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SEDGHI MASOUD N, IWAIDE S, KOBAYASHI N, NAKAGAWA D, ORITO M, IWAHASHI N, MURAKAMI T. A case report of cryptococcosis in a captive Cape hyrax (Procavia capensis). J Vet Med Sci 2024; 86:619-622. [PMID: 38631871 PMCID: PMC11187597 DOI: 10.1292/jvms.24-0079] [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: 02/22/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
Cryptococcosis, a globally distributed mycotic disease caused by Cryptococcus neoformans or C. gattii, has been extensively studied in various domestic animals and humans. However, non-domestic species have often been overlooked in the literature, with limited attention given to their susceptibility and contribution to the epidemiology of the disease. In this study, a captive two-year-old Cape hyrax in a Japanese zoo exhibited neurological symptoms and torticollis, ultimately succumbing to the infection. Necropsy and pathological analyses, including histopathological techniques and PCR, revealed the presence of C. neoformans in the lungs, cerebrum, and internal auditory canal. While cryptococcosis has been reported in various wild animals globally, this case represents the first documented cryptococcosis in Cape hyrax.
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Affiliation(s)
- Niki SEDGHI MASOUD
- Laboratory of Veterinary Toxicology, Tokyo University of
Agriculture and Technology, Tokyo, Japan
| | - Susumu IWAIDE
- Laboratory of Veterinary Toxicology, Tokyo University of
Agriculture and Technology, Tokyo, Japan
| | - Natsumi KOBAYASHI
- Laboratory of Veterinary Toxicology, Tokyo University of
Agriculture and Technology, Tokyo, Japan
| | | | | | | | - Tomoaki MURAKAMI
- Laboratory of Veterinary Toxicology, Tokyo University of
Agriculture and Technology, Tokyo, Japan
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Teh A, Pritchard E, Donahoe SL, Malik R, Krockenberger M. A case of disseminated cryptococcosis with abdominal involvement due to Cryptococcus neoformans species complex in a Ragdoll cat and false-negative cryptococcal antigen lateral flow tests due to the postzone phenomenon. Aust Vet J 2024; 102:306-312. [PMID: 38567673 DOI: 10.1111/avj.13329] [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: 11/07/2023] [Revised: 02/01/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
Although cryptococcosis is the most common systemic fungal disease of cats, abdominal involvement is rarely reported. The pathogenesis of cryptococcosis usually involves sinonasal colonisation, followed by tissue invasion and sinonasal infection, with possible subsequent spread to the lungs and/or direct extension into the central nervous system (CNS), for example, via the cribriform plate. Further haematogenous spread can occur to any tissue, including skin and the CNS. This report describes a case of disseminated cryptococcosis due to Cryptococcus neoformans species complex in a 13-year-old cat, the fourth documented Australian feline case with abdominal involvement. The cat presented with a chronic history of upper respiratory disease that progressed to severe lethargy and anorexia. An autopsy revealed striking peritonitis with multifocal abdominal involvement affecting the liver, spleen, adrenal glands, kidneys, pancreas and mesentery. Cryptococcal organisms were also observed in organs within the thoracic cavity, sinonasal tissues and the CNS. Testing of abdominal fluid and serum for cryptococcal antigen using a commercially available lateral flow assay using neat fluid specimen initially tested false-negative. However, after dilution of the sample to 1:64, a positive result was obtained, confirming a postzone phenomenon. Taken together, the collective findings were indicative of widely disseminated cryptococcosis due to Cryptococcus neoformans with atypical involvement of the abdominal cavity.
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Affiliation(s)
- A Teh
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - E Pritchard
- Animal Referral Hospital, Homebush West, New South Wales, Australia
| | - S L Donahoe
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - R Malik
- Centre for Veterinary Education, The University of Sydney, Sydney, New South Wales, Australia
| | - M Krockenberger
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
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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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Reddrop C, Yarsley E, Kelly-Bosma M, Malik R. A severe case of disseminated cryptococcosis in a young French bulldog living in South-East Queensland caused by Cryptococcus gattii VGII. Aust Vet J 2023; 101:377-382. [PMID: 37537848 DOI: 10.1111/avj.13273] [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: 04/24/2023] [Revised: 07/02/2023] [Accepted: 07/08/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Cryptococcus is one of the most common systemic mycosis worldwide, infecting young adults of the large to giant breed dogs. Infection is commonly acquired from the environment via the sinonasal cavity as the main portal of entry. It either remains there, or spreads to the central nervous system (CNS) and the eye (optic nerve and retina) by penetration of the cribriform plate, or haematogenously to other viscera. Lung involvement is uncommon in cats and dogs in contrast to human and equine patients. Whilst there is a wide genetic diversity amongst Cryptococcus neoformans and Cryptococcus gattii isolates along the West Coast and Northern parts of Australia, the molecular diversity of C. gatti is considered very low on the East Coast of Australia, with a huge preponderance of VGI cases. We report on a young small breed brachycephalic dog that presented with extreme gastrointestinal and respiratory signs, but no CNS involvement. It is the first reported case of C. gattii VGII genotype in a companion animal from Queensland. CASE REPORT A 9-month old female entire French Bulldog presented initially for diarrhoea. Clinical progression was accompanied by the development of respiratory signs, so the patient was referred to a 24 h care facility. Following hospitalisation, the patient became hypoxemic requiring mechanical ventilation. A bronchoalveolar lavage performed antemortem confirmed abundant Cryptococcal spp. Further culturing and genotyping identified the species as Cryptococcus gattii VGII. Post-mortem findings indicated gross gastrointestinal and mesenteric involvement, with possible dissemination to the local mesenteric lymph node and lungs. CONCLUSION This case describes a rare example of a Cryptococcus spp suspected of disseminating from the gastrointestinal tract to the lungs, without involvement of the CNS. The observation of this finding in a small brachycephalic breed is unusual, and the finding of genotype VGII on the East Coast of Queensland is extremely unusual as there is no prior travel history of the dog or owners. The presence of a miliary lung pattern with primary gastrointestinal disease in a small breed dog warrants adding cryptococcosis to the differential diagnosis.
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Affiliation(s)
- C Reddrop
- Animal Emergency Service, Carrara, Queensland, 4211, Australia
| | - E Yarsley
- Animal Emergency Service, Carrara, Queensland, 4211, Australia
| | - M Kelly-Bosma
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4072, Australia
| | - R Malik
- Centre for Veterinary Education, B22, University of Sydney, Sydney, New South Wales, 2006, Australia
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Jacobson E, Morton JM, Woerde DJ, Thompson MF, Spillane AM, Tebb A, Della Valle Z, Birnie G, Malik R. Clinical features, outcomes, and long-term survival times of cats and dogs with central nervous system cryptococcosis in Australia: 50 cases (2000-2020). J Am Vet Med Assoc 2022; 261:246-257. [PMID: 36434766 DOI: 10.2460/javma.22.08.0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the clinical findings and outcomes of Australian cats and dogs with CNS cryptococcosis. ANIMALS 19 cats and 31 dogs with CNS cryptococcosis diagnosed between 2000 and 2020. PROCEDURES A case series and cohort study were performed using the same 50 animals. Both studies were multi-institutional and both retrospective and prospective. Disease features were compared between cats and dogs, and associations between putative risk factors and survival time (ST) were assessed. RESULTS Dogs were younger at initial presentation than cats and had lower latex cryptococcal antigen agglutination titers. Extraneurologic signs were common and frequently involved sinonasal and contiguous tissues. Neuroanatomic localization was predominantly forebrain, central vestibular (including cerebellum), multifocal, or diffuse. CSF analysis predominantly showed pleocytosis, with eosinophilic inflammation common in dogs. Seventy-eight percent (39/50) of patients received antifungal treatment. Median STs (from presentation) in treated patients were 1,678 days for cats and 679 days for dogs. Abnormal mentation at presentation (in dogs) and CSF collection (in cats) were associated with shorter STs. In treated dogs, those that received glucocorticoids prior to diagnosis, or single rather than multiple antifungal agents, had shorter STs. CLINICAL RELEVANCE The prognosis for feline and canine CNS cryptococcosis is guarded, yet long STs are possible with appropriate treatment. Presence of subtle upper respiratory tract signs may suggest cryptococcosis in patients with neurologic signs, while the absence of neurologic signs does not preclude CNS involvement.
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Affiliation(s)
- Else Jacobson
- 1Department of Internal Medicine, Veterinary Specialist Services, Underwood, QLD, Australia
| | | | - Dennis J Woerde
- 3Department of Internal Medicine, Animal Referral Hospital, Homebush West, NSW, Australia
| | - Mary F Thompson
- 4Department of Internal Medicine, The Animal Hospital, School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | - Amanda M Spillane
- 5Department of Internal Medicine, Queensland Veterinary Specialists, Stafford, QLD, Australia
| | - Anna Tebb
- 6Department of Internal Medicine, Western Australian Veterinary Emergency and Specialty, Success, WA, Australia
| | - Zoe Della Valle
- 7Department of Internal Medicine, Melbourne Veterinary Specialist Centre, Glen Waverley, VIC, Australia
| | - Gemma Birnie
- 8Department of Internal Medicine, Brisbane Veterinary Specialist Centre, Albany Creek, QLD, Australia
| | - Richard Malik
- 9Centre for Veterinary Education, Veterinary Science Conference Centre, The University of Sydney, NSW, Australia
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Important Mycoses of Wildlife: Emphasis on Etiology, Epidemiology, Diagnosis, and Pathology—A Review: PART 1. Animals (Basel) 2022; 12:ani12151874. [PMID: 35892524 PMCID: PMC9331704 DOI: 10.3390/ani12151874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The number of wild animals is steadily declining globally, so the early diagnosis and proper treatment of emerging diseases are vital. Fungal diseases are commonly encountered in practice and have a high zoonotic potential. This article describes aspergillosis, candidiasis, histoplasmosis, cryptococcosis, and penicilliosis, and is only the first part of a detailed review. The laboratory methods (fungal isolation, gross pathology, histopathology, histochemistry, cytology, immunohistochemistry, radiography, CT, PCR, or ELISA) used in the diagnosis and the clinical details that provide a complete view of the mycoses are presented. Abstract In the past few years, there has been a spurred tripling in the figures of fungal diseases leading to one of the most alarming rates of extinction ever reported in wild species. Some of these fungal diseases are capable of virulent infections and are now considered emerging diseases due to the extremely high number of cases diagnosed with fungal infections in the last few decades. Most of these mycotic diseases in wildlife are zoonotic, and with the emergence and re-emergence of viral and bacterial zoonotic diseases originating from wildlife, which are causing devastating effects on the human population, it is important to pay attention to these wildlife-borne mycotic diseases with zoonotic capabilities. Several diagnostic techniques such as fungal isolation, gross pathology, histopathology, histochemistry, cytology, immunohistochemistry, radiography, CT, and molecular methods such as PCR or ELISA have been invaluable in the diagnosis of wildlife mycoses. The most important data used in the diagnosis of these wildlife mycoses with a zoonotic potential have been re-emphasized. This will have implications for forestalling future epidemics of these potential zoonotic mycotic diseases originating from wildlife. In conclusion, this review will highlight the etiology, epidemiology, diagnosis, pathogenesis, pathogenicity, pathology, and hematological/serum biochemical findings of five important mycoses found in wild animals.
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Abstract
Cryptococcosis is a disease caused by the pathogenic fungi Cryptococcus neoformans and Cryptococcus gattii, both environmental fungi that cause severe pneumonia and may even lead to cryptococcal meningoencephalitis. Although C. neoformans affects more fragile individuals, such as immunocompromised hosts through opportunistic infections, C. gattii causes a serious indiscriminate primary infection in immunocompetent individuals. Typically seen in tropical and subtropical environments, C. gattii has increased its endemic area over recent years, largely due to climatic factors that favor contagion in warmer climates. It is important to point out that not only C. gattii, but the Cryptococcus species complex produces a polysaccharidic capsule with immunomodulatory properties, enabling the pathogenic species of Cryptococccus to subvert the host immune response during the establishment of cryptococcosis, facilitating its dissemination in the infected organism. C. gattii causes a more severe and difficult-to-treat infection, with few antifungals eliciting an effective response during chronic treatment. Much of the immunopathology of this cryptococcosis is still poorly understood, with most studies focusing on cryptococcosis caused by the species C. neoformans. C. gattii became more important in the epidemiological scenario with the outbreaks in the Pacific Northwest of the United States, which resulted in phylogenetic studies of the virulent variant responsible for the severe infection in the region. Since then, the study of cryptococcosis caused by C. gattii has helped researchers understand the immunopathological aspects of different variants of this pathogen.
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Diniz-Lima I, da Fonseca LM, dos Reis JS, Rodrigues da Costa Santos MA, da Costa KM, do Nascimento Santos CA, Barcelos PM, Guimarães-Pinto K, Filardy AA, Freire-de-Lima ME, Decote-Ricardo D, Morrot A, Freire-de-Lima CG, Freire-de-Lima L. The Sweet Side of Fungal Infections: Structural Glycan Diversity and Its Importance for Pathogenic Adaptation. MEDICINES (BASEL, SWITZERLAND) 2022; 9:medicines9060037. [PMID: 35736250 PMCID: PMC9230512 DOI: 10.3390/medicines9060037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 12/11/2022]
Abstract
Fungal infections are the most common secondary infections in debilitated individuals in a state of chronic disease or immunosuppression. Despite this, most fungal infections are neglected, mainly due to the lower frequency of their more severe clinical forms in immunocompetent individuals with a healthy background. However, over the past few years, several cases of severe fungal infections in healthy individuals have provoked a change in the epidemiological dynamics of fungal infections around the world, both due to recurrent outbreaks in previously infrequent regions and the greater emergence of more pathogenic fungal variants affecting healthy individuals, such as in the Cryptococcus genus. Therefore, before the arrival of a scenario of prevalent severe fungal infections, it is necessary to assess more carefully what are the real reasons for the increased incidence of fungal infection globally. What are the factors that are currently contributing to this new possible epidemiological dynamic? Could these be of a structural nature? Herein, we propose a discussion based on the importance of the virulence factors of glycoconjugate composition in the adaptation of pathogenic fungal species into the current scenario of increasing severity of these infections.
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Affiliation(s)
- Israel Diniz-Lima
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Leonardo Marques da Fonseca
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Jhenifer Santos dos Reis
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Marcos André Rodrigues da Costa Santos
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Kelli Monteiro da Costa
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Carlos Antonio do Nascimento Santos
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Pedro Marçal Barcelos
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Kamila Guimarães-Pinto
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (K.G.-P.); (A.A.F.)
| | - Alessandra Almeida Filardy
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (K.G.-P.); (A.A.F.)
| | - Marco Edilson Freire-de-Lima
- Instituto de Química, Departamento de Química Orgânica, Universidade Federal Rural do Rio de Janeiro, Rio de Janeiro 23890-000, Brazil;
| | - Debora Decote-Ricardo
- Departamento de Microbiologia e Imunologia Veterinária, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, Rio de Janeiro 23890-000, Brazil;
| | - Alexandre Morrot
- Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro 21040-360, Brazil;
| | - Celio Geraldo Freire-de-Lima
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
- Correspondence: ; Tel./Fax: +55-21-3938-6646
| | - Leonardo Freire-de-Lima
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
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Tong MX, Hill SA, Romine JF. Disseminated cryptococcosis causing liver dysfunction in a pug. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Miranda X. Tong
- Department of Internal Medicine Animal Referral Centre Auckland New Zealand
- Department of Internal Medicine Queensland Veterinary Specialists North Lakes Queensland Australia
| | - Sarah A. Hill
- Department of Internal Medicine Animal Referral Centre Auckland New Zealand
| | - Jessica F. Romine
- Department of Internal Medicine Animal Referral Centre Auckland New Zealand
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McEwan SA, Sykes JE. Nasopharyngeal cryptococcosis in a cat: interlaboratory variation in cryptococcal antigen assay test results. JFMS Open Rep 2022; 8:20551169221074624. [PMID: 35359825 PMCID: PMC8961386 DOI: 10.1177/20551169221074624] [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] [Indexed: 11/29/2022] Open
Abstract
Case summary An indoor-only 6-year-old spayed female domestic cat was evaluated for a
history of stertorous respiration. Skull radiographs revealed increased soft
tissue density within the caudal aspect of the left nasal cavity. CT and
rhinoscopy revealed a mass lesion in the choana, plus a smaller lesion,
nearly completely occluding flow through the nasal passages. Rhinoscopy was
used to collect a biopsy specimen from a fleshy, tan–yellow mass visualized
in the caudal nasopharynx. Histopathology was diagnostic for
Cryptococcus species infection and systemic antifungal
therapy with fluconazole was initiated. Following a series of discordant
results, serum samples were submitted to a veterinary diagnostic laboratory
that utilized a cryptococcal antigen latex agglutination system with
pretreatment of serum with pronase. Twenty-three months after the initial
diagnosis, the cat’s serum cryptococcal antigen titer declined to 1:5 and
the cat has responded well to continuing treatment. Relevance and novel information This case illustrates challenges associated with discordant test results for
cryptococcal antigen among laboratories. Discordancies may be due to
differences in assay design, or the underlying disease state itself, or
whether serum is pre-treated with pronase; with some tests relying on the
training and experience of the operator if the cryptococcal antigen
detection test requires a subjective interpretation. It also resolves some
confusion in the literature related to the assay types available and
terminology used to describe them, and emphasizes the importance of
considering cryptococcosis as an important differential for cats with upper
respiratory signs, without nasal discharge, even if the cat is kept
exclusively indoors.
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Affiliation(s)
- Stephanie A McEwan
- Departments of Medicine and Surgery, Biological Science and Psychological Science, University of California, Irvine, CA, USA
| | - Jane E Sykes
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
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Mohammed R, Nader SM, Hamza DA, Sabry MA. Horse: a potential source of Cryptococcus neoformans and Cryptococcus gattii in Egypt. BMC Vet Res 2022; 18:17. [PMID: 34983525 PMCID: PMC8725405 DOI: 10.1186/s12917-021-03127-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/23/2021] [Indexed: 11/12/2022] Open
Abstract
Background Cryptococcosis is an opportunistic mycozoonosis of global significance in a wide variety of host species. In equines, cryptococcosis is uncommon, and sporadic cases have been reported with rhinitis, sinusitis, pneumonia, and meningitis. Cryptococcus spp. represents a potential risk for immunosuppressed and healthy persons. In Egypt, epidemiological data on cryptococcal infection in horses are limited. The current study was carried out to investigate the occurrence of Cryptococcus spp. in horses and its possible role in the epidemiology of such disease in Egypt. A total of 223 samples was collected from different localities in Egypt included 183 nasal swabs from horses, 28 nasal swabs from humans, and 12 soil samples. Bacteriological examination and the identification of Cryptococcus spp. were performed. Molecular serotyping of Cryptococcus spp. was determined by multiplex PCR using CNa-70S/A-CNb-49S/A. The virulence genes (LAC1, CAP59, and PLB1) of the identified isolates were detected by PCR. Moreover, sequencing and phylogenetic analysis of the C. gattii gene from horses, humans, and soil isolates found nearby were performed. Result The overall occurrence of Cryptococcus spp. in horses were 9.3, 25, and 10.7% in horses, the soil, and humans, respectively. Molecular serotyping of the Cryptococcus spp. isolates recovered from the nasal passages of horses proved that C. gattii (B), C. neoformans, and two hybrids between C. neoformans (A) and C. gattii (B) were identified. Meanwhile, in case of soil samples, the isolates were identified as C. gattii (B). The human isolates were serotyped as C. gattii in two isolates and C. neoformans in only one isolate. Molecular detection of some virulence genes (LAC1), (CAP59), and (PLB1) were identified in both C. gattii and C. neoformans isolates. The C. gattii gene amplicons of the isolates from horses, humans, and the soil were closely related. Conclusion This study provides the first insights into the Egyptian horse ecology of Cryptococcus species and highlights the role of horses as asymptomatic carriers in disseminating the potentially pathogenic Cryptococcus spp. It also presents the possible risk of cryptococcosis infection in humans.
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Affiliation(s)
- Rahma Mohammed
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt
| | - Sara M Nader
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt
| | - Dalia A Hamza
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt.
| | - Maha A Sabry
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt
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Reis RS, Bonna ICF, Antonio IMDS, Pereira SA, do Nascimento CRS, Ferraris FK, Brito-Santos F, Ferreira Gremião ID, Trilles L. Cryptococcus neoformans VNII as the Main Cause of Cryptococcosis in Domestic Cats from Rio de Janeiro, Brazil. J Fungi (Basel) 2021; 7:jof7110980. [PMID: 34829267 PMCID: PMC8621350 DOI: 10.3390/jof7110980] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Cryptococcosis is a systemic fungal disease acquired from contaminated environments with propagules of the basidiomycetous yeasts of the Cryptococcus neoformans and C. gattii species complexes. The C. neoformans species complex classically comprises four major molecular types (VNI, VNII, VNIII, and VNIV), and the C. gattii species complex comprises another four (VGI, VGII, VGIII, and VGIV) and the newly identified molecular type VGV. These major molecular types differ in their epidemiological and ecological features, clinical presentations, and therapeutic outcomes. Generally, the most common isolated types are VNI, VGI, and VGII. The epidemiological profile of cryptococcosis in domestic cats is poorly studied and cats can be the sentinels for human infections. Therefore, the present study aimed to determine the molecular characterization of Cryptococcus spp. isolated from domestic cats and their dwellings in the metropolitan area of Rio de Janeiro, Brazil. A total of 36 Cryptococcus spp. strains, both clinical and environmental, from 19 cats were subtyped using multilocus sequence typing (MLST). The ploidy was identified using flow cytometry and the mating type was determined through amplification with specific pheromone primers. All strains were mating type alpha and 6/36 were diploid (all VNII). Most isolates (63.88%) were identified as VNII, a rare molecular type, leading to the consideration that this genotype is more likely related to skin lesions, since there was a high percentage (68.75%) of cats with skin lesions, which is also considered rare. Further studies regarding the molecular epidemiology of cryptococcosis in felines are still needed to clarify the reason for the large proportion of the rare molecular type VNII causing infections in cats.
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Affiliation(s)
- Rosani Santos Reis
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
| | - Isabel Cristina Fábregas Bonna
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
| | - Isabela Maria da Silva Antonio
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo)/INI/Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.M.d.S.A.); (S.A.P.); (I.D.F.G.)
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo)/INI/Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.M.d.S.A.); (S.A.P.); (I.D.F.G.)
| | | | - Fausto Klabund Ferraris
- Pharmacology Laboratory/INCQS/Fiocruz. Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil;
| | - Fábio Brito-Santos
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo)/INI/Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.M.d.S.A.); (S.A.P.); (I.D.F.G.)
| | - Luciana Trilles
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
- Correspondence:
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13
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Domestic Birds as Source of Cryptococcus deuterogattii (AFLP6/VGII): Potential Risk for Cryptococcosis. Mycopathologia 2021; 187:103-111. [PMID: 34762221 PMCID: PMC8807445 DOI: 10.1007/s11046-021-00601-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
Cryptococcosis is an infection caused by encapsulated basidiomycetous yeasts belonging to the Cryptococcus neoformans/Cryptococcus gattii species complexes. It is acquired through inhalation of infectious propagules, often resulting in meningitis and meningoencephalitis. The ecological niche of these agents is a wide variety of trees species, as well as pigeon, parrot and passerine excreta. The objective of this study was to isolate Cryptococcus yeasts from excreta of commercially traded parrots and passerines. The 237 samples were collected between October 2018 and April 2019 and processed using conventional methodologies. Nineteen colonies with a dark brown phenotype, caused by phenol oxidase activity, were isolated, suggesting the presence of pathogenic Cryptococcus yeasts. All isolates tested positive for urease activity. URA5-RFLP fingerprinting identified 14 isolates (68.4%) as C. neoformans (genotype AFLP1/VNI) and 5 (26.3%) as C. deuterogattii (genotype AFLP6/VGII). Multi-locus sequence typing was applied to investigate the relatedness of the C. deuterogattii isolates with those collected globally, showing that those originating from bird-excreta were genetically indistinguishable from some clinical isolates collected during the past two decades.
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14
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de Souza Collares Maia Castelo-Branco D, Dos Santos Araújo G, Fonseca XMQC, de Melo Guedes GM, da Rocha MG, Brilhante RSN, de Aguiar Cordeiro R, Sidrim JJC, Pereira-Neto WA, Rocha MFG. Anthraquinones from Aloe spp. inhibit Cryptococcus neoformans sensu stricto: effects against growing and mature biofilms. BIOFOULING 2021; 37:809-817. [PMID: 34634964 DOI: 10.1080/08927014.2021.1958793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to evaluate the in vitro effect of aloe emodin, barbaloin and chrysophanol on growing and mature biofilms of Cryptococcus neoformans sensu stricto. The compounds were added at the moment of inducing biofilm growth or after growth for 72 h to evaluate their effects on growing and mature biofilms, respectively. Then, biofilm biomass was evaluated by crystal violet staining and metabolic activity by the XTT reduction assay. Morphological alterations were also evaluated by laser scanning confocal microscopy. Aloe emodin and barbaloin affected growing biofilms and disrupted mature biofilms, reducing metabolic activity by > 60% and biomass by > 70%. Chrysophanol only inhibited mature biofilms, but to a lesser extent. In conclusion, anthraquinones, especially aloe emodin and barbaloin, show a relevant effect against growing and mature biofilms of C. neoformans sensu stricto.
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Affiliation(s)
- Débora de Souza Collares Maia Castelo-Branco
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Géssica Dos Santos Araújo
- Postgraduate Program in Veterinary Sciences, School of Veterinary, State University of Ceará, Fortaleza, Ceará, Brazil
| | - Xhaulla Maria Quariguasi Cunha Fonseca
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Glaucia Morgana de Melo Guedes
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Maria Gleiciane da Rocha
- Postgraduate Program in Veterinary Sciences, School of Veterinary, State University of Ceará, Fortaleza, Ceará, Brazil
| | - Raimunda Sâmia Nogueira Brilhante
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Rossana de Aguiar Cordeiro
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - José Júlio Costa Sidrim
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Waldemiro Aquino Pereira-Neto
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Marcos Fábio Gadelha Rocha
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
- Postgraduate Program in Veterinary Sciences, School of Veterinary, State University of Ceará, Fortaleza, Ceará, Brazil
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15
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Cormack CA, Donahoe SL, Talbot JJ, Beatty JA, Barrs VR. Disseminated invasive aspergillosis caused by Aspergillus felis in a cat. J Vet Intern Med 2021; 35:2395-2400. [PMID: 34414603 PMCID: PMC8478040 DOI: 10.1111/jvim.16245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022] Open
Abstract
A 2‐year‐old male desexed Ragdoll cat with a 1‐year history of sneezing and nasal discharge presented with a large subcutaneous cervical mass, identified as the right medial retropharyngeal lymph node on computed tomography (CT). A right orbital mass, destructive sino‐nasal cavity disease and multiple pulmonary nodules were also identified. Aspergillus felis was cultured from the lymph node. After treatment with posaconazole and liposomal amphotericin B the lymph node enlargement and orbital mass resolved but left frontal sinus involvement and pulmonary lesions persisted despite additional caspofungin therapy. The cat was euthanized 14 months after diagnosis with dysphagia and chronic progressive exophthalmos. A meningeal granuloma with intravascular fungal hyphae was identified at post‐mortem and A felis was cultured from the left frontal sinus and a right retrobulbar fungal granuloma. This case demonstrates that disseminated disease is a possible sequel to invasive fungal rhinosinusitis caused by A felis in cats.
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Affiliation(s)
- Catherine A Cormack
- 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
| | - Shannon L Donahoe
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica J Talbot
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Julia A Beatty
- 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.,Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - 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.,Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
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Xavier AAC, Pires BG, Viana NE, Leme RA, Alfieri AA, Headley SA. Pathology in Practice. J Am Vet Med Assoc 2021; 258:587-590. [PMID: 33683964 DOI: 10.2460/javma.258.6.587] [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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Grinstead CR, Hanzlicek AS, Largura HW, Wheat LJ. Invasive fungal rhinitis with adnexal involvement caused by Histoplasma capsulatum in a cat from a non-enzootic location. JFMS Open Rep 2021; 7:2055116921993385. [PMID: 33643661 PMCID: PMC7894697 DOI: 10.1177/2055116921993385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Case summary This report describes a cat with a rare form of histoplasmosis: invasive rhinitis with adnexal involvement, mimicking disease more commonly caused by cryptococcosis or aspergillosis. This case is especially noteworthy as it was from an area where histoplasmosis is not enzootic. Relevance and novel information Invasive fungal rhinitis causes significant morbidity in cats. Diagnostic investigation of more common pathogens includes detection of fungal antigen (Cryptococcus) or antifungal antibodies (Aspergillus). This case demonstrates that histoplasmosis can present as chronic nasal disease in cats. Histoplasma antigen testing provides a non-invasive diagnostic option. Moreover, this case serves as a reminder that histoplasmosis can affect cats anywhere, even in non-enzootic areas.
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Danesi P, Falcaro C, Schmertmann LJ, de Miranda LHM, Krockenberger M, Malik R. Cryptococcus in Wildlife and Free-Living Mammals. J Fungi (Basel) 2021; 7:jof7010029. [PMID: 33419125 PMCID: PMC7825559 DOI: 10.3390/jof7010029] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/22/2020] [Accepted: 01/01/2021] [Indexed: 12/21/2022] Open
Abstract
Cryptococcosis is typically a sporadic disease that affects a broad range of animal species globally. Disease is a consequence of infection with members of the Cryptococcus neoformans or Cryptococcus gattii species complexes. Although cryptococcosis in many domestic animals has been relatively well-characterized, free-living wildlife animal species are often neglected in the literature outside of occasional case reports. This review summarizes the clinical presentation, pathological findings and potential underlying causes of cryptococcosis in various other animals, including terrestrial wildlife species and marine mammals. The evaluation of the available literature supports the hypothesis that anatomy (particularly of the respiratory tract), behavior and environmental exposures of animals play vital roles in the outcome of host–pathogen–environment interactions resulting in different clinical scenarios. Key examples range from koalas, which exhibit primarily C. gattii species complex disease presumably due to their behavior and environmental exposure to eucalypts, to cetaceans, which show predominantly pulmonary lesions due to their unique respiratory anatomy. Understanding the factors at play in each clinical scenario is a powerful investigative tool, as wildlife species may act as disease sentinels.
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Affiliation(s)
- Patrizia Danesi
- Laboratory of Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Padua, Italy;
- Correspondence:
| | - Christian Falcaro
- Laboratory of Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Padua, Italy;
| | - Laura J. Schmertmann
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, The University of Sydney, Sydney 2006, Australia; (L.J.S.); (L.H.M.d.M.); (M.K.)
| | - Luisa Helena Monteiro de Miranda
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, The University of Sydney, Sydney 2006, Australia; (L.J.S.); (L.H.M.d.M.); (M.K.)
| | - Mark Krockenberger
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, The University of Sydney, Sydney 2006, Australia; (L.J.S.); (L.H.M.d.M.); (M.K.)
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, Sydney 2006, Australia;
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Acute Fluctuant Neurological Symptoms in Stable Chronic Cryptococcus gattii Cryptococcomas: A Novel Disease Complication. Neurologist 2020; 26:24-26. [PMID: 33394909 DOI: 10.1097/nrl.0000000000000297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cryptococcus, a yeast-like fungus, is the most common cause of fungal meningitis worldwide. The Cryptococcus gattii variety is concentrated in Australia has a greater propensity to infect immunocompetent hosts, cause meningitis and form crytococcomas. This case presents a novel disease complication, that is, acute neurological symptoms without seizures, disease progression or reactivation. CASE PRESENTATION A 58-year-old immunocompetent male was brought to the emergency department with dysarthria and right arm paraesthesias. Computed tomography of the brain brain and magnetic resonance imaging revealed no stroke but found several previously identified crytococcomas that demonstrated no interval change. Blood tests and lumbar puncture found only a low cryptococcal antigen complex titer (CRAG) (1:10) and a negative cell culture. He had remained compliant on his maintenance fluconazole therapy and had no immunocompromise or seizure activity. He was initially treated as a relapse of cryptococcal disease and restarted on induction therapy but after the cell culture returned negative and the symptoms resolved over the following days he was reverted back to maintenance therapy. DISCUSSION AND CONCLUSIONS Central nervous system cryptococcomas are difficult to treat, chronic infections, that in our patient had lasted over 10 years despite treatment compliance. A true cryptococcal meningitis relapse is indicated by positive cell cultures in previously sterile fluid but cryptococcoma progression is measured by serial magnetic resonance imaging or computed tomography scans. In the case of progression or relapse induction and consolidation therapy should be restarted. Our patient demonstrated neither relapse nor progression but presented with a novel disease complication of acute fluctuating neurology in chronic stable cryptococcomas.
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20
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Johnston L, Mackay B, King T, Krockenberger MB, Malik R, Tebb A. Abdominal cryptococcosis in dogs and cats: 38 cases (2000-2018). J Small Anim Pract 2020; 62:19-27. [PMID: 33107069 DOI: 10.1111/jsap.13232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 06/05/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To report the clinical presentation, laboratory and imaging findings, treatment and outcome of abdominal cryptococcosis in dogs and cats in Australia. MATERIALS AND METHODS Canine and feline cases from Australia were retrospectively identified (2000 to 2018) via laboratory and referral centre searches for abdominal cryptococcosis diagnosed by cytology (needle aspirates) or histopathology (biopsy or necropsy) of abdominal organs/tissues. Signalment, presenting complaints, clinical signs, laboratory findings, medical imaging, latex cryptococcal antigen agglutination test (LCAT) titres, treatment and outcome data was collected. RESULTS Thirty-eight cases were included (35 dogs, three cats) in the study. Median age of presentation was 2 years for dogs and 6 years for cats. Common presenting complaints included vomiting (23/38), lethargy (19/38) and inappetence/anorexia (15/38). Abdominal ultrasound (25/38 cases) revealed mesenteric and intestinal lesions in most of the cases. On surgical exploration, seven cases had an intestinal lesion associated with an intussusception. Nineteen cases had a pre-treatment LCAT performed, with a median initial titre of 1:2048 (range 1:2 to 65,536). Twenty-four cases (23 dogs, one cat) received treatment, either medical, surgical or both. Median survival time for cases with combined medical and surgical treatment, surgical treatment alone or medical treatment alone was 730, 140 and 561 days, respectively. Eleven remain alive at the time of follow up. CLINICAL SIGNIFICANCE Abdominal cryptococcosis although rare should be a considered as a diagnostic possibility in an especially young dog presenting with gastro-intestinal signs. Older dogs can also present with this condition and should not be euthanised based on imaging alone due to the likenesses with neoplasia. With appropriate treatment and monitoring many dogs may have a prolonged survival period and some may be cured.
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Affiliation(s)
- L Johnston
- Department of Internal Medicine, Veterinary Specialist Services, Carrara, 4211, Australia
| | - B Mackay
- Department of Internal Medicine, Veterinary Specialist Services, Carrara, 4211, Australia
| | - T King
- Department of Internal Medicine, Veterinary Specialist Services, Carrara, 4211, Australia
| | - M B Krockenberger
- Sydney School of Veterinary Science, The University of Sydney, Sydney, 2006, Australia
| | - R Malik
- Centre for Veterinary Education, The University of Sydney, Sydney, 2006, Australia.,School of Animal and Veterinary Science, Charles Sturt University, Wagga Wagga, 2678, Australia
| | - A Tebb
- Western Australian Veterinary Emergency and Speciality, Success, 6164, Australia
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21
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Almendros A, Muguiro DH, Hill FI, Barrs VR. First case of feline cryptococcosis in Hong Kong, caused by Cryptococcus neoformans. Med Mycol Case Rep 2020; 29:8-11. [PMID: 32477859 PMCID: PMC7251313 DOI: 10.1016/j.mmcr.2020.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 11/25/2022] Open
Abstract
A nine-year-old domestic short hair cat was presented for a nasal planum mass, nasal discharge, hyporexia and weight loss. On physical examination nasal proliferative and ulcerative lesions and submandibular lymphadenopathy were identified. Cytology, histopathology, fungal culture, antigen serology and MALDI-TOF confirmed cryptococcal rhinitis with regional mandibular lymph node involvement due to Cryptococcus neoformans infection. This is the first reported case of cryptococcosis in a feline patient in Hong Kong.
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Affiliation(s)
- Angel Almendros
- CityU Veterinary Medical Center, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Daniela H Muguiro
- CityU Veterinary Diagnostic Laboratory, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Fraser I Hill
- CityU Veterinary Diagnostic Laboratory, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Vanessa R Barrs
- Department of Public Health & Infectious Diseases, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Kowloon Tong, Hong Kong, China
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Yang W, Jones BR, Rossi G, Stephens N, Arthur I, Merritt A, Reese S, Langner K. First case of a dog infected with Aspergillus (Phialosimplex) caninus in Australasia. N Z Vet J 2020; 68:231-237. [PMID: 31852374 DOI: 10.1080/00480169.2019.1706659] [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: 10/25/2022]
Abstract
Case history: A 2-year-old Rottweiler dog from Perth (WA, Australia) was referred for assessment of a chronic productive cough and weight loss.Clinical findings: Severely enlarged bilateral superficial cervical lymph nodes and severely enlarged abdominal organs were present. The body condition score was poor and there was moderate muscle wasting. Thoracic and abdominal computed tomography images revealed severe diffuse enlargement of thoracic and abdominal lymph nodes, hepatomegaly and diffuse splenomegaly. A diffuse bronchial pattern with severe multifocal saccular bronchiectasis was identified in the lungs.Diagnostic findings: Fungal organisms were seen within macrophages on cytological preparations and on histopathological sections of biopsies of the superficial cervical lymph node. Macrophages contained intracytoplasmic, non-filamentous round-to-ovoid organisms, which varied in size from 5-30 µm in diameter with variable morphology. Budding was not observed, and no hyphae were present. Fungal culture of lymph node tissue resulted in growth of Aspergillus (Phialosimplex) caninus which was confirmed by amplification and sequencing of a segment of the 16S-23S rRNA internal transcribed spacer. Concurrent bacterial bronchitis was diagnosed on culture of broncho-alveolar fluid.Diagnosis: Disseminated aspergillosis caused by Aspergillus caninus.Clinical relevance: This is believed to be the first report of infection caused by A. caninus in a dog in Australasia. The dog was treated with itraconazole for 7 months and was still alive 7 months after the start of treatment.
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Affiliation(s)
- W Yang
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - B R Jones
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - G Rossi
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - N Stephens
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - I Arthur
- PathWest Department of Microbiology and Infectious Disease, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia
| | - A Merritt
- PathWest Department of Microbiology and Infectious Disease, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia
| | - S Reese
- Vet Imaging Specialists, Murdoch, WA, Australia
| | - Kfa Langner
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
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Acheson ES, Galanis E, Bartlett K, Klinkenberg B. Climate Classification System-Based Determination of Temperate Climate Detection of Cryptococcus gattii sensu lato. Emerg Infect Dis 2020; 25:1723-1726. [PMID: 31441746 PMCID: PMC6711209 DOI: 10.3201/eid2509.181884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We compared 2 climate classification systems describing georeferenced environmental Cryptococcus gattii sensu lato isolations occurring during 1989–2016. Each system suggests the fungus was isolated in temperate climates before the 1999 outbreak on Vancouver Island, British Columbia, Canada. However, the Köppen-Geiger system is more precise and should be used to define climates where pathogens are detected.
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Lee GHA, Arthur I, Merritt A, Leung M. Molecular types of Cryptococcus neoformans and Cryptococcus gattii in Western Australia and correlation with antifungal susceptibility. Med Mycol 2020; 57:1004-1010. [PMID: 30649538 DOI: 10.1093/mmy/myy161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/13/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022] Open
Abstract
Cryptococcus neoformans and Cryptococcus gattii species complexes have a worldwide distribution; however, there is geographical variation in the prevalence of different molecular types. Additionally, antifungal susceptibility differences between molecular types have been demonstrated. This study investigates the distribution of cryptococcal molecular types among human clinical isolates over a 10-year period from a Western Australian population. Molecular type was determined based on polymorphisms in the phospholipase gene locus identified through amplification and sequencing. Minimum inhibitory concentrations (MICs) were identified for fluconazole, 5-fluorocytosine, posaconazole, itraconazole, voriconazole, and amphotericin B. Most isolates were C. neoformans complex (42) of which over half were molecular type VNI (22) followed by VNII (20). Among the remaining C. gattii complex (13) the majority were VGI (11) with VGII (2) uncommonly found. All isolates demonstrated low MICs to antifungal agents including fluconazole. Geometric mean MIC values against 5-fluorocytosine for VNI (1.741 mg/l) were significantly higher than those for VGI (0.47 mg/l, P = .002). Similarly fluconazole geometric mean MICs against fluconazole for VNI (2.3 mg/l) were significantly higher than VNII (0.87 mg/l, P = .036). These data reveal the presence of four molecular types (VNI, VNII, VGI and VGII) within clinical Western Australian cryptococcal isolates and, while elevated antifungal MICs were not encountered, significant molecular type dependent differences in susceptibility were found.
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Affiliation(s)
- Gar-Hing Andrew Lee
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
| | - Ian Arthur
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
| | - Adam Merritt
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
| | - Michael Leung
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
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Schmertmann LJ, Wardman A, Setyo L, Kan A, Meyer W, Malik R, Krockenberger MB. Identification of the environmental source of infection for a domestic ferret with cryptococcosis. J Vet Diagn Invest 2019; 31:828-835. [PMID: 31551015 DOI: 10.1177/1040638719876968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cryptococcosis, caused by the Cryptococcus gattii and C. neoformans species complexes, is an environmentally acquired mycosis affecting a broad range of host species. Among 9 communally housed ferrets, a 5-y-old castrated male ferret domiciled in an outdoor enclosure in Sydney, Australia was diagnosed with sinonasal cryptococcosis. Clinical signs resolved during 18 mo of itraconazole therapy, but the ferret was eventually euthanized because of splenic hemangiosarcoma. At postmortem, microscopic foci of persistent cryptococcosis were detected. The diagnosis raised concerns that the owners and other ferrets were exposed to a common environmental source of infection, thus prompting an investigation. Soil samples, swabs of a hollow eucalypt log (used for behavioral enrichment), and nasal swabs from 8 asymptomatic ferrets were collected. Nasal exudate (obtained at diagnosis) and tissues (collected at postmortem) were available from the clinical case. Bird seed agar culture resulted in a heavy growth of Cryptococcus spp. from one environmental site (the log), one nasal swab, and nasal exudate and tissues from the clinical case. All other samples were culture-negative. Sub-cultured isolates from the log were a mixture of C. gattii molecular type VGI and C. neoformans molecular type VNI. Ferret isolates were a similar mixture of C. gattii VGI (all disease isolates) and C. neoformans VNI (nasal-colonizing isolate). Multilocus sequence typing further revealed the ferret isolates as identical to environmental isolates collected from the log, confirming the log as the source of clinical disease and nasal colonization. The log was removed to prevent further exposure to a high environmental load of Cryptococcus spp.
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Affiliation(s)
- Laura J Schmertmann
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alison Wardman
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Laura Setyo
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alex Kan
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Wieland Meyer
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Richard Malik
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Mark B Krockenberger
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
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Schlacks S, Boozer T, Dial S, Eichelberger B. CT identifies pulmonary cryptococcosis in a domestic feline. Vet Radiol Ultrasound 2019; 62:E54-E57. [PMID: 31531909 DOI: 10.1111/vru.12809] [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: 03/14/2019] [Revised: 07/07/2019] [Accepted: 07/09/2019] [Indexed: 12/01/2022] Open
Abstract
A domestic cat was presented for lethargy and coughing. Thoracic radiographs identified a mass within the right cranial lung lobe and a nodule in the left cranial lung lobe. Cryptococcus spp. was diagnosed via ultrasound-guided fine needle aspirate cytology. Despite fluconazole and prednisolone treatment, clinical signs progressed and suggested airway obstruction. Computed tomography revealed mass invasion into the trachea and other areas of the lower airway resulting in obstruction. Bronchoscopy was performed to debulk the tracheal mass and obtain biopsies. Histopathology confirmed Cryptococcus spp. At the time of this report, the patient remained clinically stable with daily itraconazole (5 mg/kg) treatment.
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Affiliation(s)
| | - Tara Boozer
- Veterinary Specialty Center of Tucson, Tucson, Arizona
| | - Sharon Dial
- Arizona Veterinary Diagnostic Lab, University of Arizona, Tucson, Arizona
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Daniel AJ, Thachil A, Savory‐Davis M. Severe cryptococcal granulomas of the nasopharynx in a horse treated with standing endoscopic laser surgery and oral fluconazole. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - A. Thachil
- Department of Population Medicine and Diagnostic Services Cornell University Animal Health Diagnostic Center Ithaca New York USA
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Abstract
Cryptococcus gattii molecular type VGII is one of the etiologic agents of cryptococcosis, a systemic mycosis affecting a wide range of host species. Koalas (Phascolarctos cinereus) exhibit a comparatively high prevalence of cryptococcosis (clinical and subclinical) and nasal colonization, particularly in captivity. In Australia, disease associated with C. gattii VGII is typically confined to Western Australia and the Northern Territory (with sporadic cases reported in eastern Australia), occupying an enigmatic ecologic niche. A cluster of cryptococcosis in captive koalas in eastern Australia (five confirmed cases, a further two suspected), caused predominantly by C. gattii VGII, was investigated by surveying for subclinical disease, culturing koala nasal swabs and environmental samples, and genotyping cryptococcal isolates. URA5 restriction fragment length polymorphism analysis, multilocus sequence typing (MLST), and whole-genome sequencing (WGS) provided supportive evidence that the transfer of koalas from Western Australia and subsequently between several facilities in Queensland spread VGII into uncontaminated environments and environments in which C. gattii VGI was endemic. MLST identified VGII isolates as predominantly sequence type 7, while WGS further confirmed a limited genomic diversity and revealed a basal relationship with isolates from Western Australia. We hypothesize that this represents a founder effect following the introduction of a koala from Western Australia. Our findings suggest a possible competitive advantage for C. gattii VGII over VGI in the context of this captive koala environment. The ability of koalas to seed C. gattii VGII into new environments has implications for the management of captive populations and movements of koalas between zoos.IMPORTANCE Cryptococcus gattii molecular type VGII is one of the causes of cryptococcosis, a severe fungal disease that is acquired from the environment and affects many host species (including humans and koalas). In Australia, disease caused by C. gattii VGII is largely confined to western and central northern parts of the country, with sporadic cases reported in eastern Australia. We investigated an unusual case cluster of cryptococcosis, caused predominantly by C. gattii VGII, in a group of captive koalas in eastern Australia. This research identified that the movements of koalas between wildlife parks, including an initial transfer of a koala from Western Australia, introduced and subsequently spread C. gattii VGII in this captive environment. The spread of this pathogen by koalas could also impact other species, and these findings are significant in the implications they have for the management of koala transfers and captive environments.
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Brito-Santos F, Reis RS, Coelho RA, Almeida-Paes R, Pereira SA, Trilles L, Meyer W, Wanke B, Lazéra MDS, Gremião IDF. Cryptococcosis due to Cryptococcus gattii VGII in southeast Brazil: The One Health approach revealing a possible role for domestic cats. Med Mycol Case Rep 2019; 24:61-64. [PMID: 31061785 PMCID: PMC6487353 DOI: 10.1016/j.mmcr.2019.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/14/2019] [Accepted: 04/11/2019] [Indexed: 11/23/2022] Open
Abstract
Two cats infected by C. gattii, presented lesions on the nasal region and respiratory signs. Strains were typed as molecular type VGII, mating type alpha, MLST subtypes ST442 and ST185. Since Rio de Janeiro is known as an endemic area for C. neoformans VNI, these cases might be a warning for a possible emergence of C. gattii VGII in southeast Brazil.
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Affiliation(s)
- Fábio Brito-Santos
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
| | - Rosani Santos Reis
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
| | - Rowena Alves Coelho
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
| | - Sandro Antônio Pereira
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals, National Institute of Infectious Diseases Evandro Chagas (INI), FIOCRUZ, Rio de Janeiro, Brazil
| | - Luciana Trilles
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
| | - Wieland Meyer
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil.,Molecular Mycology Research Laboratory, Westmead Institute for Medical Research, Sydney, NSW, Australia
| | - Bodo Wanke
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
| | - Márcia Dos Santos Lazéra
- Mycology Laboratory, National Institute of Infectious Diseases Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals, National Institute of Infectious Diseases Evandro Chagas (INI), FIOCRUZ, Rio de Janeiro, Brazil
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Acheson ES, Galanis E, Bartlett K, Mak S, Klinkenberg B. Searching for clues for eighteen years: Deciphering the ecological determinants of Cryptococcus gattii on Vancouver Island, British Columbia. Med Mycol 2018; 56:129-144. [PMID: 28525610 DOI: 10.1093/mmy/myx037] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 04/06/2017] [Indexed: 12/19/2022] Open
Abstract
Cryptococcus gattii emerged on Vancouver Island in 1999 for unknown reasons, causing human and animal fatalities and illness. The apparent emergence of this fungus in another temperate area, this time in the Pacific Northwest, suggests the fungus may have expanded its ecological niche. Yet studies that directly examine the potential roles of climatic and land use changes on C. gattii are still lacking. We aim to summarize the existing global literature on the ecology of C. gattii, with particular focus on the gap in knowledge surrounding the potential effects of climatic and land use changes. We systematically reviewed English peer-reviewed literature on the ecological determinants of C. gattii. We included studies published from January 1970 through June 2016 and identified 56 relevant studies for our review. We identified environmental isolations of C. gattii from 18 countries, spanning 72 separate regions across six continents. Fifty-three tree species were associated with C. gattii, spanning 10 climate classifications and 36 terrestrial ecoregions. No studies directly tested the potential effects of climatic changes (including climatic oscillations and global climate change) on C. gattii, while only one study directly assessed those of land use change. To improve model predictions of current and future distributions of C. gattii, more focus is needed on the potential effects of climatic and land use changes to help decrease the public health risk. The apparent emergence of C. gattii in British Columbia is also an opportunity to explore the factors behind emerging infectious diseases in Canada and elsewhere.
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Affiliation(s)
- Emily Sohanna Acheson
- Department of Geography, University of British Columbia, 1984 West Mall, Vancouver, British Columbia, Canada, V6T 1Z2
| | - Eleni Galanis
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada, V5Z 4R4.,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada, V6T 1Z3
| | - Karen Bartlett
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada, V6T 1Z3
| | - Sunny Mak
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Brian Klinkenberg
- Department of Geography, University of British Columbia, 1984 West Mall, Vancouver, British Columbia, Canada, V6T 1Z2
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Therapy of Non-Dermatophytic Mycoses in Animals. J Fungi (Basel) 2018; 4:jof4040120. [PMID: 30380772 PMCID: PMC6308939 DOI: 10.3390/jof4040120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 12/13/2022] Open
Abstract
This review focuses on aspects of antimycotic therapy specific to veterinary medicine. In the first part, drug availability, limited mostly by economic consideration but also by clinical applicability and specific adverse effects, is described for polyenes, 5 fluorocytosine, azoles, echinocandins and terbinafine. In the second part, current knowledge and experience in the treatment of selected fungal infections are overviewed. These mycoses include disseminated mold infections in small animals (dogs and cats) and avian species, upper respiratory tract infections of small animals (sino-nasal and sino-orbital aspergillosis) and horses (guttural pouch mycosis), eumycetoma, infections caused by dimorphic fungi, (blastomycosis, histoplasmosis, coccidioidomycosis, paracoccidioidomycosis and sporothrichosis) and by yeasts and yeast-like microorganism (Cryptococcus spp. and Malassezia pachydermatis).
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Samarasinghe H, Xu J. Hybrids and hybridization in the Cryptococcus neoformans and Cryptococcus gattii species complexes. INFECTION GENETICS AND EVOLUTION 2018; 66:245-255. [PMID: 30342094 DOI: 10.1016/j.meegid.2018.10.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/28/2018] [Accepted: 10/16/2018] [Indexed: 12/29/2022]
Abstract
The basidiomycetous yeasts of the Cryptococcus neoformans and Cryptococcus gattii species complexes (CNSC and CGSC respectively) are the causative agents of cryptococcosis, a set of life-threatening diseases affecting the central nervous system, lungs, skin, and other body sites of humans and other mammals. Both the CNSC and CGSC can be subdivided into varieties, serotypes, molecular types, and lineages based on structural variations, molecular characteristics and genetic sequences. Hybridization between the haploid lineages within and between the two species complexes is known to occur in natural and clinical settings, giving rise to intraspecific and interspecific diploid/aneuploid hybrid strains. Since their initial discovery in 1977, cryptococcal hybrids have been increasingly discovered in both clinical and environmental settings with over 30% of all cryptococcal infections in some regions of Europe being caused by hybrid strains. This review summarizes the major findings to date on cryptococcal hybrids, including their possible origins, prevalence, genomic profiles and phenotypic characteristics. Our analyses suggest that CNSC and CGSC can be an excellent model system for studying fungal hybridization.
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Affiliation(s)
- Himeshi Samarasinghe
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Jianping Xu
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
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Esher SK, Zaragoza O, Alspaugh JA. Cryptococcal pathogenic mechanisms: a dangerous trip from the environment to the brain. Mem Inst Oswaldo Cruz 2018; 113:e180057. [PMID: 29668825 PMCID: PMC5909089 DOI: 10.1590/0074-02760180057] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/08/2018] [Indexed: 12/16/2022] Open
Abstract
Cryptococcus neoformans is an opportunistic pathogenic yeast that causes serious infections, most commonly of the central nervous system (CNS). C. neoformans is mainly found in the environment and acquired by inhalation. It could be metaphorically imagined that cryptococcal disease is a "journey" for the microorganism that starts in the environment, where this yeast loads its suitcase with virulence traits. C. neoformans first encounters the infected mammalian host in the lungs, a site in which it must choose the right elements from its "virulence suitcase" to survive the pulmonary immune response. However, the lung is often only the first stop in this journey, and in some individuals the fungal trip continues to the brain. To enter the brain, C. neoformans must "open" the main barrier that protects this organ, the blood brain barrier (BBB). Once in the brain, C. neoformans expresses a distinct set of protective attributes that confers a strong neurotropism and the ability to cause brain colonisation. In summary, C. neoformans is a unique fungal pathogen as shown in its ability to survive in the face of multiple stress factors and to express virulence factors that contribute to the development of disease.
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Affiliation(s)
- Shannon K Esher
- Duke University School of Medicine, Department of Molecular Genetics and Microbiology, Department of Medicine, Durham, USA
| | - Oscar Zaragoza
- Instituto de Salud Carlos III, National Centre for Microbiology, Mycology Reference Laboratory, Madrid, Spain
| | - James Andrew Alspaugh
- Duke University School of Medicine, Department of Molecular Genetics and Microbiology, Department of Medicine, Durham, USA
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Abstract
Fungi must meet four criteria to infect humans: growth at human body temperatures, circumvention or penetration of surface barriers, lysis and absorption of tissue, and resistance to immune defenses, including elevated body temperatures. Morphogenesis between small round, detachable cells and long, connected cells is the mechanism by which fungi solve problems of locomotion around or through host barriers. Secretion of lytic enzymes, and uptake systems for the released nutrients, are necessary if a fungus is to nutritionally utilize human tissue. Last, the potent human immune system evolved in the interaction with potential fungal pathogens, so few fungi meet all four conditions for a healthy human host. Paradoxically, the advances of modern medicine have made millions of people newly susceptible to fungal infections by disrupting immune defenses. This article explores how different members of four fungal phyla use different strategies to fulfill the four criteria to infect humans: the Entomophthorales, the Mucorales, the Ascomycota, and the Basidiomycota. Unique traits confer human pathogenic potential on various important members of these phyla: pathogenic Onygenales comprising thermal dimorphs such as Histoplasma and Coccidioides; the Cryptococcus spp. that infect immunocompromised as well as healthy humans; and important pathogens of immunocompromised patients-Candida, Pneumocystis, and Aspergillus spp. Also discussed are agents of neglected tropical diseases important in global health such as mycetoma and paracoccidiomycosis and common pathogens rarely implicated in serious illness such as dermatophytes. Commensalism is considered, as well as parasitism, in shaping genomes and physiological systems of hosts and fungi during evolution.
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Castro NB, Rolim VM, Nascimento LCD, Silveira AF, Argenta FF, Ferreiro L, Driemeier D, Sonne L. Doenças micóticas em gatos no Rio Grande do Sul. PESQUISA VETERINÁRIA BRASILEIRA 2017. [DOI: 10.1590/s0100-736x2017001100019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO: As enfermidades fúngicas são diagnósticos diferenciais de diversas morbidades de caráter infeccioso, degenerativo ou proliferativo neoplásico, principalmente em gatos, que é a espécie mais suscetível a estas. Este trabalho descreve os achados anatomopatológicos de doenças fúngicas em gatos no período de janeiro de 2005 a dezembro de 2015 pelo SPV-UFRGS. Foram revisados 1.274 protocolos de necropsia e encontrou-se 17 casos de micoses, correspondendo a 1,33% dos diagnósticos. Quanto às amostras provenientes de biopsias, foram verificados 2.615 protocolos e detectou-se 59 casos de doenças fúngicas, totalizando 2,25% dos diagnósticos, sendo revisados seus achados macroscópicos, microscópicos, colorações especiais e cultivo micológico. O principal diagnóstico encontrado foi esporotricose com 34 casos de biópsia e cinco de necropsia. Criptococose obteve seis diagnósticos na necropsia e 13 na biópsia. O pseudomicetoma dermatofítico possui cinco casos de biópsia e dois de necropsia. Histoplasmose obteve um diagnóstico na necropsia e dois na biópsia. Aspergilose teve dois casos diagnosticados na necropsia. Candidíase e feo-hifomicose obtiveram um caso cada. Em quatro ocasiões, não se pode identificar o agente envolvido na lesão e foram classificados conforme a alteração morfológica em: dermatite fúngica, enterite fúngica, rinite micótica e dermatite e osteomielite fúngica. Através deste trabalho, pode-se identificar que a esporotricose foi o diagnóstico de doença fúngica mais frequente em felinos, seguido da criptococose e pseudomicetoma dermatofítico.
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Kinne J, Joseph M, Wernery U, Nogradi N, Hagen F. Disseminated Cryptococcus deuterogattii (AFLP6/VGII) infection in an Arabian horse from Dubai, United Arab Emirates. Rev Iberoam Micol 2017; 34:229-232. [PMID: 28595777 DOI: 10.1016/j.riam.2017.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/02/2017] [Accepted: 02/20/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND During the past decades there has been an increase in cryptococcal infections caused by the basidiomycetous yeast species Cryptococcus gattii sensu lato, among humans and animals that live in endemic regions in Australia, Europe and the Americas. Unlike human cryptococcosis, little epidemiological data are available about C. gattii sensu lato infections in horses. CASE REPORT A fatal case of a disseminated C. gattii sensu lato infection in an 11-year-old Arabian gelding imported from South Africa into the United Arab Emitares is reported. Tissue samples were studied by conventional mycology procedures and the obtained cryptococcal isolate was molecularly characterized by mating-type determination, amplified fragment length polymorphism (AFLP) fingerprinting, and multi-locus sequence typing (MLST). Phylogenetic analysis was performed to investigate the geographic origin of the cryptococcal isolate. The isolate was identified as Cryptococcus deuterogattii (AFLP6/VGII), mating-type α. Phylogenetic analysis showed that it was closely related to another C. deuterogattii isolate from the Middle East. CONCLUSIONS A second case of a C. deuterogattii infection in the Middle East is described. It is likely that the horse acquired the infection in the Middle East, as the isolate is closely related to that of a recent human case from that region.
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Affiliation(s)
- Jörg Kinne
- Central Veterinary Research Laboratory, Dubai, United Arab Emirates
| | - Marina Joseph
- Central Veterinary Research Laboratory, Dubai, United Arab Emirates
| | - Ulrich Wernery
- Central Veterinary Research Laboratory, Dubai, United Arab Emirates
| | - Nora Nogradi
- Dubai Equine Hospital, Dubai, United Arab Emirates
| | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
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Maccolini ÉO, Dufresne PJ, Aschenbroich SA, McHale B, Fairbrother JH, Bédard C, Hébert JA. A DisseminatedCryptococcus gattiiVGIIa Infection in a Citron-Crested Cockatoo (Cacatua sulphurea citrinocristata) in Québec, Canada. J Avian Med Surg 2017. [DOI: 10.1647/2016-193] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Graham KJ, Brain PH, Spielman D, Martin PA, Allan GS, Malik R. Concurrent Infection with Cryptococcus Neoformans/Gattii Species Complex and Mycobacterium Avium Affecting the Subcutis and Bone of a Pelvic Limb in a Cat. J Feline Med Surg 2017; 13:776-80. [DOI: 10.1016/j.jfms.2011.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/08/2011] [Accepted: 03/14/2011] [Indexed: 10/17/2022]
Abstract
This paper describes a cat with severe localised infections with Cryptococcus neoformans/gattii species complex and Mycobacterium avium affecting the subcutis and underlying fascia and bone of the right pelvic limb. The simultaneous isolation of both pathogens in this patient was unexpected and posed unique issues concerning both diagnosis and clinical management. The aetiopathogenesis of this infection is discussed in relation to aspects of diagnosis and therapy.
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Affiliation(s)
- Karina J Graham
- North Shore Veterinary Specialist Centre, 64 Atchison Street, Crows Nest, Sydney, NSW 2065, Australia
| | - Philip H Brain
- Veterinary Specialist Centre, Delhi Road, Ryde, Sydney, 2113, Australia
| | - Derek Spielman
- Faculty of Veterinary Science, B14, The University of Sydney, 2006, Australia
| | - Patricia A Martin
- Faculty of Veterinary Science, B14, The University of Sydney, 2006, Australia
| | - Graeme S Allan
- Veterinary Imaging Associates, St Leonards, Sydney, 1590, Australia
| | - Richard Malik
- Centre for Veterinary Education, B22, The University of Sydney, 2006, Australia
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Intestinal Lesion in a Dog Due to Cryptococcus gattii Type VGII and Review of Published Cases of Canine Gastrointestinal Cryptococcosis. Mycopathologia 2016; 182:597-602. [DOI: 10.1007/s11046-016-0100-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
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Equine Pulmonary Cryptococcosis: A Comparative Literature Review and Evaluation of Fluconazole Monotherapy. Mycopathologia 2016; 182:413-423. [PMID: 27655152 DOI: 10.1007/s11046-016-0065-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 09/05/2016] [Indexed: 12/18/2022]
Abstract
Cryptococcus is the most common fungal respiratory pathogen in Australian horses, manifesting primarily as pulmonary granulomas. Disease severity at presentation is dependent on the athletic use of the horse. The diagnosis and estimation of disease severity are centred around clinical findings, cytological evaluation of respiratory tract secretions, diagnostic imaging, and antigen titre testing. Both the lateral flow assay and the latex cryptococcal antigen titre are used, and important similarities and differences between species are discussed. Cryptococcus gattii occurs with greater frequency than Cryptococcus neoformans in equine pulmonic cryptococcosis and can be successfully treated with enteral fluconazole monotherapy, with disease severity determining treatment length.
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Cryptococcus neoformans var. grubii-Induced Arthritis with Encephalitic Dissemination in a Dog and Review of Published Literature. Mycopathologia 2016; 181:595-601. [PMID: 27126588 DOI: 10.1007/s11046-016-0009-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/17/2016] [Indexed: 01/12/2023]
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Livet V, Javard R, Alexander K, Girard C, Dunn M. Cryptococcal nasopharyngeal polypoid mass in a cat. JFMS Open Rep 2015; 1:2055116915597238. [PMID: 28491377 PMCID: PMC5361995 DOI: 10.1177/2055116915597238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2015] [Indexed: 11/23/2022] Open
Abstract
Case summary An indoor 9-year-old castrated male domestic cat was referred with a 4 month history of increased upper airway noise. Computed tomography revealed a nasopharyngeal polypoid mass, which was removed endoscopically with basket forceps. Histopathology was compatible with a polypoid granulomatous pharyngitis with Cryptococcus-like organisms. This was supported by a positive serum latex cryptococcal antigen agglutination test (LCAT). Minimal inflammation of the nasal tissue was noted on histopathology, with no evidence of fungus. Following endoscopic removal of the mass, the patient was treated with systemic antifungal medication (itraconazole). One year after diagnosis, the LCAT titer was negative and the cat remained free of clinical signs. Relevance and novel information This case report emphasizes the importance of considering Cryptococcus species as a potential etiology in cats presented with signs of nasopharyngeal obstruction with an isolated nasopharyngeal polypoid mass, even if kept indoors.
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Affiliation(s)
- Véronique Livet
- Companion Animal Research Group, Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Romain Javard
- Companion Animal Research Group, Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Kate Alexander
- Companion Animal Research Group, Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Christiane Girard
- Companion Animal Research Group, Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Marilyn Dunn
- Companion Animal Research Group, Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
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Abstract
Understanding of the taxonomy and phylogeny of Cryptococcus gattii has been advanced by modern molecular techniques. C. gattii probably diverged from Cryptococcus neoformans between 16 million and 160 million years ago, depending on the dating methods applied, and maintains diversity by recombining in nature. South America is the likely source of the virulent C. gattii VGII molecular types that have emerged in North America. C. gattii shares major virulence determinants with C. neoformans, although genomic and transcriptomic studies revealed that despite similar genomes, the VGIIa and VGIIb subtypes employ very different transcriptional circuits and manifest differences in virulence phenotypes. Preliminary evidence suggests that C. gattii VGII causes severe lung disease and death without dissemination, whereas C. neoformans disseminates readily to the central nervous system (CNS) and causes death from meningoencephalitis. Overall, currently available data indicate that the C. gattii VGI, VGII, and VGIII molecular types more commonly affect nonimmunocompromised hosts, in contrast to VGIV. New, rapid, cheap diagnostic tests and imaging modalities are assisting early diagnosis and enabling better outcomes of cerebral cryptococcosis. Complications of CNS infection include increased intracranial pressure, severe neurological sequelae, and development of immune reconstitution syndrome, although the mortality rate is low. C. gattii VGII isolates may exhibit higher fluconazole MICs than other genotypes. Optimal therapeutic regimens are yet to be determined; in most cases, initial therapy with amphotericin B and 5-flucytosine is recommended.
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Headley SA, Di Santis GW, de Alcântara BK, Costa TC, da Silva EO, Pretto-Giordano LG, Gomes LA, Alfieri AA, Bracarense APFRL. Cryptococcus gattii-Induced Infections in Dogs from Southern Brazil. Mycopathologia 2015; 180:265-75. [PMID: 26025661 DOI: 10.1007/s11046-015-9901-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/13/2015] [Indexed: 12/12/2022]
Abstract
Cryptococcus gattii-induced cryptococcosis is an emerging infectious disease of humans and animals worldwide, with rare descriptions of this infection in domestic animals from Brazil. This study presents the findings associated with C. gattii in dogs from Londrina, Paraná, Southern Brazil. Two dogs, a 3-year-old, female German shepherd and a 6-year-old, male Boxer, were evaluated by a combination of pathological, mycological, and molecular diagnostic techniques. Significant pathological alterations included cryptococcal lymphadenitis, meningoencephalitis, tonsillitis, and rhinitis with nasal cryptococcomas in the German shepherd dog, while cryptococcal lymphadenitis and pneumonia were observed in the Boxer; both dogs had pseudocystic cryptococcosis. The mucicarmine histochemical stain readily identified the intralesional cryptococcal budding organisms in all affected tissues. Mycological culture and isolation confirmed the yeasts as C. gattii due to positive reaction with the L-canavanine glycine bromothymol blue agar. A PCR assay using the internal transcribed spacers (ITS)1 and ITS2 primers, which target the ITS1 and 2 regions including the 5.8S rRNA gene, amplified the desired amplicons; direct sequencing confirmed the isolate as C. gattii. ITS nucleotide differentiation demonstrated that the isolate forms part of the ITS type 4 Cryptococcus organisms which corresponds to the C. gattii VGII molecular subtype or the RAPD type 2 Cryptococcus organisms. Collectively, these findings confirmed the participation of C. gattii in the etiopathogenesis of the lesions observed in these dogs and expanded the epidemiological niche of this important mycotic agent to include Southern Brazil. It is noteworthy to mention that previous epidemiological studies have suggested that C. gattii-induced cryptococcosis is more frequently diagnosed in Northern relative to Southern Brazil, so these findings might suggest an expansion of the distribution of this agent within continental Brazil.
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Affiliation(s)
- Selwyn Arlington Headley
- Laboratory of Animal Pathology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, PR 445 Km 380, Campus Universitário, PO Box 10.011, Londrina, Paraná, 86057-970, Brazil,
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Maestrale C, Masia M, Pintus D, Lollai S, Kozel TR, Gates-Hollingsworth MA, Cancedda MG, Cabras P, Pirino S, D'Ascenzo V, Ligios C. Genetic and pathological characteristics of Cryptococcus gattii and Cryptococcus neoformans var. neoformans from meningoencephalitis in autochthonous goats and mouflons, Sardinia, Italy. Vet Microbiol 2015; 177:409-13. [PMID: 25840469 DOI: 10.1016/j.vetmic.2015.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/05/2015] [Accepted: 03/09/2015] [Indexed: 11/25/2022]
Abstract
In this study, we examined in Sardinia the brain of 555 autochthonous sheep, 50 goats, and 4 mouflons which were found affected by neurological signs. We found 6 goats and one mouflon with meningoencephalitis caused by Cryptococcus sp. There was no evidence of cryptococcal infections in any of the examined sheep. MLST genotyping on Cryptococcus sp. isolates identified Cryptococcus gatti genotype AFLP4/VGI and Cryptococcus neoformans var. neoformans genotype AFLP2/VNIV. Phylogenetically, all Cryptococcus gattii isolates fell within the autochthonous animal, human and environmental Mediterranean isolate cluster, forming a distinct branch along with environmental strains from Alicante, in the southern Mediterranean coast of Spain.
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Affiliation(s)
- Caterina Maestrale
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | - Mariangela Masia
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | - Davide Pintus
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | - Stefano Lollai
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | | | | | - Maria Giovanna Cancedda
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | - Pierangela Cabras
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | - Salvatore Pirino
- Università degli Studi di Sassari, Dipartimento di Medicina Veterinaria, via Vienna 1, 07100 Sassari, Italy.
| | - Vittoria D'Ascenzo
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | - Ciriaco Ligios
- Istituto Zooprofilattico Sperimentale della Sardegna, G.Pegreffi, via Duca degli Abruzzi 8, 07100 Sassari, Italy.
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Hagen F, Khayhan K, Theelen B, Kolecka A, Polacheck I, Sionov E, Falk R, Parnmen S, Lumbsch HT, Boekhout T. Recognition of seven species in the Cryptococcus gattii/Cryptococcus neoformans species complex. Fungal Genet Biol 2015; 78:16-48. [PMID: 25721988 DOI: 10.1016/j.fgb.2015.02.009] [Citation(s) in RCA: 452] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/12/2015] [Accepted: 02/15/2015] [Indexed: 02/08/2023]
Abstract
Phylogenetic analysis of 11 genetic loci and results from many genotyping studies revealed significant genetic diversity with the pathogenic Cryptococcus gattii/Cryptococcus neoformans species complex. Genealogical concordance, coalescence-based, and species tree approaches supported the presence of distinct and concordant lineages within the complex. Consequently, we propose to recognize the current C. neoformans var. grubii and C. neoformans var. neoformans as separate species, and five species within C. gattii. The type strain of C. neoformans CBS132 represents a serotype AD hybrid and is replaced. The newly delimited species differ in aspects of pathogenicity, prevalence for patient groups, as well as biochemical and physiological aspects, such as susceptibility to antifungals. MALDI-TOF mass spectrometry readily distinguishes the newly recognized species.
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Affiliation(s)
- Ferry Hagen
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands; Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Kantarawee Khayhan
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands; Department of Microbiology and Parasitology, Faculty of Medical Sciences, University of Phayao, Phayao, Thailand
| | - Bart Theelen
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands
| | - Anna Kolecka
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands
| | - Itzhack Polacheck
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - Edward Sionov
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel; Department of Food Quality & Safety, Institute for Postharvest and Food Sciences, Agricultural Research Organization, The Volcani Center, Bet Dagan, Israel
| | - Rama Falk
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel; Department of Fisheries and Aquaculture, Ministry of Agriculture and Rural Development, Nir-David, Israel
| | - Sittiporn Parnmen
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Teun Boekhout
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands; Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China; Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.
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47
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Siak MK, Paul A, Drees R, Arthur I, Burrows AK, Tebb AJ, Malik R. Otogenic meningoencephalomyelitis due to Cryptococcus gattii(VGII) infection in a cat from Western Australia. JFMS Open Rep 2015; 1:2055116915585022. [PMID: 28491355 PMCID: PMC5362871 DOI: 10.1177/2055116915585022] [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] [Accepted: 10/20/2014] [Indexed: 11/18/2022] Open
Abstract
Case summary A 7-year-old spayed domestic longhair cat from Perth, Western Australia, presented with left-sided head tilt, dysphonia, head shaking, inappetence and weight loss. A polypoid lesion had previously been removed from the external ear canal. Otitis media with extension into the external ear canal was suspected and investigated using video-otoscopy and computed tomography examination. Invasive disease with extension from the middle ear to the base of the skull, and intracranial extension into the caudal fossa and cranial cervical vertebral canal was detected. Cytology of external ear canal exudate showed capsulated budding yeasts and Cryptococcus gattii VGII was cultured. Treatment with amphotericin B infusions and oral fluconazole was prescribed, with nutritional support via oesophagostomy tube. The cat clinically recovered 12 months after treatment commenced. Relevance and novel information This case report describes the successful medical treatment of otogenic meningoencephalomyelitis due to C gattii (VGII) infection in a cat.
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Affiliation(s)
- Meng K Siak
- Animal Dermatology Clinic Perth, Murdoch Veterinary Hospital, School of Veterinary and Biomedical Science, Western Australia, Australia
| | - Amanada Paul
- Murdoch University Veterinary Hospital, School of Veterinary and Biomedical Science, Western Australia, Australia
| | - Randi Drees
- Vet CT Specialists, St John’s Innovation Centre, Cambridge, UK
| | - Ian Arthur
- Mycology Laboratory, PathWest Laboratory Medicine Western Australia (QEII Medical Centre), Nedlands, Western Australia, Australia
| | - Amanda K Burrows
- Animal Dermatology Clinic Perth, Murdoch Veterinary Hospital, School of Veterinary and Biomedical Science, Western Australia, Australia
| | - Anna J Tebb
- Western Australian Veterinary Emergency and Specialty, Success, Western Australia, Australia
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, New South Wales, Australia
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Trevijano-Contador N, Herrero-Fernández I, García-Barbazán I, Scorzoni L, Rueda C, Rossi SA, García-Rodas R, Zaragoza O. Cryptococcus neoformans induces antimicrobial responses and behaves as a facultative intracellular pathogen in the non mammalian model Galleria mellonella. Virulence 2015; 6:66-74. [PMID: 25531532 PMCID: PMC4603429 DOI: 10.4161/21505594.2014.986412] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/05/2014] [Accepted: 11/06/2014] [Indexed: 11/19/2022] Open
Abstract
Cryptococcus neoformans is an encapsulated opportunistic fungal pathogen that is found in multiple niches in the environment and that can cause fatal meningoencephalitis in susceptible patients, mainly HIV+ individuals. Cryptococcus also infects environmental hosts such as nematodes, insects and plants. In particular, C. neoformans can kill the lepidopteran Galleria mellonella, which offers a useful tool to study microbial virulence and drug efficacy. Galleria mellonella immunity relies on innate responses based on melanization, accumulation of antimicrobial peptides, and cellular responses as phagocytosis or multicellular encapsulation. In this work we have investigated the immune response of G. mellonella during cryptococcal infection. We found that G. mellonella infected with C. neoformans had a high lytic activity in their hemolymph. This response was temperature- and capsule-dependent. During interaction with phagocytic cells, C. neoformans behaved as an intracellular pathogen since it could replicate within hemocytes. Non-lytic events were also observed. In contrast to Candida species, C. neoformans did not induce melanization of G. mellonella after infection. Finally, passage of C. neoformans through G. mellonella resulted in changes in capsule structure as it has been also reported during infection in mammals. Our results highlight that G. mellonella is an optimal model to investigate innate immune responses against C. neoformans.
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Affiliation(s)
- Nuria Trevijano-Contador
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
| | - Inés Herrero-Fernández
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
| | - Irene García-Barbazán
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
| | - Liliana Scorzoni
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
- Laboratório de Micologia Clínica; Faculdade de Ciências Farmacêuticas; R. Expedicionários do Brasil, 1621, CEP. 14801–902, Araraquara, São Paulo, Brazil
| | - Cristina Rueda
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
| | - Suélen Andreia Rossi
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
- Laboratório de Micologia Clínica; Faculdade de Ciências Farmacêuticas; R. Expedicionários do Brasil, 1621, CEP. 14801–902, Araraquara, São Paulo, Brazil
| | - Rocío García-Rodas
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
| | - Oscar Zaragoza
- Mycology Reference Laboratory; National Center for Microbiology; Instituto de Salud Carlos III; Carretera Majadahonda-Pozuelo, Km2; Majadahonda, 28220, Madrid, Spain
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Abstract
Few among the millions of fungal species fulfill four basic conditions necessary to infect humans: high temperature tolerance, ability to invade the human host, lysis and absorption of human tissue, and resistance to the human immune system. In previously healthy individuals, invasive fungal disease is rare because animals' sophisticated immune systems evolved in constant response to fungal challenges. In contrast, fungal diseases occur frequently in immunocompromised patients. Paradoxically, successes of modern medicine have put increasing numbers of patients at risk for invasive fungal infections. Uncontrolled HIV infection additionally makes millions vulnerable to lethal fungal diseases. A concerted scientific and social effort is needed to meet these challenges.
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Affiliation(s)
- Julia R Köhler
- Division of Infectious Diseases, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Arturo Casadevall
- Departments of Microbiology and Immunology and Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine, New York, New York 10461
| | - John Perfect
- Division of Infectious Diseases, Duke Medical Center, Durham, North Carolina 27710
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50
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Souza V, Brandão C, Minto B, Estanislau C, Ranzani J, Babicsak V, Mamprim M, Rocha N, Ribeiro M. Pleuris associada à criptococose em cão: relato de caso. ARQ BRAS MED VET ZOO 2014. [DOI: 10.1590/1678-6842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A Criptococose é uma importante doença infecciosa fúngica, causada por uma levedura do gênero Cryptococcus, que acomete diferentes espécies inclusive o homem. Há poucos relatos na literatura sobre a criptococose pulmonar em cães. O presente trabalho relata um caso de criptococose em um cão apresentando alterações respiratórias, especialmente dispneia. O diagnóstico foi realizado por meio da citologia aspirativa, após toracotomia exploratória, sendo observado um quadro de pleuris grave. O paciente foi tratado durante 90 dias com itraconazol e apresentou, ao final do tratamento, a remissão completa dos sintomas relatados.
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