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Small Animal Medicine SGU > Systemic Mycoses > Flashcards

Systemic Mycoses Flashcards

1
Q

General Clinical Signs of Systemic Mycoses

A
  • Weight loss
  • Lymphadenopathy
  • Pyrexia
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2
Q

Blastomycosis Endemic Areas

A
  • WATER

- Mississippi, Missouri, Ohio, Tennessee, Great Lakes

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3
Q

Where does Blastomyces disseminate to?

A

BELLS + P

  • Bone, Eyes, Lungs, Lymph Nodes, Prostate
  • Pyogranulomatous Inflammation
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4
Q

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?

A
  • Blastomycosis
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5
Q

What is the treatment of choice for Blastomycosis?

A
  • Itraconazole
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6
Q

What is the diagnosis of choice for Blastomycosis?

A

Definitive Diagnosis = Cytology + Histopathology

  • Antigen Test in Urine (Mira vista Lab)
  • -> useful for Monitoring
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7
Q

Histoplasmosis Outbreaks are caused by?

A
  • SOIL containing BIRD and BAT MANURE
  • Missouri + Ohio River Valleys
  • young animals < 4 years
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8
Q

Where does Histoplasma disseminate to?

A

Lungs, OR GI (DOGS)**

  • LN, Liver, Spleen, BM, Eyes
  • Granulomatous inflammation
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9
Q

Clinical Signs of Histoplasmosis in Dogs

A

GI SIGNS

  • Large Intestinal Diarrhea**
  • fever, anorexia, depression, severe weight loss
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10
Q

Definitive Diagnosis of Histoplasmosis

A

Organism ID

  • Cytology**
  • Antigen Testing (Mira Vista Labs)

Chem = Hypoalbuminemia

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11
Q

Treatment of Choice for Histoplasmosis

A
  • Itraconazole (4-6 months until no CS)
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12
Q

Cryptococcosis Outbreaks are caused by?

A
  • Avian habitats (pigeon droppings)

- Worldwide (southern US, California)

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13
Q

What is the most common fungal infection in cats?

A
  • Cryptococcus
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14
Q

Cryptococcus dissemination?

A
  • CAT NOSES (Impression smear)
  • systemic fungal disease (lungs)
  • Nasal Cavity, Skin, Sinuses, Paranasal Tissues, Lungs
  • Local Invasion = Skin, Eyes, CNS
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15
Q

Clinical signs of Cryptococcus

A

Upper Respiratory / Nasopharyngeal

  • Discharge, proliferative masses (subcutaneous swelling over bridge of nose* - can ulcerate/raw surface), snoring, stertor, dyspnea
  • CNS (depression), Ocular
  • Anorexia
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16
Q

Diagnosis of Cryptococcus

A
  • Imaging = CT FIRST**
  • CSF tap (cytology + culture)
  • Organism ID = Cytology (impression smear of nose)
17
Q

Treatment of Cryptococcus

A
  • 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
18
Q

Aspergillosis Tropism

A

DOG NOSES

  • Typically localized to nasal passages and frontal sinuses
  • Young-Middle aged long nosed (Dolichocephalic) breeds
  • GERMAN SHEPARDS**
19
Q

Aspergillosis Clinical Signs in Dogs

A
  • Facial pain
  • Nasal Discharge (mucoid-hemorrhagic with crusting)
  • Nasal Depigmentation*
  • Anorexia, Sneezing
  • Masticatory Muscle Atrophy
20
Q

Diagnosis of Aspergillosis

A
  • Imaging = CT**, Skull Films, or Endoscopy (fungal plaques)

- -> frontal sinus osteomyelitis

21
Q

Treatment of Aspergillosis

A
  • TOC = **Topical Clotrimazole (1%) / Enilconazole
  • -> “Rottiserie Dog”
  • -> 85% cured with 1 treatment
22
Q

Endemic Area for Cocciodiodomycosis

A
  • Valley Fever / Rheumatism
  • -> ARIZONA*** and Texas (Southwest USA)
  • DOGS via inhalation (dust)
  • -> young, male intact medium-large outdoor breeds
  • Cutaneous with trauma
23
Q

What Fungus can you not culture?

A

Coccidiomycosis *

  • Saphrocytic cycle (can infect humans in the lab**) + Parasitic Cycle
  • Sporothrix
24
Q

Clinical Signs of Coccidiomycosis

A
  • 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
25
Q

Diagnosis of Cocciodiomycosis

A
  • In Endemic areas (Arizona) –> CS with lymphadenopathy = Diagnosis
  • Imaging = Thoracic Radiographs
  • -> Perihilar Lymphadenopathy**
  • DO NOT CULTURE*** DANGEROUS
  • -> Reportable disease in Humans (saprophytic phase is HIGHLY infective!)
26
Q

Treatment of Cocciodiomycosis

A
  • Azoles! (fluconazole) + Amphotericin B lipid complex

- ** Minimum of 4-6 months BEYOND CS resolution (relapse is common)

27
Q

Treatment of Pythiosis

A
  • Surgical resection!!

- Itraconazole + Terbinafine (< 20% survive)

28
Q

Sporothrix CS

A
  • Chronic granulmatous disease in CATS (> dogs > vets)
  • -> MUST HANDLE WITH GLOVES
  • Skin is the usual entry point (post-trauma)
29
Q

Treatment of Sporothrix

A
  • Itraconazole

- Potassium Iodide (NOT in cats)

30
Q

Diagnosis of Sporothrix

A
  • Cytology + Histopath (special stain and IFA)

- Culture (draining tract use deep material)

Small Animal Medicine SGU (4 decks)

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