Disseminated histoplasmosis in a Bengal tiger (Panthera tigris)

HISTOPLASMOSIS IN NONDOMESTIC FELIDS: A REVIEW OF SIX CASES

One adult leopard (Panthera pardus) and five adult tigers (Panthera tigris) presented with a range of nonspecific clinical signs, including lethargy (6/6), mobility deficits (4/6), and hyporexia (3/6). Hematology and biochemistry revealed a hyperproteinemia characterized by hyperglobulinemia (4/6), hepatocellular enzyme activity increases (3/6), azotemia (3/6), leukocytosis (2/6), hyperbilirubinemia (2/6), or a combination of conditions. Further diagnostics and management varied with the presenting signs and clinicopathological findings, including supportive care, diagnostic imaging, and blastomyces urine antigen analyses. Two animals died, and four were euthanatized. Postmortem findings included granulomatous pneumonia (6/6), fibrinous pleural effusion (3/ 6), pericardial effusion (2/6), and diffuse icterus (1/6). Histopathology revealed round to oval structures with a thin clear wall and purple inclusions within cells of the mononuclear phagocyte system, consistent with Histoplasma capsulatum, in each animal. Disseminated histoplasmosis was found in five cases, with organisms present in the lung (5/5), liver (3/5), lymph nodes (3/5), spleen (2/5), bone marrow (2/5), thyroid (1/5), tongue (1/ 5), kidney (1/5), or a combination of organs. One tiger was found to have pulmonary histoplasmosis without evidence of disseminated infection. On the basis of clinical and pathological findings, histoplasmosis was diagnosed. This case series illustrates the difficulties in antemortem diagnosis of histoplasmosis on the basis of complete blood count, serum biochemistry profile, and antigen testing and underscores that histoplasmosis should be considered a differential diagnosis in any felid presenting with nonspecific clinical signs in endemic areas.

INTESTINAL HISTOPLASMOSIS IN A CAPTIVE REINDEER (RANGIFER TARANDUS), MISSOURI, USA

An infection with Histoplasma capsulatum was diagnosed in a farmed reindeer in Missouri, an endemic area for histoplasmosis, localized in the intestine. The intrahistiocytic organisms were identified in tissue sections using histologic methods and confirmed by immunohistochemistry. This is the first report of histoplasmosis in a reindeer or in any deer species.

Utility of antigen testing for the diagnosis of ocular histoplasmosis in four cats: a case series and literature review

Case series summary This case series describes the clinical utility of antigen testing for the diagnosis of feline ocular histoplasmosis. Four cats with suspected (n = 2) or confirmed (n = 2) ocular histoplasmosis are described: three from Oklahoma and one from California. In one case, serial urine antigen tests, as well as a serum antigen test for Histoplasma capsulatum, were negative; however, light microscopy identified microorganisms consistent with H capsulatum in ocular tissues at necropsy. In a further two cats with recurrent ocular histoplasmosis following long-term systemic antifungal therapy, Histoplasma species urine antigen concentrations were negative, but both cats improved clinically following systemic antifungal therapy and remained in apparent clinical remission after treatment cessation (9-16 months). The final cat displayed profound bilateral endophthalmitis; however, Histoplasma species antigen testing of vitreous humor and subretinal fluid from the left eye was negative. Intralesional organisms were detected on histopathology of both eyes, and H capsulatum was subsequently isolated and sequenced from tissue of one eye. Relevance and novel information These cases highlight the potential difficulty in definitively diagnosing ocular histoplasmosis in cats when conducting antigen testing of serum, urine and even ocular fluids. Although antigen testing has previously proven useful in the diagnosis of disseminated feline histoplasmosis, it may not be adequate in cats with only ocular signs.

Usefulness of the murine model to study the immune response against Histoplasma capsulatum infection

The present paper is an overview of the primary events that are associated with the histoplasmosis immune response in the murine model. Valuable data that have been recorded in the scientific literature have contributed to an improved understanding of the clinical course of this systemic mycosis, which is caused by the dimorphic fungus Histoplasma capsulatum. Data must be analyzed carefully, given that misinterpretation could be generated because most of the available information is based on experimental host-parasite interactions that used inappropriate proceedings, i.e., the non-natural route of infection with the parasitic and virulent fungal yeast-phase, which is not the usual infective phase of the etiological agent of this mycosis. Thus, due to their versatility, complexity, and similarities with humans, several murine models have played a fundamental role in exploring the host-parasite interaction during H. capsulatum infection.