Subcutaneous granuloma caused by Mycobacterium avium complex infection in a cat

A localised subcutaneous swelling developed on the nasal bridge of a cat receiving chemotherapy for alimentary tract lymphosarcoma. Cytological and histological examination of representative samples of the lesion demonstrated pyogranulomatous inflammation and abundant acid-fast bacilli. A Mycobacterium sp was cultured from tissue excised from the lesion. Extensive testing at three reference laboratories indicated the strain was a member of the Mycobacterium avium complex. The infection was treated successfully by cytoreductive surgery and a 6 weeks course of orally administered clofazimine.     

Chylothorax associated with cryptococcal mediastinal granuloma in a cat

A 10-year-old neutered female cat had chylothorax, precaval syndrome, and a mediastinal granuloma resulting from infection with Cryptococcus neoformans. Diagnosis of a chylous effusion was made by cytologic examination of pleural fluid and by finding higher triglyceride levels in the effusion than in serum (825 vs. 64 mg/dl, respectively). Postmortem examination revealed cryptococcal organisms in the mediastinal granuloma, lungs, cerebral meninges, and connective tissues adjacent to the thyroid gland. Chylous effusion in a cat associated with cryptococcosis has not been reported previously. Cryptococcosis should be included in the differential diagnosis in chylous effusions in cats.     

Cutaneous granulomas associated with Mycobacterium fortuitum infection in a cat

Feline mycobacterial skin infections are reviewed briefly. A case of skin granulomas in a cat associated with the presence of the fast–growing acid–fast bacillus, Mycobacterium fortuitum , is reported. Surgical excision was followed by recurrence, but resolution of the lesions was obtained by tetracycline therapy for 12 weeks interspersed with a 14–day course of choloramphenicol. An attempt at experimental transmission to a kitten was unsuccessful. The characteristics of the fast–growing mycobacteria and the possible sources of infection are discussed.     

Antiepithelial autoantibodies associated with the feline eosinophilic granuloma complex

A retrospective study of banked sera from 19 cats with the eosinophilic granuloma complex revealed that 68% of affected cats had circulating antibodies to components of normal cat epithelium. Seemingly, the eosinophilic granuloma complex of cats may be an autoimmune disease; however, epidermal damage caused by the eosinophilic granuloma complex may release altered self-antigens to which the cat's immune system responds.     

Mycobacterium fortuitum pneumonia in a cat and the role of lipid in the pathogenesis of atypical mycobacterial infections

Mycobacterium fortuitum is a saprophytic, fast-growing, nontuberculous, and nonlepromatous mycobacterium that can cause infections in animals and humans. In dogs and cats, it is one of the most common agents of ulcerative dermatitides and panniculitides caused by atypical mycobacteria. In humans, it is frequently found in lipoid pneumonias or contaminated surgical sites. We report a cat with granulomatous pneumonia caused by M fortuitum resembling lipoid pneumonia in humans. The similarity between the histopathology of the lung and skin lesions caused by this organism in dogs and cats is emphasized. We discuss the role of lipids in the pathogenesis of mycobacterioses and suggest an association between atypical mycobacteria and lipid-rich environments. We conclude that M fortuitum should be included as a differential in cases of lipid-rich pneumonias that do not respond to common antibiotics.     

Disseminated Mycobacterium avium complex infection following renal transplantation in a cat

An 11-year-old cat with a history of renal transplantation and treatment with cyclosporine and prednisolone was examined because of vomiting, diarrhea, inappetence, lethargy, and weight loss. Abdominal ultrasonography revealed 2 large heteroechoic masses thought to be mesenteric lymph nodes. Ultrasound-guided biopsy was performed, and histologic examination of biopsy specimens revealed granulomatous inflammation of presumptive lymph node tissue. Examination of sections stained with acid-fast stains revealed innumerable acid-fast bacilli within histiocytes, and a presumptive diagnosis of mycobacteriosis was made. The cat's clinical condition deteriorated, and euthanasia was elected. At necropsy, granulomatous inflammation was present within the mesenteric lymph nodes, spleen, liver, small and large intestines, lungs, and bone marrow. Bacterial culture yielded Mycobacterium avium, a slow-growing, opportunistic, saprophytic mycobacterium that can cause tuberculous lesions that are clinically indistinguishable from those associated with classic tuberculosis. It is a rare cause of disseminated mycobacteriosis in human transplant recipients. To our knowledge, this is the first report of disseminated M avium complex infection in a feline transplant recipient.     

Pyogranulomatous panniculitis in a cat associated with infection by the Mycobacterium fortuitum/peregrinum group

A 6-year-old, spayed female, American domestic shorthair was presented with a 10-month history of nodules on the dorsum. Diagnosis of pyogranulomatous panniculitis caused by Mycobacterium fortuitum/peregrinum group was achieved by using tissue culture, chromatography, and histopathologic examination. Pathological findings, diagnosis, and clinical management of the condition are discussed.     

Peripheral giant cell granuloma in a cat

A gingival mass excised from a cat was determined to be a peripheral giant cell granuloma. Characteristic histologic features were large numbers of multinucleated giant cells intermixed with mononuclear mesenchymal cells in a loose fibrovascular stroma. The lesion recurred twice, indicating that these non-neoplastic growths may be locally invasive.     

Intracranial Toxoplasma gondii granuloma in a cat

An 8-year-old cat with recent-onset generalized seizures was diagnosed with a right forebrain mass using magnetic resonance imaging. The mass was excised and upon histologic and immunohistochemical examination shown to be a Toxoplasma gondii granuloma. Serology supported active T gondii infection. The cat was treated with phenobarbital to control seizures. After definitive diagnosis of toxoplasma granuloma, clindamycin was administered for approximately 1 month. Seizures recurred 8 months after initial presentation, and the cat was euthanased at the owner's request. This is a previously unreported manifestation of feline central nervous system toxoplasmosis. When a mass lesion is present in the brain of a cat and serologic test results support active infection with T gondii, toxoplasma granuloma must be a differential diagnosis. If the patient is suffering from clinical disease, surgical resection of the mass (if possible) can be complimented with medical treatment until definitive diagnosis is obtained. Immunocompromising factors should be identified and addressed if possible.     

Paraparesis caused by epidural granuloma in a cat

Caudal paraparesis in a cat was determined to be caused by an epidural mass. Surgical decompression was performed, and the mass was determined to be a granuloma. Fusobacterium and Bacteroides spp were isolated from the granuloma. Epidural granulomas are seldom reported in dogs and cats. Decompression and administration of antibiotics led to recovery of this cat even though in human beings an unfavorable prognosis is given if neurologic deficits have developed.     

Chylothorax associated with dirofilariasis in a cat

A 4-year-old castrated domestic shorthair cat was referred for treatment of chylothorax. Thoracic duct lymphangiography revealed partial obstruction of the cranial vena cava, as evidenced by filling of mediastinal lymphatics with dye instead of all of the dye entering the vena cava. The thoracic duct was ligated via left 10th intercostal space thoracotomy. Immediate postligation lymphangiography revealed successful duct ligation. Results of a serum ELISA for adult heartworm antigen that was performed before surgery were positive. Drug treatment for the heartworm disease was not recommended, because the pleural effusion had ceased (as determined by radiographic examination 3.5 and 9 months after surgery) and the cat was doing well clinically. Sixteen months after surgery, the owner reported that the cat was doing well and did not have signs of respiratory problems.