JVD 2017 #2 - Cryptococcal Maxillary Osteomyelitis and Osteonecrosis in a 18-Month-Old Dog

Question 1

What was found in this study?

Answer 1

Maxillary osteomyelitis and osteonecrosis secondary to cryptococcus infection in a dog

Question 2

What surgical and medical treatment was performed?

Answer 2

Dental extraction, flap, and debridement of affected bone.

long term treatment with oral fluconazole

Question 3

When performing surgery, how do you know when debridement is complete?

Answer 3

Debridement is considered adequate when the remaining bone appears grossly normal and bleeds readily

Question 4

What are the 4 causes of osteonecrosis?

Answer 4

Bisphosphonate

Radiation

Traumatic

non-traumatic

Question 5

What are common radiographic signs of osteonecrosis?

Answer 5

• decreased density of involved bone,
• areas of necrosis that may appear more radiopaque than the surrounding bone

Question 6

Which cryptococcus species affect immunsuppresed and immunocompetent hosts?

Answer 6

C. neoformans - immunosuppressed

C. gatti - formerly thought to be in tropics only, recently in the pacific northwest. infects immunocompetent hosts

Question 7

What is the primary mode of infection of cryptococcus and what is the zoonotic risk to humans from an infected animal?

Answer 7

primary mode of infection is inhalation of spore stage or dessivcated yeasts from envir.

no zoonotic potential from an infected animal

Question 8

What are risk factors for C. gattii in dogs?

Answer 8

• recent soil disturbance or logging within 10 km of the animals’ residences, high levels of activity outdoors, and travel on Vancouver Island.
• Steroids and immunosuppression are NOT risk factors (infects competent host)

Question 9

What other fungal organisms are reported to cause osteomyelitis?

Answer 9

Blastomycosis