Zoonotic Sporotrichosis in Rio de Janeiro, Brazil: A Protracted Epidemic yet to Be Curbed

514 used in 184 (23%) patients. Amphotericin B was very seldom used (6 patients). Al- most 2% of clinically cured patients had clinical relapses (reemergence of their le- sions), whereas 11% ( ) of the pa- n p 90 tients did not need to be treated, because of spontaneous cure. Patients were fol- lowed from 3-6 months after the end of therapy. Nine percent of the patients were lost to follow-up. Six patients were hos- pitalized, with 2 deaths. Irrespective of the drug regimens, 89% of the cases were cured. It is still not certain how the infectious agent has been disseminated throughout the Rio de Janeiro municipality and its outskirts, but it is beyond reasonable doubt that the close interaction with cats represents a key form of transmission of the fungus. Felines have very close contact with contaminated soil and organic matter and constitute a reservoir of this agent (4, 5). An improper destination given to ill or dead cats was mentioned by 71% of their current/former owners (most cats were just abandoned or died without receiving a proper burial or cremation). Such non- hygienic practices most likely foster the sustained dissemination of the mycosis, contributing to its current epidemic (en route to endemization?) status, which has yet to be curbed in Rio de Janeiro's met- ropolitan area.