Clinical laboratory evaluation of deep mycotic diseases in dogs

A retrospective study of 27 dogs with deep mycoses was conducted to evaluate the usefulness of initial laboratory results in determining a diagnosis. Fifteen cases of disseminated blastomycosis, five cases of disseminated histoplasmosis and seven cases of gastrointestinal phycomycosis were studied. Haematologic results consistent with a chronic inflammatory disease (mild to moderate anaemia and moderate to marked monocytosis) were common findings in blastomycosis and phycomycosis. Cases of histoplasmosis were characterized by a more severe anaemia with a neutrophilia and left shift. The severe anaemia present in three out of five (3/5) dogs with histoplasmosis was apparently due to myelophthisis and intravascular erythrocyte fragmentation. Coagulation function tests and/or the haemograms suggested the presence of microangiopathic haemolysis in four dogs with histoplasmosis. Clinical chemistry results in blastomycosis and phycomycosis were usually unremarkable. Hepatic lesions in histoplasmosis were suggested by increases in serum alkaline phosphatase and decreases in serum albumin. Cytology was frequently diagnostic for blastomycosis (11/13 cases) and histoplasmosis (3/4 cases) but was inconsistent in phycomycosis (1/3 cases).     

Diagnosis of histoplasmosis by detection of the internal transcribed spacer region of fungal rRNA gene from a paraffin-embedded skin sample from a dog in Japan

The lesions of histoplasmosis in dogs in Japan differ from those in dogs in North America. Affected dogs in Japan have had multiple granulomatous or ulcerated foci in skin or gingiva and have not had pulmonary or gastrointestinal lesions. The present report introduces a polymerase chain reaction (PCR) diagnosis of canine histoplasmosis and the characteristic of disease in Japan. The surgically removed skin ulcerate samples from a 5-years-old female Shiba-inu native to Japan without traveling out of the country were evaluated. Tissue samples had many yeast-like organisms in the macrophages. DNA was extracted from paraffin-embedded tissue samples. A nested PCR technique was applied. The detected sequence of the internal transcribed spacer of ribosomal RNA gene had 99.7% in homology with Ajellomyces capsulatus (the teleomorph of Histoplasma capsulatum). Clinical manifestations, historical background of equine epizootic lymphangitis in Japan, and a human autochthonous case of histoplasmosis farciminosi indicated that this dog might have been infected with H. capsulatum var. farciminosum as a heteroecism.     

Disseminated histoplasmosis in cats: 12 cases (1981-1986)

Anemia, weight loss, lethargy, fever, anorexia, and interstitial lung disease were the predominant clinical findings in 12 cats with disseminated histoplasmosis. Some cats were examined because of dysfunction or lesions of bone, eyes, or skin. In most cases, the clinical signs were observed by the owner for 4 weeks or less before seeking veterinary care. Young cats were most commonly affected, with 7 of the 12 cats less than or equal to 1 year old. Identification of Histoplasma organisms in bone marrow aspirates was used to confirm the diagnosis of histoplasmosis in 11 of the 12 cats. Histoplasma infection of multiple organs was found at necropsy. In this study, disseminated histoplasmosis had a higher prevalence in cats than in dogs at the same veterinary medical teaching hospital. Feline disseminated histoplasmosis was not associated with FeLV infection. Treatment was attempted in 7 of the 12 cats.     

Itraconazole for the Treatment of Histoplasmosis in Cats

Eight cats with histoplasmosis were treated with itraconazole at 5 mg/kg per dose PO bid. There were multiple sites of infection, and 2 of the cats had hypercalcemia that was attributed to the histoplasmosis. All 8 cats were eventually cured, but 2 cats experienced recurrences of disease after completion of therapy, requiring 2 to 3 additional months of itraconazole. There were no clinically relevant adverse effects during treatment. Although a limited number of cats were treated, the study suggests that itraconazole is a well-tolerated and effective drug for the treatment of histoplasmosis in the cat.     

B-cell lymphoma in a dog with ehrlichiosis (Ehrlichia canis) and systemic histoplasmosis (Histoplasma capsulatum)

A mixed breed dog treated for ehrlichiosis and systemic histoplasmosis developed a refractory thrombocytopenia. When an abdominal mass was detected, exploratory laparotomy and biopsies confirmed lymphoma, which on immunohistochemical stains was determined to be of B-cell origin. Conceivably, the B-cell lymphoma in this dog was associated with chronic inflammation from ehrlichiosis, histoplasmosis, or both.     

Diagnosis and treatment of pulmonary histoplasmosis in a horse

A 2-year-old Trakehner filly with pulmonary histoplasmosis is presented. Clinical signs included weight loss, intermittent fever, dyspnea and depression. Diagnosis was based on thoracic radiography, transtracheal wash cytology and lung aspirate cytology. A 5-week regimen of Amphotercin-B administered intravenously resulted in clinical recovery and return of the animal to normal activity. A brief review of histoplasmosis in man and animal is included.     

Clinical evaluation of urine Histoplasma capsulatum antigen measurement in cats with suspected disseminated histoplasmosis

Diagnosis of Histoplasma capsulatum infection in cats traditionally relies upon identification of organisms in circulating monocytes or in tissue specimens from affected organs. In this retrospective study, results of a urine antigen assay were compared with standard diagnostic methods in cats with clinical signs suggestive of histoplasmosis. Antigenuria was detected in 17/18 cats with a histopathologic or cytopathologic diagnosis of histoplasmosis. This preliminary evaluation of the Histoplasma urine antigen test suggests it may be a useful aid in diagnosing this disease in cats.     

Molecular findings of disseminated histoplasmosis in two captive snow leopards (Uncia uncia)

This paper reports two cases of disseminated histoplasmosis in captive snow leopards (Uncia uncia). Histoplasmosis was diagnosed based on histopathology, immunohistochemistry, transmission electron microscopy, and molecular findings.     

Experimentally induced Histoplasma capsulatum infection in coyotes and a dog

Captive coyotes (Canis latrans) were inoculated intragastrically (1 coyote), and intratracheally (6 coyotes) with Histoplasma capsulatum to simulate natural routes of exposure. In addition, the infectious organism was inoculated IV into another coyote and into a dog (C familiaris) to simulate hematogenous dissemination of H capsulatum. Isolation of the pathogen from various tissue specimens, using direct plating and mouse inoculation methods, provided mycologic evidence of infection. The presence of anti-Histoplasma serum antibodies also was monitored. Of the 6 coyotes challenged intratracheally, one developed a benign pulmonary form of histoplasmosis. This coyote developed a transient cough, and intracellular yeasts typical of H capsulatum were observed microscopically in pulmonary tissue specimens. The pathogen was isolated from specimens of pulmonary tissue and associated lymph nodes. The coyote that was fed Histoplasma-infected mice (intragastric challenge) did not develop clinical disease. The coyote and the dog inoculated IV developed a multifocal, nonsuppurative infection, without clinical evidence of histoplasmosis. Pathologic findings in the coyote and dog were similar; both animals had splenitis, lymphadenitis, and petechiation of the lungs. The liver and spleen were considered the primary extrapulmonary target organs on the basis of mycologic and histologic findings.     

ULTRASONOGRAPHIC APPEARANCE OF HISTOPLASMOSIS IDENTIFIED IN THE SPLEEN IN 15 CATS

Histoplasmosis is the second most common fungal infection reported in the cat. The disseminated form involving lung, liver, lymph nodes, spleen, and bone marrow is a frequent manifestation of the disease. Limited information is available in the literature regarding the ultrasonographic appearance of the spleen in cats with disseminated or splenic histoplasmosis. A retrospective review of splenic ultrasound images from 15 cats confirmed to have histoplasmosis by splenic aspirates was performed. Size, echotexture, echogenicity, margin appearance, presence of nodules, and the overall shape of the spleen were reported in each case. Splenomegaly was documented in all cases (15/15) and a hypoechoic appearance of the spleen was documented in 14/15 of cases. The spleen was diffusely and uniformly affected in 14/15 (six homogenous and eight with a subtle mottled appearance) and had discrete nodules in 1/15 cats. Histoplasmosis should be included in the differential list for an enlarged and hypoechoic spleen in cats with consistent clinical findings. Additionally, ultrasound guided splenic aspirate may be a useful method to obtain a cytology sample for diagnosis.     

Disseminated histoplasmosis in dogs: 12 cases (1981-1986)

Diarrhea, intestinal blood loss, anemia, and lethargy were predominant clinical findings in 12 dogs with disseminated histoplasmosis. Young dogs were affected most commonly, with 6 dogs being 1 to 3 years old. A diagnosis of disseminated histoplasmosis was established on the basis of histologic or cytologic detection of Histoplasma organisms in intestinal or rectal mucosa in 7 dogs, in circulating leukocytes in 5 dogs, in bone marrow in 3 dogs, and in multiple tissues at necropsy in 1 dog (4 dogs had Histoplasma organisms detected in greater than 1 site). Anemia was detected in 10 dogs (PCV less than 20% in 3 dogs), and the anemia was inadequately regenerative or nonregenerative in 7. Hypoalbuminemia was detected in 9 dogs, and serum albumin concentrations were low (less than 1.0 g/dl) in 4 of the 9 dogs. Of 5 dogs treated with ketoconazole, 2 were in remission for greater than or equal to 1 year. Corticosteroid therapy may have exacerbated the disease in 4 dogs. Histoplasma infection of multiple organs was detected in 5 necropsied dogs.     

Use of corticosteroids for treating dogs with airway obstruction secondary to hilar lymphadenopathy caused by chronic histoplasmosis: 16 cases (1979-1997).

OBJECTIVE: To examine use of corticosteroids in treating dogs with airway obstruction secondary to hilar lymphadenopathy caused by chronic histoplasmosis. DESIGN: Retrospective study. ANIMALS: 16 dogs. PROCEDURE: Records for dogs with airway obstruction examined from January 1979 through December 1997 were reviewed. Dogs were included in the study if they had hilar lymphadenopathy documented radiographically and bronchoscopically, had serum antibodies against Histoplasma capsulatum, and did not have organisms in any cytologic or histologic samples. Dogs were assigned to groups on the basis of treatment given (5 dogs, corticosteroids only; 5 dogs, corticosteroids and antifungal medication; 6 dogs, antifungal medication only). RESULTS: Clinical signs resolved in < 1 week in dogs treated only with corticosteroids. In dogs treated with corticosteroids and an antifungal medication, improvement was evident in a mean of 2.6 weeks. In 5 of 6 dogs treated with only an antifungal medication, clinical signs resolved in a mean of 8.8 weeks. Dogs receiving corticosteroids did not develop active or disseminated histoplasmosis. CLINICAL IMPLICATIONS: Corticosteroids can be used successfully in the treatment of dogs with hilar lymphadenopathy secondary to histoplasmosis. Affected dogs must be carefully evaluated for active infection. Specimens obtained by means of bronchoalveolar lavage, tracheal washing, or other methods should be examined to exclude the possibility of an active infection, which could result in corticosteroid-induced dissemination of disease.     

Counterimmunoelectrophoresis (immunoelectroosmosis) and serum electrophoretic pattern in serologic diagnosis of canine blastomycosis

Counterimmunoelectrophoresis (CIEP) with blastomyces and histoplasma antigens was used in a serologic study of 181 dogs clinically suspected of having blastomycosis and of 8 dogs with confirmed blastomycosis or histoplasmosis. Thirteen of the 181 dogs, positive by CIEP, were euthanatized, and the diagnosis was confirmed by cultivation and/or microscopic detection of Blastomyces dermatitidis. Additional CIEP-positive dogs were confirmed by staining of aspirates collected in vivo. Radiographic support for the diagnosis was reported in 4 other dogs in which histoplasmosis was excluded by a negative CIEP with histoplasma antigen. The precipitating antibody may disappear during the course of the disease, as it did in 1 dog treated with amphotericin B, but not cured. This dog reverted from CIEP-positive to CIEP-negative within 17 months of treatment (with a weak reaction after 10 months of treatment). The CIEP-detectable antibody was present only in 1 dog without a confirmation by histopathologic findings or cultivation among 24 well-documented cases and 181 total tested sera. The CIEP was more sensitive and specific than was the gel-diffusion precipitin test, eliminated the problems of anticomplementarity that often affected the results of complement-fixation tests with canine sera, and served well in detecting dogs with blastomycosis. Electrophoretic pattern of sera from CIEP-positive dogs with blastomycosis showed a decrease in albumin and an increase in alpha 2- and often in beta- and gamma-globulins, with a substantial decrease of the albumin/globulin ratio.     

Identification of Histoplasma organisms in circulating eosinophils of a dog

Disseminated histoplasmosis was diagnosed in a 10-year-old dog that had chronic diarrhea, weight loss, fever, and anemia. The diagnosis was based on detection of Histoplasma organisms in circulating neutrophils, monocytes, and eosinophils. The dog had severe histoplasmal fungemia, which may have been caused by treatment with prednisolone.     

DISSEMINATED HISTOPLASMOSIS WITH OSSEOUS LESIONS IN A CAT WITH FELINE LYMPHOSARCOMA

A cat was presented with a non-weight-bearing lameness of the left thoracic limb, painful joints and lymphadenopathy. Marked bilateral osteolysis of the distal radial and ulnar metaphyses was detected radiographically. A post mortem diagnosis of disseminated histoplasmosis and feline lymphosarcoma was made.     

Histoplasmosis in dogs and cats

Histoplasma capsulatum is endemic throughout most of the United States with a high prevalence of infections in the Midwest and South. Histoplasmosis is the second most common systemic fungal disease in cats that may be more susceptible than dogs. Infection occurs by inhalation of conidia from the mycelial phase, which subsequently convert to the yeast form. Histoplasma capsulatum is phagocytized and harbored by cells of the mononuclear phagocyte system. Infection may be subclinical or cause clinical pulmonary granulomatous disease or dissemination. Disseminated disease predominantly affects the liver, spleen, gastrointestinal tract, bone and bone marrow, integument, and eyes. Primary gastrointestinal histoplasmosis also occurs. Clinical signs of histoplasmosis often are nonspecific, including chronic wasting, fever, anorexia, respiratory signs, and lameness. Gastrointestinal signs (eg, diarrhea with hematochezia or melena) are common in dogs. The definitive diagnosis is made by identification of the yeast in tissue samples. Itraconazole is the treatment of choice.     

Neutropenia in dogs and cats: a retrospective study of 261 cases

Case records of 232 dogs and 29 cats with neutropenia were reviewed to examine the spectrum of underlying etiologies causing the neutropenia. Six etiological categories included nonbacterial infectious disease; increased demand due to marked inflammation, bacterial sepsis, or endotoxemia; drug-associated neutropenia; primary bone-marrow disease; immune-mediated neutropenia; and diseases of unclear etiology. The largest single category associated with the development of neutropenia was nonbacterial infectious disease (e.g., feline leukemia virus [FeLV], feline immunodeficiency virus [FIV], histoplasmosis, cryptococcosis, and parvovirus), with parvovirus infection accounting for 47.1% of all cases. The least common (0.38%) cause was naturally occurring immune-mediated neutropenia.     

Histoplasmosis in a dog from New Brunswick

A young dog was presented with a history of chronic diarrhea, anorexia, and weight loss. Histoplasma capsulatum was suspected, based on cytologic examination of lymph node aspirates and peritoneal fluid, and confirmed by fungal culture. To our knowledge, this is the first case of histoplasmosis diagnosed in a dog in Atlantic Canada.     

Disseminated histoplasmosis in a Bengal tiger (Panthera tigris)

Disseminated infection with Histoplasma capsulatum was diagnosed in a 7-yr-old female Bengal tiger (Panthera tigris). Clinical signs were nonspecific with the exception of brief periods of tachypnea for 5 days prior to death. H. capsulatum organisms were found in the lungs, tracheobronchial lymph nodes, and liver. Diagnosis was confirmed by tracheal wash, urine H. capsulatum enzyme immunoassay, and necropsy results. This report represents the first published account of disseminated histoplasmosis in a tiger.     

Atypical Histoplasma capsulatum infection in a dog

Disseminated histoplasmosis was diagnosed in a 10-year-old dog suspected of having hepatic carcinoma. Clinical abnormalities included diffuse hepatomegaly, gastrointestinal bleeding, thoracic and abdominal effusion, anemia, leukocytosis, and thrombocytopenia. Histoplasmosis characteristically is a disease of the mononuclear phagocyte system, but in this case was diagnosed by finding Histoplasma capsulatum organisms in neutrophils on the blood smear.