE), sporotrichosis has become a rapidly escalating public health challenge, evidenced by a notable increase in hospital admissions, despite its mostly outpatient nature. The present study, therefore, aimed to investigate the epidemiological and clinical profile of mycosis-related hospitalizations in PE from 2016 to 2024, with a primary focus on the burden of sporotrichosis. This statewide surveillance study used data from Brazil's Unified Health System Hospital Information System (SIH/SUS) to conduct a descriptive and comparative assessment of hospitalizations for ten fungal diseases in PE and nationally. Incidence rates and the Error, Trend, Seasonality (ETS) framework were applied to forecast case numbers for 2025. A total of 794 hospitalizations were recorded in PE during the study period. The most prevalent infections were aspergillosis (23.0%), sporotrichosis (17.5%), cryptococcosis (15.1%), and chromoblastomycosis (13.6%), with an overall mortality rate of 10.5%. Hospitalizations for sporotrichosis rose from five cases in 2016-28 in 2021, with local incidence rates surpassing the national average. This implantation mycosis showed a marked concentration in Recife, reflecting the zoonotic spread of Sporothrix brasiliensis in urban areas. Notably, 46.0% of sporotrichosis cases were classified as unspecified, underscoring gaps in reporting. Among specified cases, the lymphocutaneous form predominated (18.7%), followed by disseminated disease (17.3%). Forecasts for 2025 indicate a persistently high hospitalization burden. These findings highlight a pressing public health issue in PE. The surge in sporotrichosis cases and the high share of severe and unspecified forms point to weaknesses in diagnosis and data recording. Tackling this emerging endemic-epidemic threat requires improved surveillance, mandatory notification, and better data capture in SIH/SUS, alongside integrated actions across human, animal, and environmental health sectors.