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Cho J, Park C, Park J, Yoon JS. Case report: Dermatophytic pseudomycetoma in a domestic Korean short hair cat treated with intralesional injection of amphotericin B and oral terbinafine administration. Front Vet Sci 2024; 11:1402691. [PMID: 38938913 PMCID: PMC11210314 DOI: 10.3389/fvets.2024.1402691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/18/2024] [Indexed: 06/29/2024] Open
Abstract
Dermatophytic pseudomycetoma (DPM), which is a deeper dermal and/or subcutaneous infection of dermatophytes, has been rarely reported in Domestic Korean Short Hair Cats. A 3-year-old, spayed female, domestic Korean Short Hair Cat presented with a history of crusts, nodules, and pruritus for 1 year. At the initial presentation, multifocal ulcerative nodules covered with yellowish grains were noted on her ventral thorax, abdomen, flank, and left hindlimb. Cytology of ulcerative nodules revealed degenerative neutrophils, macrophages, multinucleated giant cells, and hyphae. Histological examination of nodules revealed pyogranulomatous dermatitis with fungal plaques, and Microsporum canis and Staphylococcus aureus were identified in the culture. Therefore, the cat was diagnosed with DPM with secondary pyoderma. Oral itraconazole (10 mg/kg, once a day) was administered, but no significant improvement was observed. Therefore, intralesional (IL) injection of amphotericin B (0.6 mg/nodule) and oral administration of terbinafine (30 mg/kg, twice a day) were administered to the cat. With these medications, ulceration and the number and size of nodules decreased significantly, although large dome-shaped nodules remained. Skin lesions were treated with oral terbinafine and itraconazole administration for 5 months. However, after 6 months, recurrence of multifocal ulcerative nodules was observed, and the cat died 10 months after initial presentation. In this case, IL amphotericin B and oral terbinafine administration were partially effective in DPM treatment, suggesting that this may be an option for DPM treatment. Further studies to determine dose and frequency of IL amphotericin B in the management of DPM are warranted.
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Affiliation(s)
- Jaechun Cho
- Biosafety Research Institute and Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Iksan, Republic of Korea
| | - Chul Park
- Biosafety Research Institute and Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Iksan, Republic of Korea
| | - Jinho Park
- Biosafety Research Institute and Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Iksan, Republic of Korea
| | - Ji-Seon Yoon
- Biosafety Research Institute and Laboratory of Veterinary Dermatology, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
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Sousa YV, Santiago MG, de Souza BM, Keller KM, Oliveira CSF, Mendoza L, Vilela RVR, Goulart GAC. Itraconazole in human medicine and veterinary practice. J Mycol Med 2024; 34:101473. [PMID: 38493607 DOI: 10.1016/j.mycmed.2024.101473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/03/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
Diagnosis and management of fungal infections are challenging in both animals and humans, especially in immunologically weakened hosts. Due to its broad spectrum and safety profile when compared to other antifungals, itraconazole (ITZ) has been widely used in the treatment and prophylaxis of fungal infections, both in human and veterinary medicine. The dose and duration of management depend on factors such as the type of fungal pathogen, the site of infection, sensitivity to ITZ, chronic stages of the disease, the health status of the hosts, pharmacological interactions with other medications and the therapeutic protocol used. In veterinary practice, ITZ doses generally vary between 3 mg/kg and 50 mg/kg, once or twice a day. In humans, doses usually vary between 100 and 400 mg/day. As human and veterinary fungal infections are increasingly associated, and ITZ is one of the main medications used, this review addresses relevant aspects related to the use of this drug in both clinics, including case reports and different clinical aspects available in the literature.
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Affiliation(s)
- Yamara V Sousa
- Department of Pharmaceuticals, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Marie G Santiago
- Department of Pharmaceuticals, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Bianca M de Souza
- Department of Preventive Veterinary Medicine, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Kelly M Keller
- Department of Preventive Veterinary Medicine, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Camila S F Oliveira
- Department of Preventive Veterinary Medicine, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Leonel Mendoza
- Biomedical Laboratory Diagnostics, Michigan State University, East Lansing, MI 48824, United States
| | - Raquel V R Vilela
- Biomedical Laboratory Diagnostics, Michigan State University, East Lansing, MI 48824, United States; Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Gisele A C Goulart
- Department of Pharmaceuticals, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil.
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Barrs VR, Beczkowski PM, Talbot JJ, Hobi S, Teoh SN, Hernandez Muguiro D, Shubitz LF, Sandy J. Invasive Fungal Infections and Oomycoses in Cats: 1. Diagnostic approach. J Feline Med Surg 2024; 26:1098612X231219696. [PMID: 38189288 PMCID: PMC10949879 DOI: 10.1177/1098612x231219696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
CLINICAL RELEVANCE In contrast to superficial fungal infections, such as dermatophytosis, invasive fungal infections (IFIs) are characterised by penetration of tissues by fungal elements. Disease can spread locally within a region or can disseminate haematogenously or via the lymphatics. The environment is the most common reservoir of infection. Since fungal spores are airborne, indoor cats are also susceptible to IFIs. Some environmental fungi are ubiquitous and present globally, while others are endemic or hyperendemic within specific geographic regions. Zoonotic pathogens include Microsporum canis, Sporothrix schenckii and Sporothrix brasiliensis. AIM In the first of a two-part article series, the approach to the investigation of feline IFIs and oomycoses is reviewed. As well as tips for diagnosis, and information on the ecological niche and distribution of fungal pathogens, the review covers clinical presentation of the most common IFIs, including cryptococcosis, histoplasmosis, blastomycosis, coccidioidomycosis, sporotrichosis, phaeohyphomycosis, aspergillosis and dermatophytic pseudomycetoma, as well as the oomycoses pythiosis, lagenidiosis and paralagenidiosis. In Part 2, the spectrum of activity, mechanisms of action, pharmacokinetic and pharmacodynamic properties and adverse effects of antifungal drugs are reviewed, and the treatment and prognosis for specific IFIs and oomycoses are discussed. EVIDENCE BASE The review draws on published evidence and the authors' combined expertise in feline medicine, mycology, dermatology, clinical pathology and anatomical pathology.
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Affiliation(s)
- Vanessa R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Paweł M Beczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | | | - Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Shu Ning Teoh
- Veterinary Specialists Aotearoa, Henderson, Auckland, New Zealand
| | | | - Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, AZ, USA
| | - Jeanine Sandy
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
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Turner M. Cutaneous staphylococcal granuloma in a cat. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2021; 62:1225-1227. [PMID: 34728851 PMCID: PMC8543689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 4.5-year-old domestic longhaired cat with a history of psychogenic alopecia and self-trauma exhibited progressive, severe, and extensive nodular and draining lesions on the ventral abdomen. Euthanasia was elected. A diagnosis of the rare skin disease, staphylococcal granuloma, was subsequently made based upon postmortem and histopathology findings.
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Affiliation(s)
- Morganna Turner
- Ontario Veterinary College, 50 Stone Road East, Guelph, Ontario N1G 2W1
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Schaff AR, Ferguson S, Phair K, Ferris R, Goe A. Eumycetoma and disseminated phaeohyphomycosis in a Sumatran tiger. J Vet Diagn Invest 2021; 33:1197-1201. [PMID: 34382452 DOI: 10.1177/10406387211038920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 16-y-old female Sumatran tiger (Panthera tigris sumatrae) was evaluated for hyporexia. Examination revealed chronic kidney disease and a large subcutaneous axillary mass with draining tracts that contained numerous small black grains. Histologic examination revealed the presence of intralesional fungal hyphae. Persistent hyporexia and pyogranulomatous disease, as well as progressive cachexia and azotemia occurred despite treatment, and euthanasia was performed. Disseminated phaeohyphomycosis was diagnosed on postmortem examination, additionally affecting various lymph nodes, the nasal cavity, mesenteric adipose tissue, abdominal aorta, pericardium, and kidney. Fungal culture from a deep-tissue sample isolated a pure growth of Curvularia sp., a dematiaceous opportunistic fungus able to cause eumycetomas and/or phaeohyphomycosis. Phaeohyphomycosis is a rare but emerging condition, not previously reported as disseminated disease in an exotic carnivore, to our knowledge. Aggressive systemic antifungal treatment was unsuccessful, likely complicated by diagnostic challenges and concurrent renal disease. The presence of a swelling with abundant grains exiting draining tracts should direct clinicians to the diagnosis of a mycetoma, warranting early and aggressive treatment.
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Affiliation(s)
- Amanda R Schaff
- Department of Pathology and Population Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, USA.,BluePearl Veterinary Partners Scottsdale, Scottsdale, AZ, USA
| | - Sylvia Ferguson
- Department of Pathology and Population Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, USA
| | - Kristen Phair
- Phoenix Zoo, Phoenix, AZ, USA.,San Diego Zoo Wildlife Alliance, San Diego, CA, USA
| | - Rachel Ferris
- Phoenix Zoo, Phoenix, AZ, USA.,University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - Alexandra Goe
- Department of Pathology and Population Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, USA
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Salzer HJF, Stoney RJ, Angelo KM, Rolling T, Grobusch MP, Libman M, López-Vélez R, Duvignaud A, Ásgeirsson H, Crespillo-Andújar C, Schwartz E, Gautret P, Bottieau E, Jordan S, Lange C, Hamer DH. Epidemiological aspects of travel-related systemic endemic mycoses: a GeoSentinel analysis, 1997-2017. J Travel Med 2018; 25:5067362. [PMID: 30085265 PMCID: PMC6628256 DOI: 10.1093/jtm/tay055] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/15/2018] [Indexed: 11/13/2022]
Abstract
Background International travel has increased in the past few decades, placing more travellers at risk of acquiring systemic endemic mycoses. There are limited published data on systemic endemic mycoses among international travellers. We report epidemiological characteristics of non-migrant, international travellers who acquired systemic endemic mycoses during travel. Methods We analysed records of non-migrant international travellers with a confirmed diagnosis of histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis or talaromycosis reported from 1997 through 2017 to GeoSentinel, a global surveillance network now consisting of 70 travel or tropical medicine centres in 31 countries. Results Sixty-nine records met the inclusion criteria. Histoplasmosis was most frequently reported; the 51 travellers with histoplasmosis had the lowest median age (30 years; range: 8-85) and shortest median duration of travel (12 days; range: 5-154). Coccidioidomycosis was reported in 14 travellers; travellers with coccidioidomycosis were older (median 62 years; range: 22-78) and had the longest median number of days between return from travel and presentation to a GeoSentinel site (55 days; range: 17-273). Almost all travellers with coccidioidomycosis were exposed in the USA. Other systemic endemic mycoses were less frequently reported, including blastomycosis (three travellers) and talaromycosis (one traveller). Conclusions Although relatively rare, systemic endemic mycoses should be considered as potential travel-related infections in non-migrant international travellers. Epidemiological exposures should be used to guide diagnostic evaluations and treatment.
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Affiliation(s)
- Helmut J. F. Salzer
- Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Rhett J. Stoney
- Travelers’ Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Kristina M. Angelo
- Travelers’ Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Thierry Rolling
- Section of Infectious Diseases and Tropical Medicine, 1st Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Martin P. Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Michael Libman
- J. D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Canada
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramon y Cajal University Hospital, Madrid, Spain
| | | | - Hilmir Ásgeirsson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Clara Crespillo-Andújar
- National Referral Unit for Tropical and Travel Medicine, Department of Internal Medicine, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | - Eli Schwartz
- The Center for Geographic Medicine and Internal Medicine ‘C’ Chaim Sheba Medical Center, Tel HaShomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Philippe Gautret
- Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sabine Jordan
- Section of Infectious Diseases and Tropical Medicine, 1st Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Lange
- Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA, USA
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