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Rozier LS, Mullaney SB, Thompson Iii GR, Moore GD, Ajufoh CO, Gerardo AA, Sykes JE. Coccidioides spp. exposure among military working dogs in endemic regions of the United States. Med Mycol 2023; 61:myad109. [PMID: 37935009 DOI: 10.1093/mmy/myad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/19/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023] Open
Abstract
Coccidioidomycosis is a fungal disease in arid regions of the United States that is predicted to expand with climate change. Cases in military personnel and military working dogs (MWDs) impact personnel readiness and result in healthcare costs. To examine Coccidioides exposure among MWDs, 276 banked serum samples were retrieved from dogs housed in California, Texas, Arizona, New Mexico, Nevada, and Utah. Using gel immunodiffusion, six (2.1%) specimens were IgG-positive and three (1.1%) were equivocally IgM-positive. The IgG-positive samples were from Arizona (2 [prevalence 8.0%]) and California (4 [3.7%]). These data will guide future efforts to study MWDs as sentinels for human coccidioidomycosis.
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Affiliation(s)
- Lege S Rozier
- Department of Chemistry and Life Science United States Military Academy, Bartlett Hall, West Point, NY 10996, USA
| | - Sara B Mullaney
- Department of Chemistry and Life Science United States Military Academy, Bartlett Hall, West Point, NY 10996, USA
| | - George R Thompson Iii
- Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Health, Sacramento, CA 95817, USA
- Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA
| | - Gerald D Moore
- Department of Chemistry and Life Science United States Military Academy, Bartlett Hall, West Point, NY 10996, USA
| | - Chiweta O Ajufoh
- Department of Chemistry and Life Science United States Military Academy, Bartlett Hall, West Point, NY 10996, USA
| | - Angelina A Gerardo
- Department of Defense Military Working Dog Veterinary Service, Lackland Air force base, 78236, USA
| | - Jane E Sykes
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
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2
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Siler AD, Jaffey JA, Jacobs C, Shumway K. Diagnostic Contribution of Bronchoalveolar Lavage Sampling and Fungal Culture in a Dog With Pulmonary Coccidioidomycosis. Top Companion Anim Med 2023; 52:100754. [PMID: 36538969 DOI: 10.1016/j.tcam.2022.100754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/04/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
A 7-year-old, male neutered, Miniature Australian Shepherd from Arizona was presented for evaluation of a 3-month history of progressive cough. Thoracic radiographs revealed a focal alveolar pulmonary pattern and suspected tracheobronchial lymph node enlargement. Serum anti-Coccidioides spp. IgM/IgG antibodies were not detected by agar gel immunodiffusion performed by 2 different reference commercial veterinary laboratories approximately 3.5 and 3.75 months after respiratory tract signs were first noted. The dog failed to respond to empiric therapy with a cough suppressant and various antibiotics. Tracheobronchoscopy and bronchoalveolar lavage (BAL) were subsequently performed and cytological examination of the BAL fluid identified marked neutrophilic inflammation characterized by mildly degenerate neutrophils and no infectious organisms. Bacterial cultures were negative but fungal cultures revealed growth of Coccidioides spp. Clinical signs improved shortly after initiation of fluconazole administration and the dog achieved long-term sustained clinical remission. Here, we provide a description of a dog with pulmonary coccidioidomycosis diagnosed with fungal culture of BAL fluid. Airway sampling with cytological examination and fungal culture should be considered in dogs with persistent respiratory related clinical signs, negative antibody serology, and that have lived in or traveled to endemic areas.
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Affiliation(s)
- Alexis D Siler
- Department of Primary Care, Midwestern University College of Veterinary Medicine, Glendale, AZ, USA
| | - Jared A Jaffey
- Department of Specialty Medicine, Midwestern University College of Veterinary Medicine, Glendale, AZ, USA.
| | - Casandra Jacobs
- Department of Internal Medicine, Desert Veterinary Medical Specialists, Peoria, AZ, USA
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3
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Sorum M, Wyckoff S, Pastrana D. Multifocal
Coccidioides immitis
in a donkey (
Equus asinus
). EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Sorum
- Sorum Veterinary Services Scottsdale Arizona USA
| | - S. Wyckoff
- Sorum Veterinary Services Scottsdale Arizona USA
| | - D. Pastrana
- Sorum Veterinary Services Scottsdale Arizona USA
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4
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Carter TD, Fuller BD, Shaver SL, Foy DS. Retrospective evaluation of the efficacy of fluconazole for the treatment of coccidioidomycosis in dogs: 49 cases (2015-2020). J Am Vet Med Assoc 2022; 260:1200-1205. [PMID: 35544418 DOI: 10.2460/javma.22.01.0006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize the clinical course and therapeutic response in dogs with coccidioidomycosis treated with fluconazole. ANIMALS 49 client-owned dogs with coccidioidomycosis that were treated with fluconazole and had ≥ 2 follow-up examinations. PROCEDURES Medical records were retrospectively searched to identify dogs in which coccidioidomycosis was diagnosed between January 2015 and May 2020. Data recorded from each dog included signalment, clinical signs, diagnostic test results, and treatment. RESULTS Dogs were treated with fluconazole at a median initial dosage of 19.7 mg/kg/d. Median treatment duration was 298.5 days, with 26 of the 49 dogs completing treatment during the study period. Respiratory signs, lethargy, and hyporexia were the most common clinical signs. Frequency of lethargy decreased after 30 days, whereas frequency of hyporexia and respiratory signs decreased after 90 days. Median IgG titer at diagnosis was 1:32 and was significantly decreased, compared with baseline titer, at all recheck intervals after 90 days. Hyperglobulinemia, monocytosis, and neutrophilia were the most common clinicopathologic abnormalities. Hyperglobulinemia resolved within 30 days, neutrophilia resolved within 90 days, and monocytosis resolved after 180 days. CLINICAL RELEVANCE Improvements in clinical signs, titers, and clinicopathologic abnormalities were observed after initiation of treatment with fluconazole. Improvement began as early as the first 3 months of treatment, but some variables did not resolve until after 6 to 9 months of treatment. This information provides clinical guidance and describes expectations when prescribing fluconazole to treat coccidioidomycosis in dogs.
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Affiliation(s)
- Todd D Carter
- 1Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ
| | - Brenley D Fuller
- 2College of Veterinary Medicine, Midwestern University, Glendale, AZ
| | - Stephanie L Shaver
- 1Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ
| | - Daniel S Foy
- 1Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ
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5
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Bittencourt CE, Okezie O, Tawansy K, Peterson EM, Minckler DS. Pediatric coccidioidal orbital granuloma. Am J Ophthalmol Case Rep 2022; 25:101302. [PMID: 35112028 PMCID: PMC8790595 DOI: 10.1016/j.ajoc.2022.101302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 07/14/2021] [Accepted: 01/17/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To report a case of orbital coccidiomycosis in an otherwise healthy 11-month-old male. Observations An 11-month-old male presented to his pediatrician with parental complaints of swelling, erythema, and pain of the right orbit that increased over ten days in the absence of constitutional symptoms. The child's parents reported an earlier fall onto a carpeted floor. After four weeks of conservative treatment and a course of oral cephalexin, he developed a fever, increased erythema, and palpable enlargement of a mass posterior to the lower eyelid. Ultrasound revealed an encysted mass in the inferior orbit, suggestive of an abscess. Urgent ophthalmic referral led to incision and drainage via orbitotomy. Culture, histopathology, and serological testing were positive for Coccidioides spp.. Blood studies revealed mild anemia and thrombocytosis. There was complete resolution of symptoms after surgical drainage and several weeks of oral fluconazole. Conclusion and importance We describe a patient with orbital coccidiomycosis without apparent systemic involvement, following what was most likely an unrelated minor trauma. Despite being rare, orbital coccidiomycosis should be considered as a primary manifestation of infection when ocular inflammation is encountered, especially in endemic regions.
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6
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Dowdy H, Evans JE, Jaffey JA, Wycislo KL, Struthers JD, Hostnik ET. Case Report: Successful Management of a Compressive Intraspinal Coccidioides Species Granuloma in a Cat. Front Vet Sci 2022; 8:801885. [PMID: 35036415 PMCID: PMC8757464 DOI: 10.3389/fvets.2021.801885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
A 9-year-old, neutered male, domestic shorthair cat from Arizona, was presented for evaluation of a 7-day history of hind limb paraparesis that progressed to paraplegia. There was no history of respiratory abnormalities. Neurologic examination supported localization of a T3-L3 myelopathy. Computed tomography (CT) revealed an expansile widening of the spinal canal dorsal to L4 associated with a strongly contrast-enhancing mass. Moreover, CT series of the thorax revealed a diffuse miliary pulmonary pattern, as well as tracheobronchial, sternal, and cranial mediastinal lymphadenomegaly. Transthoracic lung lobe and sternal lymph node fine needle aspiration revealed pyogranulomatous inflammation with Coccidioides spp. spherules and endospores. A suspected diagnosis of spinal coccidioidomycosis was made; fluconazole (10.9 mg/kg PO q12h) treatment was initiated, and decompressive neurosurgery was performed. The granuloma was removed en bloc and histopathology revealed marked, chronic-active, pyogranulomatous myelitis with intralesional Coccidioides spp. spherules with endosporulation. Serum anti-Coccidioides spp. antibody titer results revealed a negative IgM and a positive IgG (1:4). The cat was treated with fluconazole for 445 days and examined at various time points, with the last examination 2 years after initial presentation. The cat returned to full ambulation with only mild functional deficits of the right hind limb. In conclusion, this report documents the diagnosis, treatment, and long-term follow up of a cat with a compressive Coccidioides spp. spinal cord granuloma. This case highlights the importance of including coccidioidomycosis as a differential diagnosis for cats with peracute hindlimb paraplegia that have lived in or traveled to regions where Coccidioides spp. is endemic, and demonstrates the potential for a good long-term outcome with decompressive neurosurgery and antifungal therapy.
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Affiliation(s)
- Hannah Dowdy
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jason E Evans
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jared A Jaffey
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Kathryn L Wycislo
- Department of Pathology, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jason D Struthers
- Department of Pathology, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Eric T Hostnik
- Department of Veterinary Clinical Sciences, Veterinary Medical Center, Ohio State University, Columbus, OH, United States
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7
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Butkiewicz CD, Alcott CJ, Renschler J, Wheat LJ, Shubitz LF. The utility of Coccidioides antigen and antibody detection in cerebrospinal fluid in the diagnosis of canine central nervous system coccidioidomycosis. Am J Vet Res 2022; 83:59-63. [PMID: 34773701 DOI: 10.2460/ajvr.21.08.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the utility of enzyme immunoassays (EIAs) for the detection of Coccidioides antigen and antibody in CSF in the diagnosis of CNS coccidioidomycosis in dogs. ANIMALS 51 dogs evaluated for CNS disease in a single specialty center in Tucson in 2016. PROCEDURES Excess CSF after routine analysis was banked after collection from dogs presented to the neurology service. Samples were tested by EIA for presence of Coccidioides antigen and antibody. Clinical data were collected from medical records retrospectively. RESULTS 22 dogs were diagnosed with CNS coccidioidomycosis (CCM) or another neurologic disease (non-CCM). These groups of dogs overlapped in the presenting complaints, MRI results, and routine CSF analysis results. Four dogs, all with CCM, had positive antigen EIA results. With clinical diagnosis used as the reference standard, CSF antigen testing had low sensitivity (20%) but high specificity (100%) for diagnosis of CCM. Ten dogs with CCM and 4 dogs with other diagnoses had antibody detected in CSF by EIA. Sensitivity of CSF antibody testing was 46%, specificity was 86%, and positive and negative predictive values for the study population were 71% and 68%, respectively. Clinical Relevance Diagnosis of CNS coccidioidomycosis in dogs in an endemic region was hampered by overlap of clinical signs with other neurologic disorders and the low sensitivity of confirmatory diagnostics. The evaluated Coccidioides-specific EIAs performed on CSF can aid in the diagnosis. A prospective study is warranted to corroborate and refine these preliminary findings.
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Affiliation(s)
| | | | | | | | - Lisa F Shubitz
- The Valley Fever Center for Excellence, University of Arizona, Tucson, AZ
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8
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Shubitz LF, Schlacks S, Vishkautsan P, Butkiewicz CD, Worthing KA. Posaconazole treatment of refractory coccidioidomycosis in dogs. J Vet Intern Med 2021; 35:2772-2777. [PMID: 34658074 PMCID: PMC8692207 DOI: 10.1111/jvim.16282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background The majority of dogs with coccidioidomycosis recover with administration of fluconazole or itraconazole, although some cases are refractory or the dogs do not tolerate administration of these medications. Objectives The objective was to describe the treatment outcomes and therapeutic monitoring of 8 dogs with refractory coccidioidomycosis treated with posaconazole. Animals Eight dogs with refractory coccidioidomycosis. Methods Retrospective case series. Medical records from Veterinary Specialty Center of Tucson were searched to identify dogs with refractory coccidioidomycosis that were treated with posaconazole. Clinical information and the results of monitoring trough serum posaconazole concentrations were retrieved. Results Eight dogs with refractory coccidioidomycosis were treated with 2.5 to 10 mg/kg per day of posaconazole. Six of 8 dogs recovered or developed clinical remission while administered posaconazole. Thirteen serum concentrations from 8 dogs tested were >1 μg/mL (range, 1.52 to >6 μg/mL) and the drug was well‐tolerated by 7 dogs. One dog required dosage reductions and treatment was ultimately discontinued because of hepatotoxicosis. Conclusions and Clinical Importance Posaconazole should be considered as a treatment option for dogs with refractory coccidioidomycosis. Monitoring of indicators of liver function or injury along with therapeutic drug monitoring is recommended to tailor dosage in the event of hepatic toxicosis.
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Affiliation(s)
- Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, Tucson, Arizona, USA.,Veterinary Specialty Center of Tucson, Tucson, Arizona, USA
| | | | | | | | - Kate A Worthing
- University of Arizona College of Veterinary Medicine, Oro Valley, Arizona, USA
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9
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Kelley AJ, Stainback LB, Knowles KE, Moore TW, Plummer SB, Shoup OR. Clinical characteristics, magnetic resonance imaging features, treatment, and outcome for presumed intracranial coccidioidomycosis in 45 dogs (2009-2019). J Vet Intern Med 2021; 35:2222-2231. [PMID: 34410019 PMCID: PMC8478036 DOI: 10.1111/jvim.16243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
Background Knowledge of the clinical and magnetic resonance imaging (MRI) features of intracranial Coccidioides infection in dogs is essential for prompt diagnosis to limit disease‐associated morbidity and death. Objectives To describe the MRI appearance of intracranial coccidioidomycosis in dogs, identify associated clinical and clinicopathologic findings, and report outcomes of medical treatment. Animals Forty‐five client‐owned dogs with presumed intracranial Coccidioides infection. Methods Retrospective case series. Medical records and images were reviewed. Clinical history, examination findings, serology, imaging characteristics, treatment, and outcome were recorded. Included cases had an abnormal brain MRI and positive Coccidioides serology by agar‐gel‐immunodiffusion (AGID). Results Median age was 7‐years. Generalized tonic‐clonic seizures were the most common presenting sign (25/45). Two lesion categories were identified: a granulomatous form with 1 or more distinct, intra‐axial, contrast‐enhancing foci (37/45), and a second variation with diffuse, bilateral, symmetrical lesions of the caudate nuclei and frontal lobes (8/45). Serum IgG titers ranged from 1 : 1 to ≥ 1 : 256; 2 dogs had positive IgM titers at 1 : 2. All dogs with follow‐up serology (34/45) had a reduction in titer. Mean duration of follow‐up was 22.4 ± 20.5 months (median 16 months). Six dogs were lost to follow‐up <1‐year after diagnosis (median 9 months). Five dogs were clinically well but had yet to be followed for >1‐year. Of the remaining 34 dogs, 28 (82%) were alive ≥ 1‐year after diagnosis. Thirteen of these dogs had follow‐up times ≥ 2‐years. Conclusions and Clinical Importance The prognosis for intracranial Coccidioides infection is generally more favorable with medical treatment than in earlier reports.
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Affiliation(s)
- Ashley J Kelley
- Specialists in Companion Animal Neurology, Naples, Florida, USA
| | | | - Kim E Knowles
- Veterinary Neurological Center, Phoenix, Arizona, USA
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10
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Russell KJ, Powers DLD. What Is Your Neurologic Diagnosis? J Am Vet Med Assoc 2021; 257:1117-1120. [PMID: 33226293 DOI: 10.2460/javma.2020.257.11.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Schlacks S, Vishkautsan P, Butkiewicz C, Shubitz L. Evaluation of a commercially available, point-of-care Coccidioides antibody lateral flow assay to aid in rapid diagnosis of coccidioidomycosis in dogs. Med Mycol 2020; 58:328-332. [PMID: 31212311 DOI: 10.1093/mmy/myz067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/19/2019] [Accepted: 05/29/2019] [Indexed: 11/14/2022] Open
Abstract
Coccidioidomycosis in dogs can range from mild respiratory disease or vague, chronic malaise to acute, severe life-threatening illness. The diagnosis of coccidioidomycosis in dogs is based on clinical presentation and serology. Spherule identification is not typical because of low numbers of organisms in specimens, and the invasive nature of sampling tissues and lungs. Conventional serological assays require samples to be submitted to a reference laboratory and results take several days to one week. The sōna Coccidioides Antibody Lateral Flow Assay (LFA) (IMMY Diagnostics) is a rapid, bench-side test used for detection of Coccidioides antibodies that is available and FDA-cleared for use in humans but has not been evaluated in dogs. The goal of this study was to compare the LFA to conventional agar gel immunodiffusion (AGID). Paired serum samples were collected for screening by the LFA and submitted to a commercial reference laboratory for AGID screen and titer. Of 56 paired serum samples analyzed, 30 were positive and 26 were negative on the sōna Coccidioides antibody LFA. The overall percentage agreement plus 95% confidence interval (CI) was 87.5% (76.20-93.99). Positive percent agreement was 89.7% (73.38-96.65) and negative percent agreement was 85.2% (67.25-94.36). The kappa coefficient to assess agreement was 0.749 (95% CI, 0.576-0.923), which is interpreted as good agreement between the tests (>70%). The sōna Coccidioides antibody LFA provided rapid, point-of-care results with a high level of agreement to standard AGID serology in dogs clinically suspected to have coccidioidomycosis, and may aid in diagnosis of coccidioidomycosis in dogs.
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Affiliation(s)
- Sallianne Schlacks
- Department of Internal Medicine, Veterinary Specialty Center of Tucson, Arizona, USA
| | - Polina Vishkautsan
- Department of Internal Medicine, Veterinary Specialty Center of Tucson, Arizona, USA
| | | | - Lisa Shubitz
- Valley Fever Center for Excellence, University of Arizona, Tucson, Arizona, USA
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Gunstra A, Steurer JA, Seibert RL, Dixon BC, Russell DS. Sensitivity of Serologic Testing for Dogs Diagnosed with Coccidioidomycosis on Histology: 52 Cases (2012-2013). J Am Anim Hosp Assoc 2020; 55:238-242. [PMID: 31433229 DOI: 10.5326/jaaha-ms-6772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Coccidioidomycosis, or Valley Fever, is a fungal infection caused by Coccidioides spp., soil-living fungi endemic to the southwest region of the United States. The infection can cause various diseases including respiratory, neurologic, cardiac, dermatologic, and ocular disease as well as osteomyelitis in dogs and many other mammals. Obtaining a definitive diagnosis can be challenging. Serology is commonly used as a screening diagnostic test for disease, but both false-negative and false-positive results have been reported. Fifty-two cases of coccidioidomycosis diagnosed via histopathology were retrospectively evaluated. The sensitivity of serology in the study population was determined to be 87% for immunoglobulin G and 46% for immunoglobulin M. The cases were evaluated for an association between negative serology results and anatomic location of disease, but these variables were found to be independent. This study reports the sensitivity of serology for canine coccidioidomycosis and highlights the importance of using multiple diagnostic tests for definitive diagnosis of infection.
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Affiliation(s)
- Amber Gunstra
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Jeffrey A Steurer
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Rachel L Seibert
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Bradford C Dixon
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Duncan S Russell
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
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13
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Arbona N, Butkiewicz CD, Keyes M, Shubitz LF. Clinical features of cats diagnosed with coccidioidomycosis in Arizona, 2004-2018. J Feline Med Surg 2020; 22:129-137. [PMID: 30784342 PMCID: PMC10814570 DOI: 10.1177/1098612x19829910] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The goal of this study was to describe the clinical presentation, diagnosis and treatment of coccidioidomycosis in cats residing in a region endemic for Coccidioides species. METHODS A retrospective review of records was performed at both primary and tertiary care veterinary practices in Tucson and Phoenix, Arizona, USA. Data collected included signalment, clinical signs, physical examination findings, diagnostic test results, treatment and outcome. RESULTS Fifty-one feline cases were identified from six veterinary hospitals. Cats presented with clinical signs and laboratory abnormalities similar to what has been seen in dogs, including respiratory illness (n = 20/51), neutrophilia (n = 24/31), monocytosis (n = 17/31) and hyperglobulinemia (n = 16/30). However, cats at diagnosis were typically significantly ill, with 31/51 having disseminated infection, most commonly to the skin (n = 22). Additionally, 43/44 cats that had serum antibody tests performed were positive, and median titer at diagnosis was 1:32 (range 1:4 to ⩾1:256). Serum antibody titers were significantly reduced (P ⩽0.001) in cats that responded to treatment compared with cats that did not clinically improve. Forty of 46 cats that were treated with oral fluconazole responded and did not require additional therapy. Fourteen cats developed recurrent disease and all but one had antifungal therapy successfully reinstituted. CONCLUSIONS AND RELEVANCE Coccidioidomycosis is a disease of concern for cats residing in the regions endemic for Coccidioides species. Disease is most often disseminated at the time of diagnosis, possibly due to delays in presentation for care and recognition of the infection. Suspicion of disease, serum chemistries, blood cell counts, presence of antibody and imaging aid in the diagnosis of coccidioidomycosis in cats. Serum antibody reduction during treatment frequently correlated with an adequate response to medication. Consideration of coccidioidomycosis as a cause of illness will lead to earlier diagnosis and potentially better treatment outcomes in cats.
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Affiliation(s)
- Nichole Arbona
- College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | | | | | - Lisa F Shubitz
- Valley Fever Center for Excellence, University of Arizona, Tucson, AZ, USA
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14
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Kollath DR, Miller KJ, Barker BM. The mysterious desert dwellers: Coccidioides immitis and Coccidioides posadasii, causative fungal agents of coccidioidomycosis. Virulence 2019; 10:222-233. [PMID: 30898028 PMCID: PMC6527015 DOI: 10.1080/21505594.2019.1589363] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/07/2019] [Accepted: 02/25/2019] [Indexed: 01/31/2023] Open
Abstract
The genus Coccidioides consists of two species: C. immitis and C. posadasii. Prior to 2000, all disease was thought to be caused by a single species, C. immitis. The organism grows in arid to semiarid alkaline soils throughout western North America and into Central and South America. Regions in the United States, with highest prevalence of disease, include California, Arizona, and Texas. The Mexican states of Baja California, Coahuila, Sonora, and Neuvo Leon currently have the highest skin test positive results. Central America contains isolated endemic areas in Guatemala and Honduras. South America has isolated regions of high endemicity including areas of Colombia, Venezuela, Argentina, Paraguay, and Brazil. Although approximately 15,000 cases per year are reported in the United States, actual disease burden is estimated to be in the hundreds of thousands, as only California and Arizona have dedicated public health outreach, and report and track disease reliably. In this review, we survey genomics, epidemiology, ecology, and summarize aspects of disease, diagnosis, prevention, and treatment.
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Affiliation(s)
- Daniel R. Kollath
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Karis J. Miller
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Bridget M. Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
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Davidson AP, Shubitz LF, Alcott CJ, Sykes JE. Selected Clinical Features of Coccidioidomycosis in Dogs. Med Mycol 2019; 57:S67-S75. [PMID: 30690600 DOI: 10.1093/mmy/myy113] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 10/04/2018] [Indexed: 11/13/2022] Open
Abstract
Canine coccidioidomycosis, a systemic fungal infection endemic to arid and semiarid regions of North, Central, and South America, is commonly diagnosed in dogs living in or traveling through lower Sonoran life zones in the states of California and Arizona. Canine and human cases have geographic overlap. Similarities between clinical coccidioidomycosis in dogs and humans include asymptomatic infection, primary respiratory disease and disseminated disease. Differences include a high rate of dissemination in dogs, differences in predilection of dissemination sites, and a granulomatous or diffuse meningoencephalopathic form in the canine central nervous system (CNS) without the obstructive component seen in humans. Dogs presenting with CNS coccidioidomycosis most commonly experience seizures. Prior disease history and serology are unreliable indicators of CNS coccidioidomycosis. Magnetic resonance imaging (MRI) is advantageous for diagnosis of CNS coccidioidomycosis in dogs. Long-term administration of antifungal medication is promoted for treatment of both primary and disseminated coccidioidomycosis in dogs. Supportive treatment addressing pain, fever, inappetance, coughing, and other clinical signs improves patient care. Glucocorticoids and or anticonvulsants are also recommended for canine disseminated CNS disease. Protracted treatment times, lack of owner compliance, failure of the disease to respond to the first antifungal drug selected, and high cost are challenges of successfully treating dogs.
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Affiliation(s)
- Autumn P Davidson
- School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, Tucson, Arizona, USA
| | - Cody J Alcott
- Veterinary Specialty Center of Tucson, Tucson, Arizona, USA
| | - Jane E Sykes
- School of Veterinary Medicine, University of California-Davis, Davis, California, USA
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16
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Spoor E, Stainback L, Plummer S, Knowles K. A novel form of intracranial coccidioidomycosis is present in dogs and exhibits characteristic clinical and magnetic resonance imaging findings. Vet Radiol Ultrasound 2018; 60:47-55. [PMID: 30260537 DOI: 10.1111/vru.12688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/17/2018] [Accepted: 07/23/2018] [Indexed: 11/29/2022] Open
Abstract
The neurological examination findings, clinical pathology (including Coccidioides immitis IgG/IgM serology) and magnetic resonance imaging (MRI) findings in 13 dogs with a novel form of intracranial coccidioidomycosis are described in a retrospective case series, with long-term clinical resolution documented in 11/13 dogs (84.6% of cases) with oral fluconazole therapy. The medical records of the Veterinary Neurological Center in Phoenix, Arizona from the years 2000 to 2017 were utilized to search for dogs with appropriate inclusion criteria. Magnetic resonance imaging findings were highly consistent across all cases and characteristically demonstrated bilaterally symmetric T2 hyperintensity throughout the frontal lobes, caudate nuclei, and rostral internal capsule, ±faint, wispy contrast enhancement on T1-postcontrast images. These findings were in stark contrast to previously reported MRI findings in dogs with intracranial coccidioidomycosis, which were typically characterized by a focal, strongly contrast enhancing granuloma and extensive vasogenic edema, typically unilateral. Schnauzer breeds represented eight of 13 (61.5%) cases, possibly suggesting a breed predilection. Three cases underwent repeat MRI after resolution of neurological signs and documentation of a decreased Coccidioides titer in response to fluconazole therapy. All demonstrated complete resolution of previously identified lesions, but with marked, severe atrophy of the caudate nuclei and frontal lobes bilaterally. Findings from this study document a variant appearance for intracranial coccidioidomycosis that, to the author's knowledge, has not been previously described in dogs. Authors propose that, although this variant demonstrates extensive pathological changes within the forebrain, the clinical outcome and response to treatment is favorable in a majority of cases.
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Affiliation(s)
- Erich Spoor
- Veterinary Neurological Center, Phoenix, Arizona, 85040
| | | | - Scott Plummer
- Veterinary Neurological Center, Phoenix, Arizona, 85040
| | - Kim Knowles
- Veterinary Neurological Center, Phoenix, Arizona, 85040
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17
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Mehrkens LR, Mohr FC, Sykes JE. Clinicopathologic and Histopathologic Renal Abnormalities in Dogs with Coccidioidomycosis. J Vet Intern Med 2018; 30:1667-1671. [PMID: 27717191 PMCID: PMC5032887 DOI: 10.1111/jvim.14573] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 06/08/2016] [Accepted: 08/08/2016] [Indexed: 11/30/2022] Open
Abstract
Background We observed evidence of protein‐losing nephropathy in some dogs with coccidioidomycosis, suggestive of immune complex glomerulonephritis (ICGN). The goal of this study was to understand the prevalence of renal histopathologic lesions and proteinuria in dogs with coccidioidomycosis. Hypothesis Biochemical and histopathological evidence of glomerular lesions is present in dogs with coccidioidomycosis. Animals Hundred and fifty‐six dogs with naturally occurring coccidioidomycosis. Methods Retrospective case series. Clinical information and results of clinicopathologic testing were retrieved from the University of California, Davis Veterinary Medical Teaching Hospital (VMTH). Microscopic sections of renal tissue procured from necropsy of dogs with coccidioidomycosis were examined to evaluate the nature and distribution of lesions. Results A total of 156 dogs with coccidioidomycosis were identified; 87 dogs had serum biochemistry and a urinalysis performed, 17 had urine protein:creatinine ratios (UPCs), and 24 had renal tissue available for histopathology. Eleven (13%) of the 87 dogs were azotemic, 55 (63%) were proteinuric (of which 14 [25%] had clinically relevant proteinuria defined as ≥3+ or ≥500 mg/dL), and 14 dogs had UPC ≥0.5 (range, 0.5–21.5, median 4.2). Thirteen (54%) of 24 dogs had renal histopathologic lesions suggestive of ICGN. Seven of these dogs had urinalyses performed; 5 (71%) had clinically relevant proteinuria as described above. Two dogs (33%) with normal glomeruli had granulomatous nephritis, 1 of which had intralesional Coccidioides spherules. Conclusions and Clinical Importance Coccidioidomycosis should be considered as a possible contributor to glomerular disease in dogs. Whether similar lesions occur in other mammalian hosts, including humans, warrants further investigation.
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Affiliation(s)
- L R Mehrkens
- Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA
| | - F C Mohr
- Department of Pathology, Microbiology and Immunology, University of California, Davis, Davis, CA
| | - J E Sykes
- The Department of Medicine & Epidemiology, University of California, Davis, Davis, CA.
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18
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Bentley RT, Taylor AR, Thomovsky SA. Fungal Infections of the Central Nervous System in Small Animals: Clinical Features, Diagnosis, and Management. Vet Clin North Am Small Anim Pract 2017; 48:63-83. [PMID: 28988704 DOI: 10.1016/j.cvsm.2017.08.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Small animal mycoses vary geographically. Different clinical presentations are seen in animals with infection of the central nervous system (CNS), including multifocal meningoencephalomyelitis, intracranial lesions that accompany sinonasal lesions, rapidly progressive ventriculitis, or solitary granuloma of the brain or spinal cord. Systemic, nasal, or extraneural clinical signs are common but, especially in granuloma cases, do not always occur. Surgery may have a diagnostic and therapeutic role in CNS granuloma. There have been recent advancements in serology. Fluconazole, voriconazole, and posaconazole cross the blood-brain barrier, but voriconazole is neurotoxic to cats. Liposomal and lipid-encapsulated formulations of amphotericin B are preferred.
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Affiliation(s)
- R Timothy Bentley
- Neurology and Neurosurgery, Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, Purdue University, Lynn Hall, 625 Harrison Street, West Lafayette, IN 47907, USA.
| | - Amanda R Taylor
- Neurology and Neurosurgery, Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn University, Greene Hall, 1130 Wire Road, Auburn, AL 36849, USA
| | - Stephanie A Thomovsky
- Neurology and Neurosurgery, Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, Purdue University, Lynn Hall, 625 Harrison Street, West Lafayette, IN 47907, USA
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19
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Del Rocío Reyes-Montes M, Pérez-Huitrón MA, Ocaña-Monroy JL, Frías-De-León MG, Martínez-Herrera E, Arenas R, Duarte-Escalante E. The habitat of Coccidioides spp. and the role of animals as reservoirs and disseminators in nature. BMC Infect Dis 2016; 16:550. [PMID: 27724885 PMCID: PMC5057265 DOI: 10.1186/s12879-016-1902-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 10/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coccidioidomycosis, a potentially fatal fungal infection, is considered an emergent mycotic disease because of the increased incidence of fungal infections registered over recent years. Infection occurs through the inhalation of arthroconidia from two main species of Coccidioides: Coccidioides immitis and C. posadasii, which are both endemic to arid and semi-arid regions of North America. Coccidioides species not only infect humans but can also infect other mammals (land, aquatic, wild or domestic), reptiles and birds. OBJECTIVE To obtain information regarding the habitat of Coccidioides spp. and the animals infected by this fungus and to identify the role that infected animals play as reservoirs and disseminators of this fungus in nature. MATERIALS A literature review was conducted to identify the habitat of Coccidioides spp. and the infected non-human animal species targeted by this fungus. RESULTS AND CONCLUSIONS This review allows us to suggest that Coccidioides spp. may be classified as halotolerant organisms; nevertheless, to perpetuate their life cycle, these organisms depend on different animal species (reservoirs) that serve as a link with the environment, by acting as disseminators of the fungi in nature.
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Affiliation(s)
- María Del Rocío Reyes-Montes
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria No. 3000, Coyoacán, 04510, México Cd.Mx., Mexico
| | - María Ameyali Pérez-Huitrón
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria No. 3000, Coyoacán, 04510, México Cd.Mx., Mexico
| | - Jorge Luis Ocaña-Monroy
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria No. 3000, Coyoacán, 04510, México Cd.Mx., Mexico
| | - María Guadalupe Frías-De-León
- División de Investigación, Hospital Juárez de México, Edificio E. Av. Instituto Politécnico Nacional 5160, Col. Magdalena de las Salinas, 07760, México Cd.Mx., Mexico
| | - Erick Martínez-Herrera
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria No. 3000, Coyoacán, 04510, México Cd.Mx., Mexico
| | - Roberto Arenas
- Unidad de Micología, Hospital General "Manuel Gea González", Av. Calzada de Tlalpan 4800, Tlalpan, 14080, México, Cd.Mx., Mexico
| | - Esperanza Duarte-Escalante
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria No. 3000, Coyoacán, 04510, México Cd.Mx., Mexico.
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20
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Simões DM, Dial SM, Coyner KS, Schick AE, Lewis TP. Retrospective analysis of cutaneous lesions in 23 canine and 17 feline cases of coccidioidomycosis seen in Arizona, USA (2009–2015). Vet Dermatol 2016; 27:346-e87. [DOI: 10.1111/vde.12356] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Diana M. Simões
- Dermatology for Animals 106 East Campbell Avenue Campbell CA 95008 USA
| | - Sharon M. Dial
- Veterinary Diagnostic Laboratory The University of Arizona 2831 N. Freeway Road Tucson AZ 85705 USA
| | - Kimberly S. Coyner
- Dermatology Clinic for Animals 5608 South Durango Street Tacoma WA 98409 USA
| | - Anthea E. Schick
- Dermatology for Animals 22595 North Scottsdale Road #110 Scottsdale AZ 85255 USA
| | - Thomas P. Lewis
- Dermatology for Animals 86 West Juniper Avenue Gilbert AZ 85233 USA
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21
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Ramírez-Romero R, Silva-Pérez RA, Lara-Arias J, Ramírez-Hernández C, Marino-Martínez IA, Barbosa-Quintana Á, López-Mayagoitia A. Coccidioidomycosis in Biopsies with Presumptive Diagnosis of Malignancy in Dogs: Report of Three Cases and Comparative Discussion of Published Reports. Mycopathologia 2015; 181:151-7. [PMID: 26419685 PMCID: PMC4676787 DOI: 10.1007/s11046-015-9948-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 09/16/2015] [Indexed: 12/01/2022]
Abstract
Coccidioidomycosis is a respiratory fungal infection with occasional systemic dissemination. The disseminated coccidioidomycosis is considered a multifaceted disease. In medicine, disseminated coccidioidomycosis is included within a group of infectious diseases that have been referred as the great imitators. In many cases, malignancies are included in the presumptive diagnosis. In veterinary medicine, disseminated coccidioidomycosis is common in dogs. Nonetheless, despite of being a diagnostic dilemma, disseminated coccidioidomycosis is underestimated and frequently not included into differentials, even in endemic zones. Herein, we describe three cases of granulomatous inflammation caused by Coccidioides spp. which were masquerading malignancies in dogs (0.39 %). The presumptive diagnoses in these cases were osteosarcoma, lymphoma and neurofibroma, respectively. A PCR assay employing tissues in paraffin blocks resulted positive for C. posadasii in one of these cases. A comparative discussion on the ambiguous clinic-pathological presentation of disseminated coccidioidomycosis in dogs and humans is included.
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Affiliation(s)
- Rafael Ramírez-Romero
- Posgrado Conjunto Agronomía-Veterinaria, Facultad de Medicina Veterinaria y Zootecnia, Campus de Ciencias Agropecuarias, Universidad Autónoma de Nuevo León, Av. Francisco Villa s/n, Ex-Hacienda el Canadá, C.P. 66050, Gral. Escobedo, N.L., México.
| | - Rolando Antonio Silva-Pérez
- Posgrado Conjunto Agronomía-Veterinaria, Facultad de Medicina Veterinaria y Zootecnia, Campus de Ciencias Agropecuarias, Universidad Autónoma de Nuevo León, Av. Francisco Villa s/n, Ex-Hacienda el Canadá, C.P. 66050, Gral. Escobedo, N.L., México
| | - Jorge Lara-Arias
- Banco de Hueso y Tejidos, Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, N.L., México
| | - Cecilia Ramírez-Hernández
- Posgrado Conjunto Agronomía-Veterinaria, Facultad de Medicina Veterinaria y Zootecnia, Campus de Ciencias Agropecuarias, Universidad Autónoma de Nuevo León, Av. Francisco Villa s/n, Ex-Hacienda el Canadá, C.P. 66050, Gral. Escobedo, N.L., México
| | - Iván Alberto Marino-Martínez
- Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Monterrey, N.L., México
| | - Álvaro Barbosa-Quintana
- Departamento de Anatomía Patológica, Hospital Universitario, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, N.L., México
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22
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Bentley RT, Heng HG, Thompson C, Lee CS, Kroll RA, Roy ME, Marini L, Heo J, Wigle WL. MAGNETIC RESONANCE IMAGING FEATURES AND OUTCOME FOR SOLITARY CENTRAL NERVOUS SYSTEMCOCCIDIOIDESGRANULOMAS IN 11 DOGS AND CATS. Vet Radiol Ultrasound 2015; 56:520-30. [PMID: 25857572 DOI: 10.1111/vru.12258] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 01/21/2015] [Indexed: 02/04/2023] Open
Affiliation(s)
- R. Timothy Bentley
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Purdue University; West Lafayette IN 47907
| | - Hock Gan Heng
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Purdue University; West Lafayette IN 47907
| | - Craig Thompson
- Department of Comparative Pathobiology, College of Veterinary Medicine; Purdue University; West Lafayette IN 47907
| | - Chun-Sheng Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Purdue University; West Lafayette IN 47907
| | | | | | | | - Jin Heo
- VCA All-Care Animal Referral Center; Fountain Valley CA 92708
| | - William L. Wigle
- Department of Comparative Pathobiology, College of Veterinary Medicine; Purdue University; West Lafayette IN 47907
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23
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Lloret A, Hartmann K, Pennisi MG, Ferrer L, Addie D, Belák S, Boucraut-Baralon C, Egberink H, Frymus T, Gruffydd-Jones T, Hosie MJ, Lutz H, Marsilio F, Möstl K, Radford AD, Thiry E, Truyen U, Horzinek MC. Rare systemic mycoses in cats: blastomycosis, histoplasmosis and coccidioidomycosis: ABCD guidelines on prevention and management. J Feline Med Surg 2013; 15:624-7. [PMID: 23813828 PMCID: PMC11148945 DOI: 10.1177/1098612x13489226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
OVERVIEW Rare fungal infections, including those hitherto not reported in Europe, may occur sporadically in non-endemic areas, or imported cases may be seen. INFECTIONS Blastomycosis is mainly seen in North America; no cases have been reported in Europe. Histoplasmosis, which is endemic in the eastern US, Central and South America, has been diagnosed in Japan and Europe. Coccidioidomycosis is endemic in the southwestern US, Central and South America; only one imported case has been reported in Europe. The primary mode of transmission is inhalation of conidia or spores from the environment. DISEASE SIGNS Most feline cases present with a combination of clinical signs (mainly respiratory, along with skin, eye, central nervous system and bone). Lymphadenopathy and systemic signs may be present. DIAGNOSIS Diagnosis is based on fungal detection by cytology and/or histology. Commercial laboratories do not routinely perform fungal culture. Diagnosis of coccidioidomycosis, which is more difficult, may be supported by antibody detection. TREATMENT Treatment consists of prolonged systemic antifungal therapy, with itraconazole as the first-choice agent for histoplasmosis and blastomycosis. The prognosis is good if owner compliance is adequate and adverse drug effects do not occur. PREVENTION Cat owners travelling to endemic areas should be warned about these diseases. There is no zoonotic risk.
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24
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25
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Infectious Diseases. THE CAT 2012. [PMCID: PMC7161403 DOI: 10.1016/b978-1-4377-0660-4.00033-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Ajithdoss DK, Trainor KE, Snyder KD, Bridges CH, Langohr IM, Kiupel M, Porter BF. Coccidioidomycosis presenting as a heart base mass in two dogs. J Comp Pathol 2011; 145:132-7. [PMID: 21334001 DOI: 10.1016/j.jcpa.2010.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 10/18/2010] [Accepted: 12/22/2010] [Indexed: 11/12/2022]
Abstract
Two atypical cases of canine coccidioidomycosis presenting as heart base masses are described. An echocardiogram performed in one of the two dogs revealed a large mass at the base of the heart and a computed tomography scan showed that the mass compressed the bronchi, left atrium, aorta and pulmonary arteries. A firm, white or pale yellow mass was found at the base of the heart at necropsy examination in both cases. Microscopical examination of the masses revealed severe, chronic, locally extensive granulomatous or pyogranulomatous inflammation with intralesional spherules consistent with Coccidioides spp. The diagnosis was further confirmed by immunohistochemistry and in-situ hybridization. Coccidioides spp. have been reported to cause pericarditis in dogs, but this is the first description of coccidioidomycosis mimicking a heart-based tumour in dogs.
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Affiliation(s)
- D K Ajithdoss
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
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27
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Clinical Comparison of Two Mexican Coccidioidins. Mycopathologia 2010; 169:427-30. [DOI: 10.1007/s11046-010-9280-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Accepted: 01/21/2010] [Indexed: 10/19/2022]
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Graupmann-Kuzma A, Valentine BA, Shubitz LF, Dial SM, Watrous B, Tornquist SJ. Coccidioidomycosis in dogs and cats: a review. J Am Anim Hosp Assoc 2008; 44:226-35. [PMID: 18762558 DOI: 10.5326/0440226] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The dimorphic fungi Coccidioides immitis and Coccidioides posadasii are the causative agents of coccidioidomycosis. Dogs and cats residing in and visiting endemic areas are at risk of exposure to infectious arthrospores. The primary infection is pulmonary and frequently results in chronic cough. Disseminated disease is common and causes cutaneous, osseous, cardiac, ocular, nervous system, or other organ disease. Radiographic changes include a variable degree of interstitial pulmonary infiltration, hilar lymphadenopathy, and osseous lesions. Serological titers support the diagnosis, but definitive diagnosis relies on identification of Coccidioides in cytological or tissue samples. Coccidioidomycosis should be considered in any dog or cat that has been potentially exposed during the previous 3 years and is presented with chronic illness, respiratory signs, lameness, lymphadenopathy, nonhealing cutaneous lesions, or neurological, ocular, or cardiac abnormalities.
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Affiliation(s)
- Angela Graupmann-Kuzma
- College of Veterinary Medicine, Oregon State University. Her current address is St. Francis 24-Hr Animal Hospital, Vancouver, Washington 98682, USA
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29
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Jewell K, Cheshier R, Cage GD. Genetic diversity among clinical Coccidioides spp. isolates in Arizona. Med Mycol 2008; 46:449-55. [PMID: 18608919 DOI: 10.1080/13693780801961337] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Increasing coccidioidomycosis rates in Arizona may indicate the development of a hypervirulent strain. One hundred and twenty-one clinical Coccidioides spp. isolates were collected over 16 months from Maricopa, Graham, Yuma, and Pima counties in Arizona. The patient age distribution ranged from 9 to 91 years, with a median age of 58 years; 36% were female, and 64% male. All isolates were analyzed by measuring length polymorphisms in nine distinct microsatellite regions. The three microsatellites found to have the greatest discriminatory power for Coccidioides posadasii were: K03 (0.87), GA37 (0.83), and K01 (0.78). The majority of isolates (n=119) were C. posadasii. Duplicate isolates (n=28) from 13 patients showed single strain infections. Phylogenetic analysis of the microsatellite data showed no dominant microsatellite pattern. We conclude that the increase in reported cases of coccidioidomycosis in Arizona is not linked to a dominant, hypervirulent strain of Coccidioides posadasii.
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Affiliation(s)
- Kelsea Jewell
- Arizona Department of Health Services, Phoenix, Arizona, USA.
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30
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Laniado-Laborin R. Expanding understanding of epidemiology of coccidioidomycosis in the Western hemisphere. Ann N Y Acad Sci 2007; 1111:19-34. [PMID: 17395731 DOI: 10.1196/annals.1406.004] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Coccidioidomycosis is a disease of both national and worldwide importance that is most often diagnosed in nonendemic regions. The endemic region for Coccidioides spp. lies exclusively in the Western Hemisphere. Coccidioides spp. has long been identified in semiarid areas of the United States and Mexico, and endemic foci have been described in areas of Central and South America. Infection is usually the result of activities that cause the fungus to become airborne and inhaled by a susceptible host. Underlying medical diseases that affect T cell function are known to increase the risk of disseminated disease and include human immunodeficiency virus, cancer, and disease processes requiring transplantation and its subsequent immunosuppressive agents. In recent years the incidence of the coccidioidomycosis has increased in California and Arizona, which may be partially due to the massive migration of Americans to the Sunbelt states. To date the highest number of cases reported in Arizona was in 2004, when a total of 3,665 cases of coccidioidomycosis was reported, representing a 281% increase since 1997. Statistics on the prevalence and incidence of coccidioidomycosis in Latin America either are fragmentary or simply are not available.
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Affiliation(s)
- Rafael Laniado-Laborin
- M.P.H, F.C.C.P., Facultad de Medicina Tijuana, Universidad Autónoma de Baja, P.O. Box 436338, San Ysidro, CA 92143-6338, USA.
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31
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Abstract
Coccidioides spp. appear capable of infecting all mammals and at least some reptiles. Development of disease as a result of infection is species-dependent. Dogs seem to have a susceptibility similar to that of humans, with subclinical infections, mild-to-severe primary pulmonary disease, and disseminated disease. Whereas central nervous system disease in humans is typically meningitis, brain disease in dogs and cats takes the form of granulomatous parenchymal masses. Osteomyelitis is the most common form of disseminated disease in the dog, while skin lesions predominate in the cat. Orally administered azole antifungal agents are the backbone of therapy in animals as they are in humans.
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Affiliation(s)
- Lisa F Shubitz
- Department of Veterinary Science and Microbiology, Bldg. 90, Room 221, University of Arizona, Tucson, Arizona 85721, USA.
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32
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Hoffman K, Videan EN, Fritz J, Murphy J. Diagnosis and treatment of ocular coccidioidomycosis in a female captive chimpanzee (Pan troglodytes): a case study. Ann N Y Acad Sci 2007; 1111:404-10. [PMID: 17303834 DOI: 10.1196/annals.1406.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report here the first documented case of ocular coccidioidomycosis in a chimpanzee (Pan troglodytes). In 1996, a 12-year-old female chimpanzee was undergoing treatment with an experimental triazole, BayR3783, for coccidioidomycosis when she was diagnosed with severe conjunctivitis in the right eye. Subsequent development of a coccidioidal granuloma of the ventral conjunctiva and anterior uvea was noted over the next several months, distorting the lens, iris, pupil, and sclera and progressing to uveitis. Treatment with BayR3783 and subconjunctival injections of triamcinolone were successful in reducing the ocular mass, but extensive damage was done to the lens and cornea. This case study provides an interesting comparison to ocular coccidioidomycosis cases observed in both humans and canines.
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Affiliation(s)
- K Hoffman
- Primate Foundation of Arizona, P.O. Box 20027, Mesa, AZ 85277-0027, USA
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