Systemic Mycoses Flashcards
General Clinical Signs of Systemic Mycoses
- Weight loss
- Lymphadenopathy
- Pyrexia
Blastomycosis Endemic Areas
- WATER
- Mississippi, Missouri, Ohio, Tennessee, Great Lakes
Where does Blastomyces disseminate to?
BELLS + P
- Bone, Eyes, Lungs, Lymph Nodes, Prostate
- Pyogranulomatous Inflammation
A 2 year old golden retriever from Missouri presents with a dry cough, depigmentation of the nasal planum, anterior uveitis, lameness and lymphadenopathy. What is your top differential?
- Blastomycosis
What is the treatment of choice for Blastomycosis?
- Itraconazole
What is the diagnosis of choice for Blastomycosis?
Definitive Diagnosis = Cytology + Histopathology
- Antigen Test in Urine (Mira vista Lab)
- -> useful for Monitoring
Histoplasmosis Outbreaks are caused by?
- SOIL containing BIRD and BAT MANURE
- Missouri + Ohio River Valleys
- young animals < 4 years
Where does Histoplasma disseminate to?
Lungs, OR GI (DOGS)**
- LN, Liver, Spleen, BM, Eyes
- Granulomatous inflammation
Clinical Signs of Histoplasmosis in Dogs
GI SIGNS
- Large Intestinal Diarrhea**
- fever, anorexia, depression, severe weight loss
Definitive Diagnosis of Histoplasmosis
Organism ID
- Cytology**
- Antigen Testing (Mira Vista Labs)
Chem = Hypoalbuminemia
Treatment of Choice for Histoplasmosis
- Itraconazole (4-6 months until no CS)
Cryptococcosis Outbreaks are caused by?
- Avian habitats (pigeon droppings)
- Worldwide (southern US, California)
What is the most common fungal infection in cats?
- Cryptococcus
Cryptococcus dissemination?
- CAT NOSES (Impression smear)
- systemic fungal disease (lungs)
- Nasal Cavity, Skin, Sinuses, Paranasal Tissues, Lungs
- Local Invasion = Skin, Eyes, CNS
Clinical signs of Cryptococcus
Upper Respiratory / Nasopharyngeal
- Discharge, proliferative masses (subcutaneous swelling over bridge of nose* - can ulcerate/raw surface), snoring, stertor, dyspnea
- CNS (depression), Ocular
- Anorexia
Diagnosis of Cryptococcus
- Imaging = CT FIRST**
- CSF tap (cytology + culture)
- Organism ID = Cytology (impression smear of nose)
Treatment of Cryptococcus
- If in CNS -> Fluconazole
- If not in CNS -> Itraconazole
- If Systemic -> Combination therapy (Azole + Amphotericin B + Flucytosine)
- MUST TX 2 MONTHS PAST CS RESOLUTION***
- SURGICAL DEBRIDEMENT OF FUNGAL PLAQUES
Aspergillosis Tropism
DOG NOSES
- Typically localized to nasal passages and frontal sinuses
- Young-Middle aged long nosed (Dolichocephalic) breeds
- GERMAN SHEPARDS**
Aspergillosis Clinical Signs in Dogs
- Facial pain
- Nasal Discharge (mucoid-hemorrhagic with crusting)
- Nasal Depigmentation*
- Anorexia, Sneezing
- Masticatory Muscle Atrophy
Diagnosis of Aspergillosis
- Imaging = CT**, Skull Films, or Endoscopy (fungal plaques)
- -> frontal sinus osteomyelitis
Treatment of Aspergillosis
- TOC = **Topical Clotrimazole (1%) / Enilconazole
- -> “Rottiserie Dog”
- -> 85% cured with 1 treatment
Endemic Area for Cocciodiodomycosis
- Valley Fever / Rheumatism
- -> ARIZONA*** and Texas (Southwest USA)
- DOGS via inhalation (dust)
- -> young, male intact medium-large outdoor breeds
- Cutaneous with trauma
What Fungus can you not culture?
Coccidiomycosis *
- Saphrocytic cycle (can infect humans in the lab**) + Parasitic Cycle
- Sporothrix
Clinical Signs of Coccidiomycosis
- Depends on Host immunocompetence (Respiratory Dz ranging from self-limiting to chronic)
- -> Mild clinically silent pulmonary disease
- -> Fatal Multisystemic Disseminaton
- Lethargy, Anorexia, Fever, Weight loss
- Cough
- Chronic lameness (osteomyelitis)
- Cervical / Head Pain
