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Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]2024; 55(3); 2969-2981; doi: 10.1007/s42770-024-01435-6

Equidae pythiosis in Brazil and the world: a systematic review of the last 63 years (1960-2023).

Abstract: This systematic review compiles reports of clinical pythiosis in horses, mules and donkeys from 1960 to 2023 worldwide, focusing on Brazil. We searched databases and included 71 articles detailing clinical characteristics, geographic distribution, epidemiology, diagnostic methods, therapies, and outcomes. The results showed that publications on equine pythiosis have significantly increased since 2010. Brazil reported the highest incidence, comprising 55% of cases, predominantly in the southern, northeastern, and central-western regions during summer and autumn. Cutaneous pythiosis was the most prevalent form, generally presenting as single lesions in the appendicular region, and affected females more than males. Diagnosis typically involved histopathology, used alone or with other methods. Various treatments have been employed, with surgery, often combined with chemotherapy and immunotherapy, being the most common. Notably, 80.84% of treated animals recovered, highlighting the effectiveness of these therapies in enhancing survival rates. The limitations of the study included the lack of data in published case reports, which made it difficult to collect and calculate epidemiological data. Additionally, we recognize that pythiosis in Brazil is underreported, since this disease does not have mandatory notification and several cases are not registered and/or reported in the literature. Lastly, it is hypothesized that equid pythiosis may be more widespread than currently known, and its real occurrence in Brazil remains uncertain.
© 2024. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.
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Publication Date: 2024-07-05 PubMed ID: 38967702PubMed Central: PMC11405592DOI: 10.1007/s42770-024-01435-6Google Scholar: Lookup
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  • Journal Article
  • Systematic Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Equine pythiosis, a rare but significant infectious disease affecting horses, mules, and donkeys, has become increasingly reported worldwide, especially in Brazil. This review compiles and analyzes data from 1960 to 2023, highlighting clinical features, diagnosis, treatment, and epidemiological patterns of the disease.

Purpose and Scope of the Review

  • Systematically analyze clinical reports of equine pythiosis globally from 1960 to 2023.
  • Focus particularly on Brazil, which had the highest reported incidence.
  • Summarize clinical characteristics, geographic distribution, epidemiology, diagnostic approaches, therapeutic interventions, and outcomes.
  • Assess temporal trends to gauge changes in reporting frequency and disease recognition.

Methodology and Data Sources

  • Systematic search of relevant databases for articles published between 1960 and 2023.
  • Inclusion criteria focused on reports documenting clinical equine pythiosis in horses, mules, and donkeys.
  • Final selection of 71 articles providing detailed data on clinical and epidemiologic features.
  • Data extraction on lesion characteristics, affected species, gender distribution, seasonal prevalence, diagnostic methods, treatment types, and outcomes.

Findings: Epidemiology and Geographic Distribution

  • Brazil accounted for 55% of all published cases, indicating a high endemicity in this country.
  • Within Brazil, cases were concentrated mainly in the southern, northeastern, and central-western regions.
  • Seasonal pattern observed: most cases occurred during summer and autumn months, corresponding to warmer and wetter periods favorable for the pathogen’s growth.
  • Increasing trend in publication frequency since 2010, likely reflecting heightened awareness, diagnostic improvements, or rising incidence.
  • Hypothesized underreporting in Brazil due to lack of notification mandates and incomplete case documentation.
  • Potential that equine pythiosis is more widespread than literature suggests, both in Brazil and globally.

Clinical Presentation

  • Cutaneous pythiosis was the predominant clinical form (skin lesions), particularly affecting limbs (appendicular region).
  • Most animals presented with solitary lesions rather than multiple distributed lesions.
  • Higher prevalence in females than males, although reasons for this sex difference were not elaborated.
  • The disease mainly affects equids (horses, mules, donkeys), suggesting host susceptibility patterns.

Diagnostic Approaches

  • Histopathological examination was the cornerstone diagnostic method, often combined with other techniques.
  • Histopathology enabled observation of characteristic features supporting diagnosis.
  • Additional methods commonly included culture, serological testing, and molecular diagnostics (not described in detail here).
  • Reliable diagnosis is key to effective treatment and epidemiological understanding.

Treatment Modalities and Outcomes

  • Surgical excision of affected tissue was the most common treatment modality.
  • Therapies often combined surgery with chemotherapy (antifungal/antimicrobial agents) and immunotherapy to improve outcomes.
  • Treated cases had a high recovery rate of approximately 80.84%, underscoring the success of combined therapeutic strategies.
  • Combination therapy likely enhances survival versus monotherapy, though exact comparative efficacy was not detailed.

Limitations and Challenges

  • Significant gaps in epidemiological data due to incomplete reporting in case studies.
  • Lack of mandatory notification leads to underreporting and possible bias in incidence estimates.
  • Heterogeneity in reported data and diagnostic standards may affect the comparability of cases.
  • The true distribution and burden of equine pythiosis remain uncertain worldwide and in Brazil specifically.

Conclusions and Implications

  • Increase in reports since 2010 suggests growing recognition and possibly rising incidence of equine pythiosis.
  • Brazil stands out as a major hotspot, especially during warm/wet seasons in certain regions.
  • Cutaneous manifestations predominate, with effective diagnosis relying heavily on histopathology.
  • Combination treatment involving surgery and adjunct therapies significantly improves survival.
  • Calls for mandatory reporting and improved surveillance to better define the epidemiology and improve disease control measures.
  • Further research needed to elucidate environmental and host risk factors and to develop standardized treatment protocols.

Cite This Article

APA
Pereira DIB, Botton SA, Ianiski LB, Braga CQ, Maciel AF, Melo LG, Zambrano CG, Bruhn FRP, Santurio JM. (2024). Equidae pythiosis in Brazil and the world: a systematic review of the last 63 years (1960-2023). Braz J Microbiol, 55(3), 2969-2981. https://doi.org/10.1007/s42770-024-01435-6

Publication

Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]
ISSN: 1678-4405
NlmUniqueID: 101095924
Country: Brazil
Language: English
Volume: 55
Issue: 3
Pages: 2969-2981

Researcher Affiliations

Pereira, Daniela Isabel Brayer
  • Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil. danielabrayer@gmail.com.
Botton, Sônia Avila
  • Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil.
Ianiski, Lara Baccarin
  • Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil.
Braga, Caroline Quintana
  • Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil.
Maciel, Aline Fontanella
  • Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil.
Melo, Luíze Garcia
  • Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil.
Zambrano, Cristina Gomes
  • Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil.
Bruhn, Fábio Raphael Pascoti
  • Faculdade de Veterinária, Departamento de Medicina Veterinária Preventiva, Universidade Federal de Pelotas, Programa de Pós-Graduação em Medicina Veterinária, Pelotas, RS, Brazil.
Santurio, Janio Morais
  • Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil.

MeSH Terms

  • Animals
  • Female
  • Male
  • Brazil / epidemiology
  • History, 21st Century
  • Horse Diseases / diagnosis
  • Horse Diseases / drug therapy
  • Horse Diseases / epidemiology
  • Horse Diseases / parasitology
  • Horses / parasitology
  • Pythiosis / diagnosis
  • Pythiosis / drug therapy
  • Pythiosis / epidemiology
  • Pythiosis / parasitology
  • Pythium / isolation & purification

Grant Funding

  • Financial code 001 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico / Conselho Nacional de Desenvolvimento Científico e Tecnológico

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

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Citations

This article has been cited 2 times.
  1. Jaturapaktrarak C, Sae-Chew P, Rujirawat T, Reamtong O, Krajaejun T. Immunoproteomic approach identifies a putative virulence chaperone DnaK protein as a candidate diagnostic marker and therapeutic target for Pythium insidiosum infection. Heliyon 2025 Feb 28;11(4):e42487.
    doi: 10.1016/j.heliyon.2025.e42487pubmed: 41477492google scholar: lookup
  2. Vasconcelos AB, França DA, Prado ACD, Yamauchi DH, Silva ACAD, Barros IO, Valença SRFA, Lucheis SB, Bosco SMG. Molecular Detection of Pythium insidiosum in Cutaneous Lesions of Horses from Northeastern Brazil. Animals (Basel) 2025 Sep 30;15(19).
    doi: 10.3390/ani15192863pubmed: 41096457google scholar: lookup
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