1
|
Omura M, Satoh K, Tamura T, Komori A, Makimura K. Molecular epidemiological investigation of Cryptococcus spp. carried by captive koalas ( Phascolarctos cinereus) in Japan. Microbiol Spectr 2024; 12:e0290323. [PMID: 38411053 PMCID: PMC11210188 DOI: 10.1128/spectrum.02903-23] [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: 07/20/2023] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Cryptococcus neoformans and Cryptococcus gattii cause cryptococcosis, a systemic mycosis that infects a wide range of species. Recent molecular biological investigations have allowed for the genotyping of these species, providing more detailed information on their pathogenicity and infection routes. Koalas (Phascolarctos cinereus) are frequently colonized by Cryptococcus spp., but molecular epidemiological studies have yet to be conducted in Japan. Here, we conducted multi-locus sequence typing (MLST) analysis on Cryptococcus spp. colonization isolates obtained from all koalas kept in seven parks across Japan. Out of 46 koalas examined, 10 (22%) were positive for C. gattii and 3 (6.5%) were positive for C. neoformans. All C. gattii isolates belonged to molecular type VGI and were either sequence type (ST) 51 or a novel ST, and all C. neoformans isolates belonged to molecular type VNI and ST23. Despite the frequent movement of koalas between parks, the STs were relatively park-specific, suggesting that the floor of the rearing barns is a source of infection and may act as a reservoir. MLST analysis confirmed that C. gattii was transported, established, and spread by koalas in areas where C. gattii was not originally present. MLST analysis is considered useful in assessing the pathogenicity and tracing the transmission routes of Cryptococcus spp. carried by koalas.IMPORTANCEThis is the first study to conduct a multi-locus sequence typing analysis on Cryptococcus spp. carried by captive koalas in Japan. Cryptococcosis remains a globally high-fatality fungal infection in humans, and captive koalas are known to carry a high percentage of Cryptococcus spp. Through this research, the molecular types and transmission routes of Cryptococcus spp. carried by koalas have been elucidated, revealing the potential role of enclosure flooring as a reservoir. It has been confirmed that Cryptococcus gattii, which is not endemic in Japan, has become established through koalas and is spreading to new individuals in Japan. This study is believed to provide valuable insights into koala conservation and contribute to the One Health approach for Cryptococcosis, a zoonotic infection.
Collapse
Affiliation(s)
- Miki Omura
- Laboratory of Medical Mycology, Graduate School of Medicine, Teikyo University, Tokyo, Japan
| | - Kazuo Satoh
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Takashi Tamura
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Aya Komori
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Koichi Makimura
- Laboratory of Medical Mycology, Graduate School of Medicine, Teikyo University, Tokyo, Japan
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Galosi L, Falcaro C, Danesi P, Zanardello C, Berardi S, Biagini L, Attili AR, Rossi G. Atypical Mycosis in Psittacine Birds: A Retrospective Study. Front Vet Sci 2022; 9:883276. [PMID: 35647088 PMCID: PMC9135461 DOI: 10.3389/fvets.2022.883276] [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: 02/24/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
A retrospective study was conducted on parrots submitted from necropsy to the Department of Veterinary Pathology, School of Biosciences and Veterinary, University of Camerino, Italy, from 2007 to 2018. From a total of 2,153 parrots examined at post-mortem, four cases were diagnosed with atypical mycosis and were considered for determination of the fungus species by PCR. A Fischer's lovebird (Agapornis fischeri), Peach-faced lovebirds (Agapornis roseicollis), and two Blue and Gold Macaws (Ara ararauna) from four different aviaries died after some days of lethargy and ruffled feathers. Records of gross necropsy and histopathological exams (H&E, PAS, and Grocott stain) were described and biomolecular analyses were carried out. No specific gross lesions were appreciated at necropsy, while histopathology evidenced a systemic mycosis in several organs, particularly in the lungs. In affected organs, broad and non-septate hyphae, suggestive of mycoses, were observed. Molecularly, Mucor racemosus (Fischer's lovebird) and M. circinelloides (Peach-faced lovebirds) were identified from formalin-fixed and paraffin-embedded (FFPE) lung and liver tissue. In addition, Alternaria alternata and Fusicladium spp. (respectively in male and female Blue and Gold macaws) were identified in FFPE tissue from several organs; whereas the role of Mucor spp. as true pathogens is well-demonstrated, and the behavior of A. alternata and Fusicladium spp. in macaws as opportunistic pathogens have been discussed. To our knowledge, this report is the first one reporting mucormycosis caused by M. racemosus and M. circinelloides in lovebirds, and A. alternata and Fusicladium spp. in macaws.
Collapse
Affiliation(s)
- Livio Galosi
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
- *Correspondence: Livio Galosi
| | - Christian Falcaro
- Laboratory of Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Patrizia Danesi
- Laboratory of Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Claudia Zanardello
- Laboratory of Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Sara Berardi
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Lucia Biagini
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Anna-Rita Attili
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Giacomo Rossi
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| |
Collapse
|
4
|
Teman SJ, Gaydos JK, Norman SA, Huggins JL, Lambourn DM, Calambokidis J, Ford JKB, Hanson MB, Haulena M, Zabek E, Cottrell P, Hoang L, Morshed M, Garner MM, Raverty S. Epizootiology of a Cryptococcus gattii outbreak in porpoises and dolphins from the Salish Sea. DISEASES OF AQUATIC ORGANISMS 2021; 146:129-143. [PMID: 34672263 DOI: 10.3354/dao03630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cryptococcus gattii is a fungal pathogen that primarily affects the respiratory and nervous systems of humans and other animals. C. gattii emerged in temperate North America in 1999 as a multispecies outbreak of cryptococcosis in British Columbia (Canada) and Washington State and Oregon (USA), affecting humans, domestic animals, and wildlife. Here we describe the C. gattii epizootic in odontocetes. Cases of C. gattii were identified in 42 odontocetes in Washington and British Columbia between 1997 and 2016. Species affected included harbor porpoises Phocoena phocoena (n = 26), Dall's porpoises Phocoenoides dalli (n = 14), and Pacific white-sided dolphins Lagenorhynchus obliquidens (n = 2). The probable index case was identified in an adult male Dall's porpoise in 1997, 2 yr prior to the initial terrestrial outbreak. The spatiotemporal extent of the C. gattii epizootic was defined, and cases in odontocetes were found to be clustered around terrestrial C. gattii hotspots. Case-control analyses with stranded, uninfected odontocetes revealed that risk factors for infection were species (Dall's porpoises), age class (adult animals), and season (winter). This study suggests that mycoses are an emerging source of mortality for odontocetes, and that outbreaks may be associated with anthropogenic environmental disturbance.
Collapse
Affiliation(s)
- Sarah J Teman
- The SeaDoc Society, Karen C. Drayer Wildlife Health Center - Orcas Island Office, UC Davis School of Veterinary Medicine, Eastsound, WA 98245, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Olivares RWI, Mora KQ, Bass LG, Matamoros VC, Álvarez PP, Herrera FDR, Cortés DSZ. First report of a subcutaneous infection by Cryptococcus neoformans (former Cryptococcus neoformans var. grubii) in a cat in Costa Rica. Braz J Microbiol 2021; 52:2535-2540. [PMID: 34185280 DOI: 10.1007/s42770-021-00555-7] [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: 03/07/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022] Open
Abstract
This is a case report of a feline animal that presented with a skin infection on the neck from which Cryptococcus neoformans (former C. neoformans var. grubii) was isolated and identified. The cat presented two nodular tumors, approximately 2 cm in diameter, raised, solid, with a slightly irregular surface and a reddish color with white areas. Histologically, these tumors corresponded to granulomatous dermatitis and panniculitis with the presence of a large number of intralesional yeasts. From identification with biochemical and spectroscopic techniques of these lesion samples, it was determined that the etiological agent was C. neoformans. There is little information on this variety of Cryptococcus causing subcutaneous infection without involvement of other organs, and the presence of this pathogen in the few reports available has not been reliably determined. This is the first report of a cat affected by C. neoformans in Costa Rica.
Collapse
Affiliation(s)
- Roberto W I Olivares
- Servicio de Patología Diagnóstica LAPAVET-ESFA, Cátedra de Patología E Histología, Escuela de Medicina Y Cirugía Veterinaria San Francisco de Asís, Universidad Veritas, Vázquez de Coronado, San José, Costa Rica.
| | - Karla Quesada Mora
- Hospital ESFA, Universidad Veritas, Vázquez de Coronado, San José, Costa Rica
| | - Laura G Bass
- Servicio de Patología Diagnóstica LAPAVET-ESFA, Cátedra de Patología E Histología, Escuela de Medicina Y Cirugía Veterinaria San Francisco de Asís, Universidad Veritas, Vázquez de Coronado, San José, Costa Rica
| | | | - Paula Peña Álvarez
- Servicio de Patología Diagnóstica LAPAVET-ESFA, Cátedra de Patología E Histología, Escuela de Medicina Y Cirugía Veterinaria San Francisco de Asís, Universidad Veritas, Vázquez de Coronado, San José, Costa Rica
| | - Fernando D Robles Herrera
- Servicio de Patología Diagnóstica LAPAVET-ESFA, Cátedra de Patología E Histología, Escuela de Medicina Y Cirugía Veterinaria San Francisco de Asís, Universidad Veritas, Vázquez de Coronado, San José, Costa Rica
| | - Diego S Zúñiga Cortés
- Servicio de Patología Diagnóstica LAPAVET-ESFA, Cátedra de Patología E Histología, Escuela de Medicina Y Cirugía Veterinaria San Francisco de Asís, Universidad Veritas, Vázquez de Coronado, San José, Costa Rica
| |
Collapse
|
6
|
Florek M, Nawrot U, Korzeniowska-Kowal A, Włodarczyk K, Wzorek A, Woźniak-Biel A, Brzozowska M, Galli J, Bogucka A, Król J. An analysis of the population of Cryptococcus neoformans strains isolated from animals in Poland, in the years 2015-2019. Sci Rep 2021; 11:6639. [PMID: 33758319 PMCID: PMC7987961 DOI: 10.1038/s41598-021-86169-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/11/2021] [Indexed: 02/07/2023] Open
Abstract
Fungi belonging to the Cryptococcus neoformans/C. gattii species complex (CNGSC) are pathogens causing severe infections in humans and animals, that for humans may result in a mortality rate ranging up to 70%. The CNGSC is divided into eight major molecular types, that may differ in their virulence and susceptibility. In order to fully understand the epidemiology of cryptococcosis, it is important to study the world distribution and population structure of these pathogens. The present study is the first presenting a population of strains isolated in Poland and one of the few using a multi-species animal group as a source of the specimen. The pathogen was present in 2.375% of the tested animals. The URA5-RFLP and MALDI-TOF MS analyses have revealed that the population consisted exclusively of C. neoformans strains, with a predominance of major molecular type VNIV (C. neoformans var. neoformans). The MALDI-TOF MS was used to perform the CNGSC strains identification on both the species and sub-species level. Despite the fact that the animals providing the specimens were not treated with 5-fluorocytosine, around 10% of the tested population presented MIC values exceeding 64 mg/L, indicating the existence of the 5-fluorocytosine-resistant strains in the environment.
Collapse
Affiliation(s)
- Magdalena Florek
- Department of Pathology, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland.
| | - Urszula Nawrot
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211a, 50-556, Wrocław, Poland
| | - Agnieszka Korzeniowska-Kowal
- Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Katarzyna Włodarczyk
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211a, 50-556, Wrocław, Poland
| | - Anna Wzorek
- Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Anna Woźniak-Biel
- Department of Epizootiology and Clinic of Birds and Exotic Animals, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, pl. Grunwaldzki 45, 50-366, Wrocław, Poland
| | - Magdalena Brzozowska
- Referral Animal Hospital Strömsholm, Djursjukhusvägen 11, 73494, Strömsholm, Sweden
| | - Józef Galli
- Veterinary Laboratory Vetlab, Wodzisławska 6, 52-017, Wrocław, Poland
| | - Anna Bogucka
- Veterinary Laboratory Vetlab, Wodzisławska 6, 52-017, Wrocław, Poland
| | - Jarosław Król
- Department of Pathology, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Schmertmann LJ, Kan A, Mella VSA, Fernandez CM, Crowther MS, Madani G, Malik R, Meyer W, Krockenberger MB. Prevalence of cryptococcal antigenemia and nasal colonization in a free-ranging koala population. Med Mycol 2020; 57:848-857. [PMID: 30649397 DOI: 10.1093/mmy/myy144] [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: 09/13/2018] [Revised: 11/06/2018] [Accepted: 11/30/2018] [Indexed: 02/06/2023] Open
Abstract
Cryptococcosis, caused by environmental fungi in the Cryptococcus neoformans and Cryptococcus gattii species complexes, affects a variety of hosts, including koalas (Phascolarctos cinereus). Cryptococcal antigenemia and nasal colonization are well characterized in captive koalas, but free-ranging populations have not been studied systematically. Free-ranging koalas (181) from the Liverpool Plains region of New South Wales, Australia, were tested for cryptococcal antigenemia (lateral flow immunoassay) and nasal colonization (bird seed agar culture). Results were related to environmental and individual koala characteristics. Eucalypt trees (14) were also randomly tested for the presence of Cryptococcus spp. by bird seed agar culture. In sum, 5.5% (10/181) and 6.6% (12/181) of koalas were positive for antigenemia and nasal colonization, respectively, on at least one occasion. And 64.3% (9/14) of eucalypts were culture-positive for Cryptococcus spp. URA5 restriction fragment length polymorphism analysis identified most isolates as C. gattii VGI, while C. neoformans VNI was only found in one koala and one tree. Colonized koalas were significantly more likely to test positive for antigenemia. No associations between antigenemia or colonization, and external environmental characteristics (the relative abundance of Eucalyptus camaldulensis and season), or individual koala characteristics (body condition, sex, and age), could be established, suggesting that antigenemia and colonization are random outcomes of host-pathogen-environment interactions. The relationship between positive antigenemia status and a relatively high abundance of E. camaldulensis requires further investigation. This study characterizes cryptococcosis in a free-ranging koala population, expands the ecological niche of the C. gattii/C. neoformans species complexes and highlights free-ranging koalas as important sentinels for this disease.
Collapse
Affiliation(s)
- Laura J Schmertmann
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Hospital, Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Alex Kan
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Hospital, Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Valentina S A Mella
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Cristina M Fernandez
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Hospital, Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Mathew S Crowther
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - George Madani
- PO Box 3113, Hilltop, New South Wales 2575, Australia
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, Sydney, New South Wales, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Hospital, Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, Westmead, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark B Krockenberger
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.,Veterinary Pathology Diagnostic Services, B14, The University of Sydney, Sydney, New South Wales, Australia 2006
| |
Collapse
|
10
|
Schmertmann LJ, Irinyi L, Malik R, Powell JR, Meyer W, Krockenberger MB. The mycobiome of Australian tree hollows in relation to the Cryptococcus gattii and C. neoformans species complexes. Ecol Evol 2019; 9:9684-9700. [PMID: 31534685 PMCID: PMC6745847 DOI: 10.1002/ece3.5498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/26/2022] Open
Abstract
Cryptococcosis is a fungal infection caused by members of the Cryptococcus gattii and C. neoformans species complexes. The C. gattii species complex has a strong environmental association with eucalypt hollows (particularly Eucalyptus camaldulensis), which may present a source of infection. It remains unclear whether a specific mycobiome is required to support its environmental survival and growth. Conventional detection of environmental Cryptococcus spp. involves culture on differential media, such as Guizotia abyssinica seed agar. Next-generation sequencing (NGS)-based culture-independent identification aids in contextualising these species in the environmental mycobiome. Samples from 23 Australian tree hollows were subjected to both culture- and amplicon-based metagenomic analysis to characterize the mycobiome and assess relationships between Cryptococcus spp. and other fungal taxa. The most abundant genera detected were Coniochaeta, Aspergillus, and Penicillium, all being commonly isolated from decaying wood. There was no correlation between the presence of Cryptococcus spp. in a tree hollow and the presence of any other fungal genus. Some differences in the abundance of numerous taxa were noted in a differential heat tree comparing samples with or without Cryptococcus-NGS reads. The study expanded the known environmental niche of the C. gattii and C. neoformans species complexes in Australia with detections from a further five tree species. Discrepancies between the detection of Cryptococcus spp. using culture or NGS suggest that neither is superior per se and that, rather, these methodologies are complementary. The inherent biases of amplicon-based metagenomics require cautious interpretation of data through consideration of its biological relevance.
Collapse
Affiliation(s)
- Laura J. Schmertmann
- Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
| | - Laszlo Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
| | - Richard Malik
- Centre for Veterinary Education, Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
| | - Jeff R. Powell
- Hawkesbury Institute for the EnvironmentWestern Sydney UniversityPenrithNSWAustralia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
| | - Mark B. Krockenberger
- Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
| |
Collapse
|
11
|
Guess TE, Rosen JA, McClelland EE. An Overview of Sex Bias in C. neoformans Infections. J Fungi (Basel) 2018; 4:E49. [PMID: 29670032 PMCID: PMC6023476 DOI: 10.3390/jof4020049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 04/02/2018] [Accepted: 04/16/2018] [Indexed: 11/27/2022] Open
Abstract
Cryptococcosis, a fungal disease arising from the etiologic agent Cryptococcus neoformans, sickens a quarter of a million people annually, resulting in over 180,000 deaths. Interestingly, males are affected by cryptococcosis more frequently than females, a phenomenon observed for more than a half century. This disparity is seen in both HIV− (~3M:1F) and HIV⁺ (~8M:2F) populations of cryptococcal patients. In humans, male sex is considered a pre-disposing risk factor for cryptococcosis and males suffering from the disease have more severe symptoms and poorer outcomes. There are numerous observational, clinical and epidemiological studies documenting the male disadvantage in C. neoformans but with no further explanation of cause or mechanism. Despite being commonly acknowledged, little primary research has been conducted elucidating the reasons for these differences. The research that has been conducted, however, suggests sex hormones are a likely cause. Given that the sex difference is both prevalent and accepted by many researchers in the field, it is surprising that more is not known. This review highlights the data regarding differences in sexual dimorphism in C. neoformans infections and suggests future directions to close the research gap in this area.
Collapse
Affiliation(s)
- Tiffany E Guess
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN 37132, USA.
| | - Joseph A Rosen
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN 37132, USA.
| | - Erin E McClelland
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN 37132, USA.
| |
Collapse
|
12
|
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: 58] [Impact Index Per Article: 9.7] [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.
Collapse
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
| |
Collapse
|
13
|
Schunk RSK, Sitinas NE, Quesenberry KE, Grodio JL. Multicentric Cryptococcosis in a Congo African Grey Parrot (Psittacus erithacus erithacus). J Avian Med Surg 2017; 31:373-381. [DOI: 10.1647/2017-259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
14
|
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.
Collapse
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.
| |
Collapse
|
15
|
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]
|
16
|
Künzel F, Rebel-Bauder B, Kassl C, Leschnik M, Url A. Meningoencephalitis in cats in Austria: a study of infectious causes, including Encephalitozoon cuniculi. J Feline Med Surg 2017; 19:171-176. [PMID: 26662038 PMCID: PMC10816562 DOI: 10.1177/1098612x15621352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives Despite comprehensive diagnostics, the aetiology of meningoencephalitis (ME) in cats often remains undetermined. As a result of recently published surveys, Encephalitozoon cuniculi has gained growing importance in cats not only with ocular disorders, but also with central nervous system disease. Therefore, it was hypothesised that E cuniculi may be an underestimated pathogen in the development of feline non-suppurative and/or granulomatous ME. Methods As a first step, histopathological sections of the brain of cats with encephalopathy were retrospectively reviewed to identify cases of granulomatous ME. In a second step, an immunohistochemical screening for detection of E cuniculi was performed in cases with ME of unknown origin. Results In 59/89 (66.3%) cats with ME, an aetiologically relevant pathogen was detected. Forty-three of 89 (48.3%) cats had a diagnosis of feline infectious peritonitis. In 14/89 (15.7%) cats, protozoan cysts were identified and infection with Toxoplasma gondii was confirmed by immunohistochemistry (IHC) in all cases. In 2/89 (2.3%) cats with granulomatous ME, fungal organisms were identified. Thirty of 89 (33.7%) cats with ME of unknown origin that underwent IHC for the detection of E cuniculi remained negative. Conclusions and relevance The results of this study suggest that E cuniculi is unlikely to be directly associated with (non-suppurative and/or granulomatous) ME in cats in Austria.
Collapse
Affiliation(s)
- Frank Künzel
- Clinical Department of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | | | - Christine Kassl
- Statistics Austria, Consumer Health Information System (VIS), Vienna, Austria
| | - Michael Leschnik
- Clinical Department of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Angelika Url
- Department of Pathobiology, University of Veterinary Medicine, Vienna, Austria
| |
Collapse
|
17
|
Species in the Cryptococcus gattii Complex Differ in Capsule and Cell Size following Growth under Capsule-Inducing Conditions. mSphere 2016; 1:mSphere00350-16. [PMID: 28066814 PMCID: PMC5196034 DOI: 10.1128/msphere.00350-16] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/05/2016] [Indexed: 01/20/2023] Open
Abstract
Infections with the fungal pathogen Cryptococcus gattii have been increasing in recent years. Recently, four different species have been described within C. gattii, which correspond to four previously known molecular genotypes (VGI to VGIV). Examining traits related to infection and disease is important for determining whether these different species have clinical relevance. This study examined variation in attributes that are important for infecting and surviving in the host, including tolerance to various stresses, yeast cell size, and the amount of polysaccharide capsule that covers the cell. The cell size and capsule size were significantly different and inversely correlated across the species. Thermotolerance was highest in C. deuterogattii (VGII), the only species known to cause outbreaks, while most strains of the species C. bacillisporus (VGIII) and C. tetragattii (VGIV) grew poorly at 37°C. These findings argue for increased acceptance of the new species and may be useful for informing diagnosis and prognosis in clinical infection. Cryptococcus gattii causes invasive fungal infections that have been increasing in incidence and global distribution in recent years. The major molecular genotypes of C. gattii that were previously classified as VGI to VGIV have recently been described as four new species: C. gattii (VGI), C. deuterogattii (VGII), C. bacillisporus (VGIII), and C. tetragattii (VGIV). The main driver for their classification has been phylogeny, and phenotypic diversity has not yet been extensively characterized. This study examines variation in attributes related to virulence and pathogenicity, including capsule thickness, cell size, tolerance to temperature, oxidative and osmotic stress, and cell wall integrity. A capsule induction agar using diluted Sabouraud medium revealed significant differences in capsule and cell size across the C. gattii species complex and produced irregularly shaped elongated cells in a number of strains. C. gattii/VGI strains possessed the largest capsules of all species but had smaller cells, while C. deuterogattii/VGII strains possessed the largest cells of all species but had smaller capsules. Overall thermotolerance was highest in C. deuterogattii/VGII strains, while a number of C. bacillisporus/VGIII, and C. tetragattii/VGIV strains had substantially reduced growth at 37°C. There was no significant difference among species in their tolerances to oxidative or osmotic stresses, and there was no evidence for defects in cell wall integrity in strains producing irregular cells. These data support the division of the C. gattii species complex into distinctly identified species and suggest underlying reasons for their differences in virulence, epidemiology, and host preference. IMPORTANCE Infections with the fungal pathogen Cryptococcus gattii have been increasing in recent years. Recently, four different species have been described within C. gattii, which correspond to four previously known molecular genotypes (VGI to VGIV). Examining traits related to infection and disease is important for determining whether these different species have clinical relevance. This study examined variation in attributes that are important for infecting and surviving in the host, including tolerance to various stresses, yeast cell size, and the amount of polysaccharide capsule that covers the cell. The cell size and capsule size were significantly different and inversely correlated across the species. Thermotolerance was highest in C. deuterogattii (VGII), the only species known to cause outbreaks, while most strains of the species C. bacillisporus (VGIII) and C. tetragattii (VGIV) grew poorly at 37°C. These findings argue for increased acceptance of the new species and may be useful for informing diagnosis and prognosis in clinical infection.
Collapse
|
18
|
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.
Collapse
|
19
|
Cryptococcus gattii Type VGIIa Infection in Harbor Seals ( Phoca vitulina ) in British Columbia, Canada. J Wildl Dis 2016; 52:677-81. [PMID: 27243332 DOI: 10.7589/2015-11-299] [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: 11/20/2022]
Abstract
Cryptococcosis has been reported in marine mammals in the northeastern Pacific with increasing frequency in the last 15 yr. Although a variety of cetaceans have been diagnosed with cryptococcosis, Cryptococcus gattii has not been reported in pinnipeds. We document C. gattii VGIIa in a harbor seal ( Phoca vitulina ) pup and in an unrelated adult. Both animals were presented to Vancouver Aquarium's Marine Mammal Rescue Centre (VAMMRC) with generalized weakness, dehydration, respiratory compromise, minimally responsive mentation, and suboptimal body condition. Necropsy and histopathology findings were consistent in both animals and featured generalized lymphadenopathy, bronchopneumonia, and meningoencephalitis with intralesional yeast and fungemia. Cryptococcal serum antigen titers were ≥1,024 in both animals. Fungal culture of lung and lymph nodes confirmed C. gattii . Exposure was likely via inhalation prior to presentation to VAMMRC, and C. gattii infection was the proximate cause of death. This report expands the range of susceptible host species as C. gattii continues to emerge as a pathogen of concern in marine mammals in the northeastern Pacific.
Collapse
|
20
|
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.
Collapse
|
21
|
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: 460] [Impact Index Per Article: 51.1] [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.
Collapse
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.
| |
Collapse
|
22
|
Uchiumi K, Stowe DM, DeVanna JC, Willcox JL, Neel JA. Pathology in practice. Cryptococcus sp in a dog. J Am Vet Med Assoc 2014; 245:893-5. [PMID: 25285929 DOI: 10.2460/javma.245.8.893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Kaori Uchiumi
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607
| | | | | | | | | |
Collapse
|
23
|
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.
Collapse
|
24
|
Antifungal drug susceptibility and phylogenetic diversity among Cryptococcus isolates from dogs and cats in North America. J Clin Microbiol 2014; 52:2061-70. [PMID: 24696030 DOI: 10.1128/jcm.03392-13] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Molecular types of the Cryptococcus neoformans/Cryptococcus gattii species complex that infect dogs and cats differ regionally and with host species. Antifungal drug susceptibility can vary with molecular type, but the susceptibility of Cryptococcus isolates from dogs and cats is largely unknown. Cryptococcus isolates from 15 dogs and 27 cats were typed using URA5 restriction fragment length polymorphism analysis (RFLP), PCR fingerprinting, and multilocus sequence typing (MLST). Susceptibility was determined using a microdilution assay (Sensititre YeastOne; Trek Diagnostic Systems). MICs were compared among groups. The 42 isolates studied comprised molecular types VGI (7%), VGIIa (7%), VGIIb (5%), VGIIc (5%), VGIII (38%), VGIV (2%), VNI (33%), and VNII (2%), as determined by URA5 RFLP. The VGIV isolate was more closely related to VGIII according to MLST. All VGIII isolates were from cats. All sequence types identified from veterinary isolates clustered with isolates from humans. VGIII isolates showed considerable genetic diversity compared with other Cryptococcus molecular types and could be divided into two major subgroups. Compared with C. neoformans MICs, C. gattii MICs were lower for flucytosine, and VGIII MICs were lower for flucytosine and itraconazole. For all drugs except itraconazole, C. gattii isolates exhibited a wider range of MICs than C. neoformans. MICs varied with Cryptococcus species and molecular type in dogs and cats, and MICs of VGIII isolates were most variable and may reflect phylogenetic diversity in this group. Because sequence types of dogs and cats reflect those infecting humans, these observations may also have implications for treatment of human cryptococcosis.
Collapse
|
25
|
CRYPTOCOCCUS GATTIIOSTEOMYELITIS AND COMPOUNDED ITRACONAZOLE TREATMENT FAILURE IN A PESQUET'S PARROT (PSITTRICHAS FULGIDUS). J Zoo Wildl Med 2014; 45:127-33. [DOI: 10.1638/2013-0042r1.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
26
|
Paula DAD, Almeida ABFD, Cruz FSD, Furlan FH, Colodel EM, Sousa VR, Nakazato L, Dutra V. Occurrence and molecular characterization of cryptococcosis in dogs and cats in Mato Grosso, Brazil. PESQUISA VETERINARIA BRASILEIRA 2014. [DOI: 10.1590/s0100-736x2014000200012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cryptococcosis is an infection that affects humans and animals, the etiology is attributed to Cryptococcus neoformans variety neoformans, C. neoformans var. grubii and Cryptococcus gattii. The infection is common in dogs and cats, causing respiratory, neurological, cutaneous and ocular infections. Aiming to better understand the epidemiology of cryptococcosis in animals in the region, this paper describe the occurrence and characterization of the Cryptococcus species involved in this illness in pet animals at Mato Grosso State, Brazil. Clinical samples of four cases, two in cats and two dogs, were submitted for pathological, microbiological and molecular analysis. Microscopically, in three cases, tissue sections stained with hematoxylin and eosin had absence to severe granulomatous reaction composed by histiocytes, multinucleated cells and lymphocytes infiltration. In one case, citological imprint analysis showed similar inflammatory mainly mononuclear and lymphocyte cells infiltration. All cases had variable amounts of intracellular and extracellular fungal structures compatible with Cryptococcus sp. on Periodic Acid-Schiff (PAS) stain. All clinical samples were positive for culture on Sabouraud Dextrose Agar (SDA) and morphologically classified as Cryptococcus sp. The isolates were PCR positive for C. gatti, being confirmed by sequencing technique. The findings characterize the molecular species involved in animal infections in the region, and may contribute to future studies of the epidemiology of C. gattii.
Collapse
|
27
|
Affiliation(s)
- James A Lavely
- Department of Neurology and Neurosurgery, VCA Animal Care Center of Sonoma, 6470 Redwood Drive, Rohnert Park, CA 94928, USA.
| |
Collapse
|
28
|
Pennisi MG, Hartmann K, Lloret A, Ferrer L, Addie D, Belák S, Boucraut-Baralon C, Egberink H, Frymus T, Gruffydd-Jones T, Hosie MJ, Lutz H, Marsilio F, Möstl K, Radford AD, Thiry E, Truyen U, Horzinek MC. Cryptococcosis in cats: ABCD guidelines on prevention and management. J Feline Med Surg 2013; 15:611-8. [PMID: 23813826 PMCID: PMC11148960 DOI: 10.1177/1098612x13489224] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OVERVIEW Cryptococcosis is worldwide the most common systemic fungal disease in cats; it is caused by the Cryptococcus neoformans- Cryptococcus gattii species complex, which includes eight genotypes and some subtypes (strains) with varying geographical distribution, pathogenicity and antimicrobial susceptibility. Cats acquire the infection from a contaminated environment. The prognosis is favourable in most cases, provided a diagnosis is obtained sufficiently early and prolonged treatment is maintained. INFECTION Basidiospores are the infectious propagules of Cryptococcus species as they penetrate the respiratory system and induce primary infection. Asymptomatic colonisation of the respiratory tract is more common than clinical disease. Avian guanos, particularly pigeon droppings, offer favourable conditions for the reproduction of C neoformans. Both Cryptococcus species are associated with decaying vegetation. DISEASE SIGNS Cryptococcosis caused by C neoformans or C gattii is indistinguishable clinically. The disease can present in nasal, central nervous system (which can derive from the nasal form or occur independently), cutaneous and systemic forms. DIAGNOSIS An easy and reliable test for cryptococcosis diagnosis is antigen detection in body fluids. Only isolation and polymerase chain reaction allow identification of the species genotype. DISEASE MANAGEMENT Amphotericin B, ketoconazole, fluconazole and itraconazole have all been used to treat cats. Surgical excision of any nodules in the skin, nasal or oral mucosa assists recovery. Continued treatment is recommended until the antigen test is negative. PREVENTION Efficient preventive measures have not been demonstrated. Vaccines are not available.
Collapse
|
29
|
Abstract
Since their introduction as pets several decades ago, ferrets have become an increasingly popular household pet. Great strides have been made in improving their diet and understanding common diseases (eg, insulinoma, hyperadrenocorticism, lymphoma) that affect them. With the frequency with which these conditions are seen, it sometimes is easy to forget that ferrets can be affected by other diseases. Some of these diseases, such as cryptococcosis, are known, but may be increasing in incidence and range, whereas others, such as hypothyroidism and pure red cell aplasia, may be underrecognized or underreported. This review highlights new and emerging diseases not already well reviewed in the literature.
Collapse
Affiliation(s)
- Nicole R Wyre
- Section of Exotic Companion Animal Medicine and Surgery, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | | | | |
Collapse
|
30
|
Magalhães G, Saut JE, Beninati T, Medeiros A, Queiroz G, Tsuruta S, Krockenberger M, Headley S. Cerebral Cryptococcomas in a Cow. J Comp Pathol 2012; 147:106-10. [PMID: 22520822 DOI: 10.1016/j.jcpa.2012.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/09/2011] [Accepted: 01/02/2012] [Indexed: 10/28/2022]
|
31
|
Zoonotic diseases of common pet birds: psittacine, passerine, and columbiform species. Vet Clin North Am Exot Anim Pract 2012; 14:457-76, vi. [PMID: 21872782 DOI: 10.1016/j.cvex.2011.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Zoonotic transmission of disease from pet birds is uncommon, but there are some recognized dangers. Most notably, Chlamydophila psittaci can be transmitted from pet birds to humans. Allergic responses to pet birds, including pneumonitis and contact dermatitis, have also been documented. Bite wounds from pet birds are rarely reported but can cause trauma and develop infection. The other diseases discussed here are considered potential zoonotic diseases of pet birds because of either isolated reports of suspected but unconfirmed transmission to humans or from reports of wild conspecifics being reported to have the disease.
Collapse
|
32
|
Anholt RM, Stephen C, Copes R. Strategies for collaboration in the interdisciplinary field of emerging zoonotic diseases. Zoonoses Public Health 2012; 59:229-40. [PMID: 22273426 DOI: 10.1111/j.1863-2378.2011.01449.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The integration of the veterinary, medical and environmental sciences necessary to predict, prevent or respond to emerging zoonotic diseases requires effective collaboration and exchange of knowledge across these disciplines. There has been no research into how to connect and integrate these professions in the pursuit of a common task. We conducted a literature search looking at the experiences and wisdom resulting from collaborations built in health partnerships, health research knowledge transfer and exchange, business knowledge management and systems design engineering to identify key attributes of successful interdisciplinary (ID) collaboration. This was followed by a workshop with 16 experts experienced in ID collaboration including physicians, veterinarians and biologists from private practice, academia and government agencies. The workshop participants shared their perspectives on the facilitators and barriers to ID collaboration. Our results found that the elements that can support or impede ID collaboration can be categorized as follows: the characteristics of the people, the degree to which the task is a shared goal, the policies, practices and resources of the workplace, how information technology is used and the evaluation of the results. Above all, personal relationships built on trust and respect are needed to best assemble the disciplinary strength of the professions. The challenge of meeting collaborators outside the boundaries of one's discipline or jurisdiction may be met by an independent third party, an ID knowledge broker. The broker would know where the knowledge could be found, would facilitate introductions and would help to build effective ID teams.
Collapse
Affiliation(s)
- R M Anholt
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, AB, Canada.
| | | | | |
Collapse
|
33
|
Byrnes EJ, Bartlett KH, Perfect JR, Heitman J. Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals. Microbes Infect 2011; 13:895-907. [PMID: 21684347 PMCID: PMC3318971 DOI: 10.1016/j.micinf.2011.05.009] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 05/19/2011] [Accepted: 05/20/2011] [Indexed: 01/01/2023]
Abstract
Infectious fungi are among a broad group of microbial pathogens that has and continues to emerge concomitantly due to the global AIDS pandemic as well as an overall increase of patients with compromised immune systems. In addition, many pathogens have been emerging and re-emerging, causing disease in both individuals who have an identifiable immune defect and those who do not. The fungal pathogen Cryptococcus gattii can infect individuals with and without an identifiable immune defect, with a broad geographic range including both endemic areas and emerging outbreak regions. Infections in patients and animals can be severe and often fatal if untreated. We review the molecular epidemiology, population structure, clinical manifestations, and ecological niche of this emerging pathogen.
Collapse
Affiliation(s)
- Edmond J. Byrnes
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, USA
| | - Karen H. Bartlett
- School of Environmental Health, University of British Columbia, Vancouver, BC, Canada
| | - John R. Perfect
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Joseph Heitman
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
34
|
A decade of experience: Cryptococcus gattii in British Columbia. Mycopathologia 2011; 173:311-9. [PMID: 21960040 DOI: 10.1007/s11046-011-9475-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 09/02/2011] [Indexed: 12/31/2022]
Abstract
It has been over a decade since Cryptococcus gattii was first recognized as the causative organism of an outbreak of cryptococcosis on Vancouver Island, British Columbia. A number of novel observations have been associated with the study of this emergent pathogen. A novel genotype of C. gattii, VGIIa was described as the major genotype associated with clinical disease. Minor genotypes, VGIIb and VGI, are also responsible for disease in British Columbians, in both human and animal populations. The clinical major genotype VGIIa and minor genotype VGIIb are identical to C. gattii isolated from the environment of Vancouver Island. There is more heterogeneity in VGI, and a clear association with the environment is not apparent. Between 1999 and 2010, there have been 281 cases of C. gattii cryptococcosis. Risk factors for infection are reported to be age greater than 50 years, history of smoking, corticosteroid use, HIV infection, and history of cancer or chronic lung disease. The major C. gattii genotype VGIIa is as virulent in mice as the model Cryptococcus, H99 C. neoformans, although the outbreak strain produces a less protective inflammatory response in C57BL/6 mice. The minor genotype VGIIb is significantly less virulent in mouse models. Cryptococcus gattii is found associated with native trees and soil on Vancouver Island. Transiently positive isolations have been made from air and water. An ecological niche for this organism is associated within a limited biogeoclimatic zone characterized by daily average winter temperatures above freezing.
Collapse
|
35
|
Abstract
Infections caused by the emerging pathogen Cryptococcus gattii are increasing in frequency in North America. During the past decade, interest in the pathogen has continued to grow, not only in North America but also in other areas of the world where infections have recently been documented. This review synthesizes existing data and raises issues that remain to be addressed.
Collapse
Affiliation(s)
- Julie Harris
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS C-09, Atlanta, GA 30309 USA.
| | | | | |
Collapse
|
36
|
Trivedi SR, Sykes JE, Cannon MS, Wisner ER, Meyer W, Sturges BK, Dickinson PJ, Johnson LR. Clinical features and epidemiology of cryptococcosis in cats and dogs in California: 93 cases (1988–2010). J Am Vet Med Assoc 2011; 239:357-69. [DOI: 10.2460/javma.239.3.357] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
37
|
Ropstad EO, Leiva M, Peña T, Morera N, Martorell J. Cryptococcus gattii chorioretinitis in a ferret. Vet Ophthalmol 2011; 14:262-6. [PMID: 21733068 DOI: 10.1111/j.1463-5224.2011.00885.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Bilateral exudative chorioretinitis was diagnosed in an 18-month-old male neutered ferret (Mustela putorius furo) with a generalized Cryptococcus gattii infection confirmed by PCR. The animal was referred to the Ophthalmology Service of the Autonomous University of Barcelona (VTH-UAB) for acute onset blindness. Complete ophthalmic examination revealed absent menace response and dazzle reflex in both eyes (OU), as well as subretinal edema located in the tapetal fundus. At that time, the clinical ophthalmologic diagnosis was bilateral exudative chorioretinitis. Treatment with prednisone (0.5 mg/kg PO q24 h) was instituted in addition to the ongoing treatment with fluconazole (10 mg/kg PO q24 h). The following rechecks revealed secondary cataracts with subsequent lens subluxation and panretinal degeneration OU. Despite being blind and the poor prognosis of disseminate cryptococcosis, the patient remained active and in good body condition during 6 months after the initial diagnosis. At that time, the ferret showed ataxia, incontinence, and generalized pain. A magnetic resonance imaging study revealed a mass affecting the spine. The owners declined further investigations and the ferret was humanely euthanized. The postmortem histopathology confirmed the initial diagnosis of cryptococcosis and the presence of intraretinal Cryptococcus spp. To the authors' knowledge, this is the first report of Cryptococcus spp. induced exudative chorioretinitis in a ferret.
Collapse
Affiliation(s)
- Ernst-Otto Ropstad
- Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Servei d'Oftalmologia, Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | | | | | | |
Collapse
|
38
|
Morera N, Juan-Sallés C, Torres JM, Andreu M, Sánchez M, Zamora MÁ, Colom MF. Cryptococcus gattii infection in a Spanish pet ferret (Mustela putorius furo) and asymptomatic carriage in ferrets and humans from its environment. Med Mycol 2011; 49:779-84. [PMID: 21395475 DOI: 10.3109/13693786.2011.564216] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A domestic ferret (Mustela putorius furo) was presented with lymphadenopathy and acute bilateral blindness. Cytologic evaluation and biopsy of an affected lymph node revealed pyogranulomatous lymphadenitis with intralesional yeast consistent with Cryptococcus sp. Subsequent studies demonstrated Cryptococcus gattii serotype B VGI/AFLP4 as the causative agent. The ferret was treated with fluconazole and prednisone. After one month of therapy, an improvement of the clinical symptoms was detected although blindness persisted. Seven months after presentation, the disease progressed to a severe neurologic condition, and it was euthanized. Postmortem exam revealed disseminated cryptococcosis with prominent neurologic involvement. Nasal swabs of other ferrets and humans from the same household revealed that two ferrets and two humans to be asymptomatic carriers of the same strain of cryptococcus as the necropsied ferret. These findings stress the importance of veterinary diagnostic work with pets and epidemiological investigations for disease prevention in them and in their owners.
Collapse
|
39
|
Duncan C, Bartlett KH, Lester S, Bobsien B, Campbell J, Stephen C, Raverty S. Surveillance for Cryptococcus gattii in horses of Vancouver Island, British Columbia, Canada. Med Mycol 2011; 49:734-8. [PMID: 21375433 DOI: 10.3109/13693786.2011.560196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the last decade Cryptococcus gattii has emerged as an important human and animal pathogen in southwestern British Columbia (BC), Canada. When the disease initially emerged it was identified in humans and multiple animal species on the east coast of Vancouver Island. From fall 2003 until summer 2004, active surveillance was initiated to look for horses exposed to or infected with the organism by performing nasal cultures and serum antigen testing in horses residing within 10 km of known areas of environmental reservoirs of the fungus. Surveillance efforts were facilitated by local equine practitioners who were also encouraged to report clinical cases. Nasal colonization was identified in four of the 260 horses tested but none had a serum cryptococcal antigen titer. All positive horses were from the same geographic area near Duncan, BC. During the study period, a single horse was diagnosed with systemic cryptococcosis and euthanized; clinical and post mortem information is described. As this organism continues to disseminate in the Pacific Northwest it is important for veterinarians to be familiar with the disease as early diagnosis may enable more effective treatment.
Collapse
Affiliation(s)
- Colleen Duncan
- Department of Microbiology, Immunology, Pathology, Colorado State University, Fort Collins, CO, USA.
| | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Disease summary Cryptococcosis, principally caused by Cryptococcus neoformans and Cryptococcus gattii, is the most common systemic mycosis of cats worldwide. Cats may be infected following inhalation of spores from the environment, with the nasal cavity suspected as being the initial site of colonization and subsequent infection. Other sites of infection in cats are the skin, lungs, lymph nodes, central nervous system (CNS), eyes and, occasionally, periarticular connective tissue. Cryptococcosis can be diagnosed using serology (antigen testing), cytologic examination of smears, histopathology or culture. Treatment of localized disease is generally successful using azole antifungal drugs; however, cats with CNS involvement or disseminated disease require additional treatment with amphotericin B, with or without flucytosine. The prognosis is variable, depending on host and pathogen factors. Some cats require long-term (>1 year) treatment or indefinite therapy. Patient group Cats of any breed, gender and age may be affected. Retroviral status does not appear to be a risk factor for developing cryptococcosis and indoor cats are not protected from disease. Global importance Feline cryptococcosis occurs worldwide, but is most frequently reported in Australia, western Canada and the western United States. Species and molecular type vary in different geographical regions and may affect clinical presentation and antifungal susceptibility patterns. Clinical challenges Serologic tests that detect cryptococcal antigen in serum are sensitive and specific, but false negatives can occur in cats with localized disease. Long-term drug therapy can be expensive and has the potential for toxicity. The extent to which the pathogenicity and antifungal susceptibility is affected by molecular type is currently under study. Evidence base This review draws on recent literature relating to epidemiology, CNS involvement and advanced diagnostic imaging to update clinicians regarding research findings relevant to clinical practice.
Collapse
Affiliation(s)
- Sameer R Trivedi
- Animal Surgical and Emergency Center, 1535 S Sepulveda Blvd, Los Angeles, CA 90025, USA
| | - Richard Malik
- Centre for Veterinary Education, B22, The University of Sydney, NSW 2006, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Center for infectious Diseases and Microbiology, Westmead Millennium Institute, Sydney Medical School — Westmead Hospital, The University of Sydney, Westmead, NSW 2145, Australia
| | - Jane E Sykes
- Department of Medicine and Epidemiology, University of California, Davis, Davis, CA 95616, USA
| |
Collapse
|
41
|
Krockenberger MB, Lester SJ. Cryptococcosis--clinical advice on an emerging global concern. J Feline Med Surg 2011; 13:158-60. [PMID: 21338939 DOI: 10.1016/j.jfms.2011.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
42
|
Martins DB, Zanette RA, França RT, Howes F, Azevedo MI, Botton SA, Mazzanti C, Lopes STA, Santurio JM. Massive cryptococcal disseminated infection in an immunocompetent cat. Vet Dermatol 2010; 22:232-4. [PMID: 21182547 DOI: 10.1111/j.1365-3164.2010.00948.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
43
|
Jobbins SE, Hill CJ, D'Souza-Basseal JM, Padula MP, Herbert BR, Krockenberger MB. Immunoproteomic approach to elucidating the pathogenesis of cryptococcosis caused by Cryptococcus gattii. J Proteome Res 2010; 9:3832-41. [PMID: 20545298 DOI: 10.1021/pr100028t] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cryptococcosis caused by Cryptococcus gattii is a devastating disease of immunocompetent hosts with an incompletely understood pathogenesis. Utilizing an immunoproteomic approach in a naturally occurring koala model of disease, a number of key proteins and pathways are identified in the early and late pathogenesis of cryptococcosis for the first time. In particular, the thioredoxin system appears important in the pathogenesis of cryptococcosis caused by C. gattii VGII.
Collapse
Affiliation(s)
- Sarah E Jobbins
- The Faculty of Veterinary Science, the University of Sydney, Australia
| | | | | | | | | | | |
Collapse
|
44
|
Lockhart SR, Harris J. Cryptococcus gattii: Clinical Importance and Emergence in North America. CURRENT FUNGAL INFECTION REPORTS 2010. [DOI: 10.1007/s12281-010-0021-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
45
|
Krockenberger MB, Malik R, Ngamskulrungroj P, Trilles L, Escandon P, Dowd S, Allen C, Himmelreich U, Canfield PJ, Sorrell TC, Meyer W. Pathogenesis of pulmonary Cryptococcus gattii infection: a rat model. Mycopathologia 2010; 170:315-30. [PMID: 20552280 DOI: 10.1007/s11046-010-9328-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Accepted: 05/25/2010] [Indexed: 01/31/2023]
Abstract
A model of pulmonary cryptococcosis in immunocompetent rats was developed to better understand the virulence of Cryptococcus gattii. Six isolates were studied, representing four molecular genotypes (VGI-MATα, VGIIa-MATα, VGIIa-MAT a, VGIIb-MATα), obtained from Australia, Vancouver (Canada) and Colombia. These originated from human patients, a cat and the environment and were administered intratracheally (i.t.) or transthoracically into Fischer 344 or Wistar-Furth rats in doses varying from 10(4) to 10(7) colony-forming units (CFU) in 0.1 ml of saline. With the exception of animals given the VGIIa-MAT a isolate, rats consistently became ill or died of progressive cryptococcal pneumonia following i.t. doses exceeding 10(7) CFU. Affected lungs increased in weight up to tenfold and contained numerous circumscribed, gelatinous lesions. These became larger and more extensive, progressing from limited hilar and/or tracheal lesions, to virtually confluent gelatinous masses. Disease was localized to the lungs for at least 3-4 weeks, with dissemination to the brain occurring in some animals after day 29. The dose-response relationship was steep for two VGI isolates studied (human WM179, environmental WM276); doses up to 10(6) CFU i.t. did not produce lesions, while 10(7) or more yeast cells produced progressive pneumonia. Intratracheal inoculation of rats with C. gattii provides an excellent model of human pulmonary cryptococcosis in healthy hosts, mimicking natural infections. Disease produced by C. gattii in rats is distinct from that caused by C. neoformans in that infections are progressive and ultimately fatal.
Collapse
Affiliation(s)
- Mark B Krockenberger
- Faculty of Veterinary Science, Building B14, University of Sydney, Sydney, NSW, 2006, Australia
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Burns RE, Mohr FC. Pathology in practice. Severe chronic multifocal to coalescing granulomatous meningoencephalomyelitis, rhinitis and sinusitis, with intralesional yeasts consistent with Cryptococcus spp. J Am Vet Med Assoc 2010; 236:1069-70. [PMID: 20470067 DOI: 10.2460/javma.236.10.1069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Rachel E Burns
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.
| | | |
Collapse
|
47
|
Bartlett KH, Kidd SE, Kronstad JW. The emergence of Cryptococcus gattii in British Columbia and the Pacific Northwest. Curr Infect Dis Rep 2010; 10:58-65. [PMID: 18377817 DOI: 10.1007/s11908-008-0011-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
An unprecedented emergence of cryptococcal infections in animals and otherwise healthy humans was recognized in 1999 on the east coast of Vancouver Island, British Columbia. Unexpectedly, these infections were caused by Cryptococcus gattii, a species closely related to the AIDS-associated fungal pathogen Cryptococcus neoformans. Human cases have continued over the past 8 years and now total approximately 170 with eight deaths. Extensive environmental sampling, coupled with detailed molecular typing of isolates, revealed areas of permanent and transient colonization with primarily three genotypes of the fungus. C. gattii was found in air, soil, water, and in association with numerous tree species. Importantly, there is solid evidence for human-mediated dispersal of the pathogen, and C. gattii has now been detected in the environment on the mainland of British Columbia and in the Pacific Northwest. Associated animal and human cases are now being reported and further spread of the pathogen may be inevitable.
Collapse
Affiliation(s)
- Karen H Bartlett
- The Michael Smith Laboratories, University of British Columbia, 2185 East Mall, Vancouver, BC, V6T 1Z4, Canada
| | | | | |
Collapse
|
48
|
Eshar D, Mayer J, Parry NM, Williams-Fritze MJ, Bradway DS. Disseminated, histologically confirmedCryptococcusspp infection in a domestic ferret. J Am Vet Med Assoc 2010; 236:770-4. [DOI: 10.2460/javma.236.7.770] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
49
|
McGill S, Malik R, Saul N, Beetson S, Secombe C, Robertson I, Irwin P. Cryptococcosis in domestic animals in Western Australia: a retrospective study from 1995-2006. Med Mycol 2010; 47:625-39. [PMID: 19306217 DOI: 10.1080/13693780802512519] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
A retrospective study of cryptococcosis in domestic animals residing in Western Australia was conducted over an 11-year-period (from 1995 to 2006) by searching the data base of Murdoch University Veterinary Teaching hospital and the largest private clinical pathology laboratory in Perth. Cryptococcosis was identified in 155 animals: 72 cats, 57 dogs, 20 horses, three alpacas, two ferrets and a sheep. There was no seasonal trend apparent from the dates of diagnosis. Taking into account the commonness of accessions to Murdoch University, cats were five to six times more likely to develop this disease than dogs, and three times more likely than horses, while horses were almost twice as likely as dogs to become infected. Amongst the feline cohort, Ragdoll and Birman breeds were over-represented, while in dogs several pedigree breeds were similarly overrepresented. Dogs and horses tended to develop disease at an early age (one to five years), while cats were presented over a much wider range of ages. In cats and dogs the upper respiratory tract was the most common primary site of infection, while horses and alpacas tended to have lower respiratory involvement. The most striking finding of the study was the high frequency with which C. gattii was identified, with infections attributable to this species comprising 5/9 cats, 11/22 dogs, 9/9 horses and 1/1 alpaca, where appropriate testing was conducted. Preliminary molecular genotyping suggested that most of the C. gattii infections in domestic animals (9/9 cases) were of the VGII genotype. This contrasts the situation on the eastern seaboard of Australia, where disease attributable to C. gattii is less common and mainly due to the VGI genotype. C. gattii therefore appears to be an important cause of cryptococcosis in Western Australia.
Collapse
Affiliation(s)
- S McGill
- School of Veterinary and Biomedical Sciences, Murdoch University, Perth, Western Australia, Australia
| | | | | | | | | | | | | |
Collapse
|
50
|
Stewart AJ, Salazar T, Waldridge BM, Schumacher J, Welles EG, Hanson RR, Sartin EA, Lenz SD, Holland M, Beard DM. Multimodal treatment of recurrent sinonasal cryptococcal granulomas in a horse. J Am Vet Med Assoc 2009; 235:723-30. [PMID: 19751170 DOI: 10.2460/javma.235.6.723] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 7-year-old 509-kg (1,120-lb) Tennessee Walking Horse mare was evaluated because of bilateral mucosanguinous nasal discharge, intermittent right-sided epistaxis, and worsening dyspnea of 9 months' duration. CLINICAL FINDINGS Multiple masses in the nasopharynx were detected via endoscopic and radiographic examinations. Cytologic and histologic examinations of biopsy specimens of 1 mass revealed round yeasts with thick nonstaining capsules and occasional narrow-based budding that resembled cryptococcal organisms. TREATMENT AND OUTCOME Oral administration of fluconazole and organic ethylenediamine dihydriodide and intermittent intralesional injections with fluconazole, amphotericin B, and formalin resulted in resolution of lesions for a period of 2.5 years. The horse then developed exophthalmos, recurring clinical signs, and extensive nasopharyngeal masses. The masses were surgically debulked via a large frontonasal bone flap, and the horse was treated with IV injections of amphotericin B and long-term oral administration of fluconazole. Clinical signs did not recur in the following 2-year period. A presumptive diagnosis of cryptococcosis was made following cytologic and histologic evaluations of the masses; results of serologic analysis and fungal culture confirmed infection with Cryptococcus neoformans. CLINICAL RELEVANCE Cryptococcal infection of the upper respiratory tract in horses has previously been described as a uniformly fatal disease. As this case report illustrates, medical and surgical treatment of sinonasal cryptococcal granulomas in horses may be successful, but the importance of long-term follow-up and the potential for disease recrudescence should be considered. As efficacious antifungal agents become less expensive, their increased use will likely decrease mortality rates in horses with fungal infections.
Collapse
Affiliation(s)
- Allison J Stewart
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|