ACUTE DIFFUSE MYCOTIC PNEUMONIA IN A 7-MONTH-OLD COLT

A 7-month-old Quarter horse colt developed acute diarrhea, laminitis, bilateral uveitis, and severe respiratory distress after intramuscular injection with a bacterial vaccine. Thoracic radiographs revealed diffuse unstructured, nodular interstitial, and peribronchial opacities throughout the lung. Despite intensive supportive therapy, the colt became progressively hypoxemic and died. At postmortem examination, severe multifocal to coalescing hemorrhagic, necrotizing fibrinous pneumonia was found. Histologic study revealed numerous branched septate fungal hyphae diffusely distributed throughout the lung parenchyma. Fungal culture of lung tissue grew Aspergillus fumigatus. This report presents the radiographic, clinical, and pathologic features of acute mycotic pneumonia in horses.     

Disseminated blastomycosis in two California sea lions (Zalophus californianus).

Two captive California sea lions (Zalophus californianus) from different facilities were diagnosed with disseminated blastomycosis. The first, a 12-yr-old male, died after a 3-wk history of progressive anorexia and lethargy. Gross examination revealed acute jejunitis with focal perforation and associated peritonitis, along with severe purulent bronchopneumonia. The second, a 15-yr-old female, was euthanized after a 2-wk history of severe cutaneous ulceration and declining clinical condition. Gross examination revealed severe pyogranulomatous bronchopneumonia and ulcerative dermatitis. Histopathologic examination in both individuals revealed severe multifocal subacute to chronic pyogranulomatous pneumonia associated with massive numbers of fungal organisms morphologically compatible with Blastomyces sp. Fungal organisms were 8-20-microm-diameter broad-based budding yeasts with thick, refractile, double-contoured walls. The male sea lion had multifocal transmural Blastomyces-induced enteritis with subsequent rupture and peritonitis. The organism was also present in the liver, with minimal associated inflammation. The female had severe multifocal pyogranulomatous ulcerative dermatitis associated with large numbers of intralesional fungal organisms. Dissemination to the spleen had occurred in both animals. A serologic immunodiffusion test for Blastomyces dermatitidis was positive in the male. The presumptive primary pathogen in both cases was Blastomyces dermatitidis.     

Oxalate-producing pulmonary aspergillosis in an alpaca

An aging lactating alpaca was presented in sternal recumbency. Although bright and alert, she did not respond to symptomatic treatment and was euthanized 5 weeks after initial presentation. Gross postmortem examination revealed purulent material in the pulmonary airways. Histologic examination of the lungs revealed an extensive pyogranulomatous pneumonia with bronchiectasis. There were abundant fungal hyphae and high numbers of associated oxalate crystals, which were presumed to have been produced by the fungus. Low numbers of yeast cells were also present. Microbiological culture of tissues on horse blood agar and Sabouraud's agar identified the fungus to be Aspergillus niger. There was also moderate growth of Candida albicans. Calcium oxalate crystals in cytologic and histologic preparations can suggest an underlying Aspergillus infection. This is the first reported veterinary case of pneumonia due to Aspergillus niger infection and the associated production of oxalate crystals.     

Aspergillus fumigatus infection in two wild Eurasian black vultures (Aegypius monachus Linnaeus) with carbofuran insecticide poisoning: a case report

Aspergillus spp. are opportunistic pathogens which cause pulmonary aspergillosis in animals and humans with compromised immune systems. Two Eurasian black vultures (Aegypius monachus Linnaeus) were found dead or clinically ill from carbofuran insecticide during the winter of 2004. Carbofuran was detected in the stomach contents by gas chromatograph-mass spectrometry. Gross lesions showed severe granulomatous pneumonia and serofibrinous pleuropneumonia in both birds, with most lesions restricted to the pulmonary system. Histological lesions included pyogranulomatous pneumonia and suppurative parabronchiolitis/pleuritis/air sacculitis with a number of septated fungal hyphae, suggesting severe pulmonary aspergillosis. Fungal isolates from each vulture were identified as Aspergillus fumigatus by both lactophenol cotton blue staining and genetic analysis. This is the first report of pulmonary aspergillosis caused by A. fumigatus in wild Eurasian black vultures and suggests that Aspergillus infection could be an important cause of death in these birds which migrate from Mongolia to Korea during the winter. The incidence of the disease may be related to impaired immunity caused directly or indirectly by carbofuran poisoning.     

Pulmonary hyalohyphomycosis caused by Fusarium spp in a Kemp's ridley sea turtle (Lepidochelys kempi): an immunohistochemical study

AIM: To describe the microscopic and immunohistochemical findings in a case of pulmonary hyalohyphomycosis in a Kemp's ridley sea turtle (Lepidochelys kempi). METHODS: Samples of lung, liver and kidney from a stranded, dead Kemp's ridley sea turtle were routinely processed for histopathological studies. Two monoclonal antibodies that reacted specifically with antigens of Aspergillus spp and the Mucorales (Zygomycetes) group, and a panel of polyclonal antibodies raised against Aspergillus fumigatus, Candida albicans, Geotrichum candidum, Fusarium solani, and Scedosporium apiospermum were used for immunohistochemical or immunofluorescence staining. RESULTS: Histologically, a severe multifocal granulomatous pneumonia associated with fungal infection was diagnosed. All hyphae were identified as Fusarium spp because a strong and uniform reactivity was obtained only with a heterologously-absorbed polyclonal antibody raised against somatic antigens of Fusarium solani. CONCLUSIONS: Fusarium spp should be included in the differential diagnosis of mycotic pneumonia in Kemp's ridley sea turtles. CLINICAL RELEVANCE: This is the first report of a pulmonary mycotic infection in a sea turtle diagnosed using immunohistochemistry. Wildlife rehabilitators and pathologists should be aware of the availability of immunohistochemical techniques for identifying fungi in sea turtles.     

Eosinophilic crystalline pneumonia as a major cause of death in 129S4/SvJae mice

Eosinophilic crystalline pneumonia is an idiopathic disease that occurs in many strains and stocks of mice, more commonly in strains on a C57BL/6 background. The disease occurs sporadically in most strains of mice and varies from mild and subclinical to severe and fulminating, sometimes resulting in respiratory distress and death. In this study, 94 aged male and female 129S4/SvJae mice were evaluated for eosinophilic crystalline pneumonia lesions. There was an 87% incidence, with females overrepresented. Histologically, there were multifocal to coalescing inflammatory infiltrates composed of numerous large eosinophilic macrophages and multinucleate cells admixed with eosinophils, neutrophils, lymphocytes, and plasma cells within alveolar and bronchiolar spaces, associated with refractile, brightly eosinophilic, angular crystals. Alveolar macrophages and multinucleate cells contained fine needlelike to rectangular intracytoplasmic crystalline material. Similar crystals were often free within alveoli and conducting airways, often associated with mucous metaplasia of bronchiolar epithelium. This disease may occur spontaneously or in concert with other pulmonary lesions, such as pulmonary adenomas, lymphoproliferative disease, allergic pulmonary disease, and parasitic or fungal infections. The characteristic crystals morphologically resemble Charcot-Leyden crystals, which represent eosinophil breakdown products in humans with eosinophil-related disease. However, crystals in eosinophilic crystalline pneumonia are composed predominantly of Ym1 protein, a chitinase-like protein associated with neutrophil granule products and secreted by activated macrophages. The function of Ym1 protein is not fully understood but is believed to be involved in host immune defense, eosinophil recruitment, and cell-cell and cell-matrix interactions consistent with tissue repair. The mechanism of induction of eosinophilic crystalline pneumonia with Ym1 crystal formation is unknown.     

Disseminated acute concomitant aspergillosis and mucormycosis in a pony

A 6-year-old female pony died after 2 days of prostration. Clinical signs included hyperthermia and abnormal pulmonary auscultation sounds. Necropsy revealed diffuse severe necrohaemorrhagic colitis and splenitis, multiple visceral ecchymoses, petechial haemorrhages in the brain and lungs. Microscopical examination showed acute necrohaemorrhagic colitis, encephalitis, pneumonia and splenitis associated with fibrinoid vasculitis, thrombosis and fungal hyphae within and around vessels. Immunohistologically, concomitant aspergillosis (caused by Aspergillus fumigatus) and mucormycosis (causde by Absidia corymbifera) were identified in the colonic and pulmonary lesions, whereas pure mucormycosis was observed in cerebral and splenic lesions. Dual mycotic infections are very rarely described, and the present case emphasizes the need of immunohistochemistry in order to obtain a clear-cut diagnosis of mixed fungal infections.     

Pathological findings in dogs naturally infected with Angiostrongylus vasorum in Newfoundland and Labrador, Canada.

Fifty-six dogs from St. John's, Newfoundland, Canada, were evaluated for Angiostrongylus vasorum infection. Small numbers of nematodes were found within pulmonary arteries of 6 dogs. Larvae were identified in fecal samples in 2 of 6 dogs. All 6 dogs had multifocal granulomatous pneumonia and sometimes foci of chronic thrombosis, which varied from very mild to severe. One dog had extensive pulmonary lesions resulting in cor pulmonale. Right heart failure was characterized by right ventricular hypertrophy, hepatic congestion, ascites, and hydrothorax. Microscopically, in most cases, eggs, larvae, and sometimes intravascular adults, were present within lung tissue sections. Small foci of granulomatous inflammation with and without larvae were present in kidney and brain in 4 dogs. An additional dog, diagnosed antemortem with angiostrongylosis via fecal examination, was also examined. Pathological findings consisted of severe pyogranulomatous interstitial pneumonia with myriad eggs, larvae, and numerous intravascular pulmonary adult nematodes with extensive arterial thrombosis. Five hundred and seventy-two adult worms were removed from pulmonary arteries. Foci of granulomatous inflammation, often associated with larvae and/or eggs, were present in tracheobronchial lymph nodes, adrenal gland, brain, and kidneys. Severe seizuring noted antemortem was attributed to several large, discrete areas of acute hemorrhagic infarction within the cerebrum and cerebellum. Natural A. vasorum infection in domestic dogs in eastern Newfoundland causes lung pathology of variable severity, which in some cases, may progress to cor pulmonale and which may be associated with extrapulmonary lesions and clinical signs.     

Hypokalaemic myopathy in Burmese kittens

AIM: To describe the microscopic and immunohistochemical findings in a case of pulmonary hyalohyphomycosis in a Kemp's ridley sea turtle (Lepidochelys kempi).

METHODS: Samples of lung, liver and kidney from a stranded, dead Kemp's ridley sea turtle were routinely processed for histopathological studies. Two monoclonal antibodies that reacted specifically with antigens of Aspergillus spp and the Mucorales (Zygomycetes) group, and a panel of polyclonal antibodies raised against Aspergillus fumigatus, Candida albicans, Geotrichum candidum, Fusarium solani, and Scedosporium apiospermum were used for immunohistochemical or immunofluorescence staining.

RESULTS: Histologically, a severe multifocal granulomatous pneumonia associated with fungal infection was diagnosed. All hyphae were identified as Fusarium spp because a strong and uniform reactivity was obtained only with a heterologously-absorbed polyclonal antibody raised against somatic antigens of Fusarium solani.

CONCLUSIONS: Fusarium spp should be included in the differential diagnosis of mycotic pneumonia in Kemp's ridley sea turtles.

CLINICAL RELEVANCE: This is the first report of a pulmonary mycotic infection in a sea turtle diagnosed using immunohistochemistry. Wildlife rehabilitators and pathologists should be aware of the availability of immunohistochemical techniques for identifying fungi in sea turtles.     

Transtracheal aspiration in the diagnosis of pulmonary blastomycosis (17 cases: 2000-2005)

Blastomyces dermatitidis is a common etiologic agent of fungal pneumonia in dogs. Definitive diagnosis is based on cytologic demonstration of the organism in affected tissues. Fluid obtained through transtracheal aspiration has previously been reported to have a low diagnostic yield for B. dermatitidis organisms. This retrospective study identified B. dermatitidis organisms in 76% of samples when transtracheal aspiration was performed in 17 nonsedated dogs with pulmonary blastomycosis. Transtracheal aspiration is a noninvasive and simple procedure that should be considered as an early diagnostic test whenever blastomycosis is a differential diagnosis in dogs with pulmonary disease.     

CT findings in Pneumocystis carinii pneumonia in five dogs

Pneumocystis carinii pneumonia is a rare disease in dogs. It is primarily reported in cavalier King Charles spaniels and miniature dachshunds with suspected underlying immunodeficiency. This case series reports the findings in five dogs (four cavalier King Charles spaniels and one Bedlington terrier) with confirmed P. carinii pneumonia. Thoracic (CT) revealed ground glass opacity of the pulmonary parenchyma with a diffuse or multifocal distribution. The severity of this pattern was variable. Less consistent imaging findings included parenchymal bands, bronchial dilation and signs consistent with pulmonary hypertension. Four dogs recovered well with treatment and there was resolution of CT abnormalities in all dogs with follow‐up.     

Control of the cattle louse Bovicola bovis with the fungal pathogen Metarhizium anisopliae

The effects of the entomopathogenic fungus Metarhizium anisopliae (Metschnikoff) were evaluated against the common louse parasite of cattle, Bovicola bovis (Piaget) (Trichodectidae: Ischnocera). Two different concentrations and formulations of conidial suspensions were applied to contained populations of adult female lice. In vitro, lice immersed in suspensions of M. anisopliae formulated in 0.03% Tween 80 developed infections; at the highest concentration (1x10(8)conidia ml-1) a mean of 71% (+/-11.52%, 95% C.I.) of lice became infected. Lice exposed to the Tween 80 only in vitro, showed high levels of survival and zero infection. In vivo, fungal conidia were applied to louse populations contained in 7 cm diameter circular arenas glued to the backs of Holstein cattle, maintained in controlled climate conditions. Conidia were formulated in either Tween 80 or silicone oil. The treatment with M. anisopliae resulted in high levels of infection and there was no overall difference between the two formulations in the number of infections observed. At the highest concentration (1x10(8)conidia ml-1) a mean of 73% (+/-15.57%, 95% C.I.) lice became infected. It is concluded that the strategic seasonal use of a fungal pathogen on cattle, applied in early winter, may be of value in suppressing the winter increase in abundance, preventing the population increasing to clinically significant levels.     

Fatal Beauveria bassiana infection in a captive American alligator

The entomopathogenic fungus, Beauveria bassiana, was isolated from pulmonary lesions of a dead American alligator (Alligator mississipiensis) at the Oklahoma City Zoo. Colonies of the fungus, which had sporulated in vivo, were found in the thoracic air spaces. Septate, branching hyphae and fungal spores were seen in stained histologic sections of pleura and lung. Dissemination to other viscera had not occurred. This case indicated that B bassiana, a rare vertebrate pathogen, may be a fatal mycotic agent in captive reptiles.     

Canine neosporosis in South Africa.

Neospora caninum was identified in tissues of one neonatal and two adolescent dogs by a specific immunohistochemical technique during a retrospective study. The histological lesions included multifocal polymyositis, multifocal parasitic myocarditis, interstitial pneumonia, severe multifocal encephalitis and myelitis with perivascular cuffing. This report extends the known range of the parasite to the African continent.     

Chronic pneumonia caused by Mycobacterium thermoresistibile in a cat

Mycobacterium thermoresistibile was isolated in pure culture from ultrasound-guided pulmonary aspirates taken from a young cat with severe, chronic, pyogranulomatous pneumonia. Thoracic radiography and ultrasonography before therapy demonstrated severe diffuse alveolar disease. Twelve months combination therapy with doxycycline, rifampicin and clarithromycin resolved the infection. Thoracic radiographs taken at the completion of therapy showed multifocal pulmonary mineralisation. M thermoresistibile has been infrequently reported as a human or animal pathogen. This is the first reported pulmonary infection by M thermoresistibile in a cat and documents the successful treatment of the organism in a feline patient.     

Bronchoscopic and serologic diagnosis of Aspergillus fumigatus pulmonary infection in a bottlenose dolphin (Tursiops truncatus).

A 4-yr-old male bottlenose dolphin (Tursiops truncatus) developed an Aspergillus fumigatus pneumonia. Fungal elements were identified by cytology and microbiology from endoscopic bronchoalveolar lavage and brushings of a raised yellow endobronchial lesion. The results of qualitative immunodiffusion serology, a technique that identifies specific circulating antibodies to Aspergillus fumigatus, were suggestive of an active infection. The dolphin was treated with itraconazole for over 2 yr, which resulted in remission of clinical signs. Pneumonia caused by Aspergillus sp. accounts for the large majority of pulmonary mycoses in marine mammals. Bronchoscopy facilitated an early definitive diagnosis, accurate treatment, and remission.     

Fungal infections of the central nervous system in the dog and cat

Fungal infections of the central nervous system (CNS) in dogs and cats are uncommon. The purpose of this paper is to review the clinical signs, diagnostic tests, and therapeutic options of fungal infections of the CNS in the dog and cat. Clinical signs are dependent on lesion location and are often multifocal. Extraneural involvement is common. Antemortem diagnosis can be difficult and is definitively made via cytology, biopsy, or culture of an affected organ or cerebrospinal fluid (CSF). Magnetic resonance imaging can support a diagnosis and may assist in therapeutic decisions. Fungal serology can support a diagnosis when direct visualization of the organism is not possible. Long-term azole maintenance therapy is suggested to enhance survival and prevent relapse. Serial cerebrospinal fluid evaluation and magnetic resonance imaging may identify early relapse.     

Effect of Metarhizium anisopliae fungus on off-host Rhipicephalus (Boophilus) microplus from tick-infested pasture under cattle grazing in Brazil

This work aimed to assess the effect of the fungus Metarhizium anisopliae on off-host Rhipicephalus (Boophilus) microplus from tick-infested Brachiaria decumbens pasture undergoing cattle grazing. For this purpose a naturally tick-infested Brachiaria decumbens pasture of 60 m × 100 m with twelve grazing Holstein Friesian-Nelore (Bos indicus) cross breed bovines was sprayed 12 times, 21 days apart with an aqueous conidial suspension of the E9 isolate of M. anisopliae fungus. Control pasture was treated with conidial suspension vehicle only. Efficacy of treatment was evaluated by tick larvae counts on the pasture and that of engorged female ticks on grazing cattle. Fungus persistence on grass stems as well as soil pasture was assessed after each spray. Efficacy of fungus against ticks was also measured by an in vitro immersion test. Whereas in vitro test showed a clear pathogenic effect of the fungus on ticks, no pathogenic effect over R. (B.) microplus ticks was detected in the field trial by spraying pasture with fungal suspension. Fungus from the suspension could be recovered from both the grass stem as well as the soil of sprayed pasture, even though the numbers obtained varied distinctly and could only be recovered shortly after spray. Pasture environments with exposure to sun and rain, seem to be very detrimental to the fungus, thus suspensions which provide fungus with protection or more resistant isolates to these should be looked for. In order to achieve high fungal efficacy against tick under field conditions, accurate laboratory assays, optimization of application strategy and knowledge of interactions between fungal strains and environmental factors are warranted.     

An indoor air quality study of an alligator (Alligator mississippiensis) holding facility.

An environmental microbiologic investigation was conducted in an alligator (Alligator mississippiensis) holding facility in a zoo in the southeastern U.S. The facility had housed five alligators between March 1999 and February 2005. In the exhibit, one alligator died and all experienced poor health. It was hypothesized that environmental microbial contamination was associated with these issues. Samples were collected for fungal identification and quantification, microcystin analysis, and airborne mycotoxins. Analyses of air and water were conducted and an examination of the heating, ventilation, and air-conditioning system (HVAC) for design, maintenance, and operating issues was made. Two control sites, a facility for false gharials (Tomistoma schlegelii) and an off-site alligator breeding facility, were also tested. Morbidity and mortality records were examined for all sites. Results showed that, compared to the control sites, the test alligator facility and its HVAC system were extensively contaminated with a range of fungi. Nearly all sampled surfaces featured fungal growth. There were also significantly higher counts of Penicillium/Aspergillus-like and Chrysosporium-like spores in the air (P < 0.004). The design, maintenance, and operation of the HVAC system were all inadequate, resulting in poorly conditioned and mold-contaminated air being introduced to the facility. Morbidity records revealed solitary pulmonary disorders over time in three alligators, with one dying as a result. The other two alligators suffered from general malaise and a range of nonspecific symptoms. The control facilities had no morbidity or mortality issues. In conclusion, although no causal links could be demonstrated because of the nature of the morbidity data, environmental mold contamination appeared to be associated with the history of morbidity and mortality in the alligator exhibit.     

Disseminated fungal infection in two species of captive sharks

In this report, two cases of systemic mycosis in captive sharks are characterized. These cases were progressive and ultimately culminated in terminal disease. Paecilomyces lilacinus, an uncommon pathogen in human and veterinary medicine, was associated with areas of necrosis in the liver, heart, and gill in a great hammerhead shark (Sphyrna mokarran). Fungal growth was observed from samples of kidney, spleen, spinal fluid, and coelomic cavity swabs. Dual fungal infection by Exophiala pisciphila and Mucor circinelloides was diagnosed in a juvenile zebra shark (Stegostoma fasciatum). Both fungi were present in the liver, with more severe tissue destruction associated with E. pisciphila. E. pisciphila also produced significant necrosis in the spleen and gill, while M. circinelloides was associated with only minimal tissue changes in the heart. Fungal cultures from liver, kidney, and spleen were positive for both E. pisciphila and M. circinelloides. Identification of P. lilacinus and M. circinelloides was based on colonial and hyphal morphology. E. pisciphila was identified by sequence analysis of the 28S rRNA D1/D2 region and the internal transcribed spacer (ITS) region between the 18S and 28S rRNA subunit. These cases, and a lack of information in the literature, highlight the need for further research and diagnostic sampling to further characterize the host-pathogen interaction between elasmobranchs and fungi.