Localized Cutaneous Versus Deep Sporotrichosis at Hospital das Clínicas, UFMG, Belo Horizonte, Brazil: A Cohort of 213 Culture-Confirmed Cases, 2011 to 2026

Background: The zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis has expanded throughout Brazil and other countries, with a rise in deep forms of disease. Detailed comparative data on the presentation, treatment and outcomes of cutaneous and deep disease are needed to follow how Brazilian cohorts are evolving. Methods: The study involves a retrospective observational cohort of patients with sporotrichosis treated at a quaternary university hospital in Belo Horizonte between 2011 and 2026, restricted to culture-positive cases. Localized cutaneous disease was compared with deep infection using logistic regression adjusted for age and sex. Results: Of 313 patients, 213 had a positive culture. The median age was 41 years, and 54.0% were women. Lymphocutaneous disease predominated (54.0%), and contact with cats was reported by 53.1%. The median treatment duration was 150 days. Among the 101 patients with a defined outcome, 97 were cured (96.0%), with no documented treatment failure. All four sporotrichosis-related deaths occurred in the deep infection group, which was independently associated with comorbidity (OR 9.69; 95% CI 2.52 to 37.23) and an immunosuppressive condition (OR 6.61; 95% CI 1.89 to 23.09). Conclusions: Localized cutaneous sporotrichosis was cured in nearly all the patients with documented follow-up, whereas mortality was confined to deep infection associated with comorbidities and immunosuppression.