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van Dijk MAM, Buil JB, Tehupeiory-Kooreman M, Broekhuizen MJ, Broens EM, Wagenaar JA, Verweij PE. Azole Resistance in Veterinary Clinical Aspergillus fumigatus Isolates in the Netherlands. Mycopathologia 2024; 189:50. [PMID: 38864903 PMCID: PMC11169034 DOI: 10.1007/s11046-024-00850-5] [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: 01/19/2024] [Accepted: 03/14/2024] [Indexed: 06/13/2024]
Abstract
Aspergillus fumigatus is a saprophytic fungal pathogen that causes opportunistic infections in animals and humans. Azole resistance has been reported globally in human A. fumigatus isolates, but the prevalence of resistance in isolates from animals is largely unknown. A retrospective resistance surveillance study was performed using a collection of clinical A. fumigatus isolates from various animal species collected between 2015 and 2020. Agar-based azole resistance screening of all isolates was followed by in vitro antifungal susceptibility testing and cyp51A gene sequencing of the azole-resistant isolates. Over the 5 year period 16 (11.3%) of 142 A. fumigatus culture-positive animals harbored an azole-resistant isolate. Resistant isolates were found in birds (15%; 2/13), cats (21%; 6/28), dogs (8%; 6/75) and free-ranging harbor porpoise (33%; 2/6). Azole-resistance was cyp51A mediated in all isolates: 81.3% (T-67G/)TR34/L98H, 12.5% TR46/Y121F/T289A. In one azole-resistant A. fumigatus isolate a combination of C(-70)T/F46Y/C(intron7)T/C(intron66)T/M172V/E427K single-nucleotide polymorphisms in the cyp51A gene was found. Of the animals with an azole-resistant isolate and known azole exposure status 71.4% (10/14) were azole naive. Azole resistance in A. fumigatus isolates from animals in the Netherlands is present and predominantly cyp51A TR-mediated, supporting an environmental route of resistance selection. Our data supports the need to include veterinary isolates in resistance surveillance programs. Veterinarians should consider azole resistance as a reason for therapy failure when treating aspergillosis and consider resistance testing of relevant isolates.
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Affiliation(s)
- Marloes A M van Dijk
- Faculty of Veterinary Medicine, Utrecht University, 3584 CL, Utrecht, The Netherlands.
| | - Jochem B Buil
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Marlou Tehupeiory-Kooreman
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Marian J Broekhuizen
- Faculty of Veterinary Medicine, Utrecht University, 3584 CL, Utrecht, The Netherlands
| | - Els M Broens
- Faculty of Veterinary Medicine, Utrecht University, 3584 CL, Utrecht, The Netherlands
| | - Jaap A Wagenaar
- Faculty of Veterinary Medicine, Utrecht University, 3584 CL, Utrecht, The Netherlands
- Wageningen Bioveterinary Research, 8221 RA, Lelystad, The Netherlands
| | - Paul E Verweij
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
- Radboudumc-CWZ Center of Expertise for Mycology, 6525 GA, Nijmegen, The Netherlands
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Fawsitt J, Russell O, Alexander A, Peschard AL, Wong H, Kortum A. Clinical remission of feline sino-nasal aspergillosis despite evidence of persistent infection. JFMS Open Rep 2023; 9:20551169231201605. [PMID: 37799297 PMCID: PMC10548797 DOI: 10.1177/20551169231201605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Case summary Feline sino-nasal aspergillosis is a rare condition with only sparse heterogeneous reports in the literature regarding its treatment. This report describes the presentation, treatment and outcome of a cat with sino-nasal aspergillosis treated by meticulous debridement in combination with topical and systemic azole therapy. Diagnosis was based on MRI, in combination with rhinoscopic assessment and visualisation of fungal plaques, followed by histopathology, fungal culture and panfungal PCR. The cat was treated by debridement of fungal plaques via anterior rhinoscopy and frontal sinusotomy and local instillation of 1% clotrimazole solution, followed by a 4-week course of oral itraconazole. Histopathology confirmed fungal rhinitis and culture identified Aspergillus fumigatus and Aspergillus versicolor. Clinical remission was achieved after treatment; however, evidence of persistent infection was confirmed in the post-mortem examination 8 months after the cat was euthanased for unrelated reasons. Relevance and novel information Despite clinical remission, the persistence of fungal infection post mortem highlights the challenges of monitoring the response to treatment and illustrates that the resolution of clinical signs does not necessarily equate with a disease cure.
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Affiliation(s)
- Jack Fawsitt
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Oliver Russell
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Akash Alexander
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Anne-Lorraine Peschard
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Hannah Wong
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Andre Kortum
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
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Vekšins A. Feline upper respiratory tract disease – Computed tomography and laboratory diagnostic. Vet World 2022; 15:1880-1886. [PMID: 36185517 PMCID: PMC9394148 DOI: 10.14202/vetworld.2022.1880-1886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Upper respiratory tract disease (URTD) is prevalent in cats, and diagnosis can be challenging. This study aimed to determine the most common causes of cat URTD in Latvia and describe computed tomography (CT) and laboratory diagnostic findings.
Materials and Methods: The present retrospective study included a total of 94 cats who were diagnosed with URTD. All cats underwent CT, and 50 of them had additional diagnostic tests, such as histology and respiratory infection polymerase chain reaction (PCR) testing.
Results: The most common CT finding was rhinosinusitis (55.32%) followed by nasal neoplasia (26.6%) and nasopharyngeal polyp (14.89%), but in three cats, a cause of respiratory symptoms was larynx neoplasia, nasal dermoid cyst, and an oronasal fistula. PCR test showed that the most cause of rhinosinusitis was Mycoplasma felis. Nasopharyngeal polyp as the primary diagnosis was identified in 14 cats from 3 months to 6 years, with an average age of 1.85 ± 1.915 years, and 54% of cats were female. Nasal neoplasia as a primary CT diagnosis was determined in 25 cats at the age of 5–18 years, with an average age of 10.56 ± 3.416 years. Histology diagnosis included four types of neoplasia – squamous cell carcinoma, sarcoma, adenocarcinoma, and aplastic carcinoma.
Conclusion: This study describes the most common CT and laboratory findings in cats with URTD. Included information will be helpful for general veterinary practitioners and researchers and will update their knowledge on feline URTD.
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Affiliation(s)
- Armands Vekšins
- Clinical Institute, Faculty of Veterinary Medicine, Latvia University of Life Sciences and Technologies, Jelgava, Latvia
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Bartels C, Alvarez-Sanchez A, Ranganathan B, O’Neill TW, Townsend KL. Ventral cervical subcutaneous Aspergillus species fungal granuloma in a cat. JFMS Open Rep 2022; 8:20551169221121916. [PMID: 36157251 PMCID: PMC9500275 DOI: 10.1177/20551169221121916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary An 8-year-old domestic longhair cat was evaluated for a right ventral subcutaneous cervical mass. Serial bloodwork and contrast-enhanced cranial and thoracic CT initially lacked ethmoturbinate lysis and showed a progressive, vascularized, right ventral cervical mass involving local lymph nodes. The mass was removed surgically on two occasions. Histopathology and fungal culture were diagnostic for a recurring sclerosing fungal granuloma and pyogranulomatous and eosinophilic lymphadenitis, consistent with Aspergillus species. The cat was treated with oral itraconazole; however, owing to the owner’s non-compliance in administering the medication and disease progression, the cat was humanely euthanized 3 years after diagnosis. Relevance and novel information The development of a cervical subcutaneous fungal granuloma of Aspergillus species in a domestic longhair cat before obvious maxillary, orbital or ethmoturbinate lysis on initial diagnostics is rare and suggests an early onset of lymphatic or hematogenous spread from a suspected nidus of infection within the sinonasal cavity.
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Affiliation(s)
- Courtney Bartels
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - Alejandro Alvarez-Sanchez
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Bharadhwaj Ranganathan
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - T William O’Neill
- Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
- Digital Pathology, Charles River Laboratories, Ashland, OH, USA
| | - Katy L Townsend
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
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Liatis T, Theochari F, Kalogianni L, Soubasis N, Oikonomidis IL, Velegraki A, Psalla D, Triantafyllou E, Patsikas M, Polizopoulou Z. Brainstem phaeohyphomycosis due to Curvularia lunata (Cochliobolus lunatus) in a cat. Aust Vet J 2021; 99:273-278. [PMID: 33830496 DOI: 10.1111/avj.13067] [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: 10/20/2020] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/30/2022]
Abstract
A 13-year-old female neutered domestic short-hair cat was presented with chronic progressive vestibular ataxia, lethargy and anorexia. Clinical examination revealed bilateral mucopurulent nasal discharge. Neurological examination revealed obtundation, a right head tilt, ambulatory tetraparesis, generalised vestibular ataxia, decreased postural reactions in all limbs, right Horner's syndrome, spontaneous conjugate jerk rotatory nystagmus and right positional ventral strabismus. Neuroanatomical localisation was observed in the right central vestibular system. Computed tomography revealed a solitary ill-defined contrast-enhancing mass lesion at the level of the right cerebellopontine angle. Cerebrospinal fluid (CSF) analysis revealed mild mononuclear pleocytosis and fungal elements. CSF culture was positive for Curvularia spp. Further tests for underlying diseases were all negative. The cat was treated with antibiotic and antifungal treatment, but it deteriorated rapidly and was euthanased. Necropsy of the brainstem mass lesion revealed pyogranulomatous inflammation. Panfungal polymerase chain reaction (PCR) targeting the internal transcribed spacer (ITS) region and subsequent sequencing identified Curvularia lunata in the formalin fixed brain tissue. This is the first report of brainstem phaeohyphomycosis by Curvularia lunata (Pleosporales) in a cat. In addition, this is the first report among animal and humans where fungal elements of Curvularia lunata were found in the CSF cytology. Opportunistic fungal pathogens should be always considered within the differential diagnoses list in cats with neurological signs and advanced imaging findings compatible with solitary mass lesions in the brain. In feline patients with pyogranulomatous meningoencephalitis and a suspicion of a fungal aetiology, panfungal PCR for the ITS region and sequencing should be performed regardless of the absence of fungal elements in histopathology.
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Affiliation(s)
- T Liatis
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG, UK.,Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
| | - F Theochari
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
| | - L Kalogianni
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
| | - N Soubasis
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
| | - I L Oikonomidis
- Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, EH25 9RG, UK.,Diagnostic Laboratory, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
| | - A Velegraki
- Mycology Research Laboratory and UOA/HCPF Culture Collection, Microbiology Department, Medical School, National and Kapodistrian University of Athens, Athens, 115 27, Greece.,Mycology Laboratory, Biomedicine S.A., Athens, 115 25, Greece
| | - D Psalla
- Pathology Laboratory, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
| | - E Triantafyllou
- Vet Analyses - Veterinary Diagnostic Lab S.A., Larissa, 412 22, Greece
| | - M Patsikas
- Diagnostic Imaging Laboratory, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
| | - Z Polizopoulou
- Diagnostic Laboratory, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, 546 27, Greece
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Savelieff MG, Pappalardo L, Azmanis P. The current status of avian aspergillosis diagnoses: Veterinary practice to novel research avenues. Vet Clin Pathol 2018; 47:342-362. [DOI: 10.1111/vcp.12644] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | - Lucia Pappalardo
- Department of Biology, Chemistry and Environmental Sciences; American University of Sharjah; Sharjah United Arab Emirates
| | - Panagiotis Azmanis
- Dubai Falcon Hospital/Wadi Al Safa Wildlife Center; Dubai United Arab Emirates
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Backel K, Cain C. Skin as a marker of general feline health: Cutaneous manifestations of infectious disease. J Feline Med Surg 2017; 19:1149-1165. [PMID: 29068251 PMCID: PMC10816623 DOI: 10.1177/1098612x17735764] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Practical relevance: Infectious disease in feline patients often presents a diagnostic challenge. This article reviews the most relevant viral, bacterial and protozoal diseases and their cutaneous manifestations. Many of the diseases discussed have overlapping presentations or may mimic more common noninfectious disease processes. The purpose of the article is to reinforce knowledge of common and uncommon infectious diseases, help practitioners identify possible infectious dermatoses, create a comprehensive and prioritized differential list, and provide guidance for the diagnosis of these diseases. A working knowledge of these clinical syndromes is important if what is thought to be a case of a common disease does not respond to conventional management. AUDIENCE This review is aimed at veterinarians who treat cats and especially those with an interest in feline dermatology. Tables are included to allow the reader to formulate a concise list of differential diagnoses for clinically similar presentations. The diagnostic approach to a case of ulcerative facial dermatitis is reviewed in a Case Notes quiz. Evidence base: This article includes up-to-date information regarding dermatologic manifestations of less commonly encountered feline cutaneous infectious diseases. Information has been drawn from the published, peer-reviewed literature and the most recent textbook chapters with a particular aim of describing and differentiating clinical lesions and the diagnostic approach to cutaneous disease, especially in unusual cases.
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Affiliation(s)
- Katherine Backel
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Spruce Street, Philadelphia, PA 19104, USA
| | - Christine Cain
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Spruce Street, Philadelphia, PA 19104, USA
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Payne CL, Dark MJ, Conway JA, Farina LL. A retrospective study of the prevalence of calcium oxalate crystals in veterinary Aspergillus cases. J Vet Diagn Invest 2016; 29:51-58. [PMID: 27852812 DOI: 10.1177/1040638716672254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fungi in the genus Aspergillus are some of the most common fungal pathogens in veterinary species, primarily affecting the respiratory tract. In both human and veterinary cases, calcium oxalate crystals have been documented in sites of Aspergillus infection. Cases in multiple species (16 birds, 15 horses, 5 dogs, 1 ox, and 1 dolphin) were identified that had either positive cultures for Aspergillus sp., or had conidiophores present that could be identified as belonging to the genus Aspergillus. Histologic slides were examined to confirm the presence of oxalate crystals and how often they were identified on the original report. Calcium oxalate deposition was detected in 14 of 38 cases examined, including A. fumigatus, A. versicolor, A. niger, and unspecified Aspergillus sp. infections. Calcium oxalate crystals were identified in 11 of 16 avian cases, as well as in 1 of 1 bovine, 1 of 15 equine, and 1 of 5 canine cases. Crystals were described in only 3 of the 14 original pathology reports of these cases, indicating that identification and reporting of crystals in histologic specimens could be improved. All the tissues with crystals were respiratory tissues with air interfaces, including nasal sinus, trachea, syrinx, lung, and air sac. In cases with crystals identified on H&E-stained sections, crystals were frequently not present or were fewer in number in tissue sections stained with Gomori methenamine silver and periodic acid-Schiff. Routine polarization of slides of fungal infections, especially in the respiratory tract, should be considered to check for calcium oxalate crystals.
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Affiliation(s)
- Courtney L Payne
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Michael J Dark
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Julia A Conway
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Lisa L Farina
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
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