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Fawsitt J, Russell O, Alexander A, Peschard AL, Wong H, Kortum A. Clinical remission of feline sino-nasal aspergillosis despite evidence of persistent infection. JFMS Open Rep 2023; 9:20551169231201605. [PMID: 37799297 PMCID: PMC10548797 DOI: 10.1177/20551169231201605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Case summary Feline sino-nasal aspergillosis is a rare condition with only sparse heterogeneous reports in the literature regarding its treatment. This report describes the presentation, treatment and outcome of a cat with sino-nasal aspergillosis treated by meticulous debridement in combination with topical and systemic azole therapy. Diagnosis was based on MRI, in combination with rhinoscopic assessment and visualisation of fungal plaques, followed by histopathology, fungal culture and panfungal PCR. The cat was treated by debridement of fungal plaques via anterior rhinoscopy and frontal sinusotomy and local instillation of 1% clotrimazole solution, followed by a 4-week course of oral itraconazole. Histopathology confirmed fungal rhinitis and culture identified Aspergillus fumigatus and Aspergillus versicolor. Clinical remission was achieved after treatment; however, evidence of persistent infection was confirmed in the post-mortem examination 8 months after the cat was euthanased for unrelated reasons. Relevance and novel information Despite clinical remission, the persistence of fungal infection post mortem highlights the challenges of monitoring the response to treatment and illustrates that the resolution of clinical signs does not necessarily equate with a disease cure.
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Affiliation(s)
- Jack Fawsitt
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Oliver Russell
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Akash Alexander
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Anne-Lorraine Peschard
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Hannah Wong
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
| | - Andre Kortum
- The Queen’s Veterinary School Hospital Cambridge University Veterinary School, Cambridge, UK
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Santi JP, Santos CRGR, dos Santos AS, Souza HJM. Intranasal clotrimazole spray 1% associated with oral itraconazole for nasal feline sporotrichosis: a case series. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2022; 44:e004821. [PMID: 35749092 PMCID: PMC9179194 DOI: 10.29374/2527-2179.bjvm004821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
Feline sporotrichosis is a major clinical problem among cats in Brazil and is also a neglected, but important, public health issue, due to its zoonotic potential. The nasal clinical form of the disease is particularly challenging, having treatment refractoriness and clinical signs relapse as common features. This case series study aimed to preliminarily describe the effects of the azolic antifungal drug, clotrimazole, as a topical 1% solution spray, together with per os itraconazole on inducing disease remission, as well as treatment tolerability and safety. Medical records of the Feline Medicine Service from the Universidade Federal Rural do Rio de Janeiro were reviewed, and 7 feline patients met the inclusion criteria (confirmatory diagnostic reached, available follow-up records, and use of intranasal clotrimazole 1% solution -1 spray per nostril every 24 hours- as adjunctive therapy to itraconazole - 100 mg/cat per os every 24 hours). Among these, 4 had a history of treatment refractoriness done until then. Follow-up records included clinical evaluation, along with complementary tests and owner reports on tolerability and occurrence of adverse reactions. All patients have undergone clinical remission within 60 days. Tolerability were satisfactory, and adverse reactions were only found on complementary tests (hepatic enzyme elevation), without clinical repercussion. The intranasal use of 1% clotrimazole solution has shown as a promising adjunctive therapy to itraconazole for feline nasal sporotrichosis, even in previous refractory cases.
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Affiliation(s)
- Julia Possebon Santi
- Veterinarian, Resident, Programa de Residência em Medicina Veterinária – Clínica Médica dos Gatos Domésticos. Departamento de Medicina e Cirurgia Veterinária (DMCV), Instituto de Veterinária (IV), Universidade Federal Rural do Rio de Janeiro (UFRJ). Seropédica, RJ, Brazil.
- Correspondence Julia Possebon Santi Departamento de Medicina e Cirurgia Veterinária, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro – UFRRJ Rodovia BR 465, Km 7, Campus Universitário, Bairro Zona Rural CEP 23897-000 - Seropédica (RJ), Brasil E-mail:
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Isabelle L, Vanessa BR, Philippe DJ. Rhinitis due to Aspergillus pseudoviridinutans in an orange-winged Amazon parrot ( Amazona amazonica). Med Mycol Case Rep 2020; 30:46-50. [PMID: 33304803 PMCID: PMC7708752 DOI: 10.1016/j.mmcr.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 11/19/2022] Open
Abstract
Species within the Aspergillus viridinutans complex are being increasingly recognized as pathogens of animals and humans. An orange-winged Amazon parrot (Amazona amazonica) was referred for a 6 month-history of a slowly developing swelling involving the right nostril. Abnormal physical exam findings included a mild firm swelling at the dorsolateral aspect of the right nostril with no nasal discharge. Computed tomographic examination showed mild deformation of the right naris and nasal conchae without distinct granuloma. A cryptic Aspergillus species in Aspergillus section Fumigati was cultivated and identified by PCR and comparative sequence analysis as Aspergillus pseudoviridinutans. Successful treatment was achieved using topical clotrimazole and systemic antifungals (itraconazole, terbinafine). This is the first report of A. pseudoviridinutans infection in a bird.
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Affiliation(s)
- Langlois Isabelle
- Centre Hospitalier Universitaire Vétérinaire (Langlois), Université de Montréal, Faculty of Veterinary Medicine, 3200 Sicotte St, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Barrs R Vanessa
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Dufresne J Philippe
- Laboratoire de santé publique du Québec (LSPQ), Institut national de santé publique du Québec, 20045 chemin Sainte-Marie, Sainte-Anne-de-Bellevue, QC, H9X 3R5, Canada
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Barrs VR, Talbot JJ. Fungal Rhinosinusitis and Disseminated Invasive Aspergillosis in Cats. Vet Clin North Am Small Anim Pract 2019; 50:331-357. [PMID: 31866094 DOI: 10.1016/j.cvsm.2019.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Fungal rhinosinusitis, including sinonasal aspergillosis (SNA) and sino-orbital aspergillosis (SOA), is the most common type of aspergillosis encountered in cats. Other focal forms of aspergillosis including disseminated invasive aspergillosis occur less frequently. SOA is an invasive mycosis that is increasingly recognized and is most commonly caused by Aspergillus felis, a close relative of Aspergillus fumigatus. SNA can be invasive or noninvasive and is most commonly caused by A fumigatus and Aspergillus niger. Molecular methods are required to correctly identify the fungi that cause SNA and SOA. SNA has a favorable prognosis with treatment, whereas the prognosis for SOA remains poor.
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Affiliation(s)
- Vanessa R Barrs
- City University of Hong Kong, Department of Infectious Diseases & Public Health, Jockey Club College of Veterinary Medicine, Kowloon, Hong Kong SAR, China.
| | - Jessica J Talbot
- Faculty of Veterinary Science, University Veterinary Teaching Hospital, Sydney, University of Sydney, Faculty of Science, Sydney School of Veterinary Science, Camperdown, New South Wales 2006, Australia
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Gagini T, Borba-Santos LP, Messias Rodrigues A, Pires de Camargo Z, Rozental S. Clotrimazole is highly effective in vitro against feline Sporothrix brasiliensis isolates. J Med Microbiol 2017; 66:1573-1580. [PMID: 28984226 DOI: 10.1099/jmm.0.000608] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Sporothrix brasiliensis, the most virulent species in the Sporothrix schenckii complex, is responsible for the ongoing epidemics of human and animal sporotrichosis in Brazil. Feline outbreaks are usually driven by S. brasiliensis and followed by extensive transmission to humans. Itraconazole is the first-line treatment for both feline and human sporotrichosis; however, reduced sensitivity is an emerging issue. Thus, we investigated the effect of the widely used antifungal clotrimazole - alone or in combination with itraconazole - against the pathogenic (yeast) form of feline and human S. brasiliensis isolates, in vitro. METHODOLOGY Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) values were determined for treatment with clotrimazole and itraconazole, as monotherapy or in combination. In addition, the effect of the drugs on neutral lipid levels and the yeast ultrastructure were evaluated by flow cytometry and transmission electron microscopy (TEM), respectively. RESULTS The MIC and MFC values show that clotrimazole was more effective than itraconazole against feline S. brasiliensis isolates, while human isolates were more sensitive to itraconazole. Similarly to itraconazole, treatment with clotrimazole induced statistically significant neutral lipid accumulation in S. brasiliensis yeasts, and treated yeasts displayed irregularities in the cell membrane and a thicker cell wall when observed by TEM. Clotrimazole increased the antifungal activity of itraconazole in combination assays, with a synergistic effect for two feline isolates. CONCLUSION The strong activity of clotrimazole against feline S. brasiliensis isolates suggests that this drug is potentially a new alternative for the treatment of feline sporotrichosis, alone or in combination with itraconazole.
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Affiliation(s)
- Thalita Gagini
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luana Pereira Borba-Santos
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Anderson Messias Rodrigues
- Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Zoilo Pires de Camargo
- Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Sonia Rozental
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Talbot JJ, Houbraken J, Frisvad JC, Samson RA, Kidd SE, Pitt J, Lindsay S, Beatty JA, Barrs VR. Discovery of Aspergillus frankstonensis sp. nov. during environmental sampling for animal and human fungal pathogens. PLoS One 2017; 12:e0181660. [PMID: 28792943 PMCID: PMC5549889 DOI: 10.1371/journal.pone.0181660] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/05/2017] [Indexed: 12/15/2022] Open
Abstract
Invasive fungal infections (IFI) due to species in Aspergillus section Fumigati (ASF), including the Aspergillus viridinutans species complex (AVSC), are increasingly reported in humans and cats. The risk of exposure to these medically important fungi in Australia is unknown. Air and soil was sampled from the domiciles of pet cats diagnosed with these IFI and from a nature reserve in Frankston, Victoria, where Aspergillus viridinutans sensu stricto was discovered in 1954. Of 104 ASF species isolated, 61% were A. fumigatus sensu stricto, 9% were AVSC (A. felis-clade and A. frankstonensis sp. nov.) and 30% were other species (30%). Seven pathogenic ASF species known to cause disease in humans and animals (A. felis-clade, A. fischeri, A. thermomutatus, A. lentulus, A. laciniosus A. fumisynnematus, A. hiratsukae) comprised 25% of isolates overall. AVSC species were only isolated from Frankston soil where they were abundant, suggesting a particular ecological niche. Phylogenetic, morphological and metabolomic analyses of these isolates identified a new species, A. frankstonensis that is phylogenetically distinct from other AVSC species, heterothallic and produces a unique array of extrolites, including the UV spectrum characterized compounds DOLD, RAIMO and CALBO. Shared morphological and physiological characteristics with other AVSC species include slow sporulation, optimal growth at 37°C, no growth at 50°C, and viriditoxin production. Overall, the risk of environmental exposure to pathogenic species in ASF in Australia appears to be high, but there was no evidence of direct environmental exposure to AVSC species in areas where humans and cats cohabitate.
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Affiliation(s)
- Jessica J Talbot
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jos Houbraken
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Jens C Frisvad
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Robert A Samson
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Sarah E Kidd
- National Mycology Reference Centre, Microbiology and Infectious Diseases, SA Pathology, Adelaide, South Australia, Australia
| | - John Pitt
- CSIRO Food Science, CSIRO, North Ryde, New South Wales, Australia
| | - Sue Lindsay
- Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia
| | - Julia A Beatty
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Vanessa R Barrs
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
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Taylor A, Peters I, Dhand NK, Whitney J, Johnson LR, Beatty JA, Barrs VR. Evaluation of Serum Aspergillus-Specific Immunoglobulin A by Indirect ELISA for Diagnosis of Feline Upper Respiratory Tract Aspergillosis. J Vet Intern Med 2016; 30:1708-1714. [PMID: 27581099 PMCID: PMC5032860 DOI: 10.1111/jvim.14567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/12/2016] [Accepted: 07/21/2016] [Indexed: 12/12/2022] Open
Abstract
Background Serological tests for diagnosis of aspergillosis in immunocompetent humans and animals are based on Aspergillus‐specific IgG (As‐IgG). In humans with chronic pulmonary aspergillosis, As‐IgA may be detectable even if IgG titers are negative. Cats with upper respiratory tract aspergillosis (URTA) have detectable As‐IgG, but their ability to mount an IgA response and its diagnostic utility are unknown. Objectives To determine whether serum As‐IgA can be detected in cats with URTA and evaluate its diagnostic utility alone or combined with As‐IgG. Animals Twenty‐three cats with URTA (Group 1), 32 cats with other respiratory diseases (Group 2), and 84 nonrespiratory controls (Group 3). Methods Serum As‐IgA and As‐IgG was measured by indirect ELISA. Optimal cutoff values were determined by receiver‐operating curve analysis. Sensitivity (Se) and specificity (Sp) for URTA diagnosis were determined. Results Serum IgA was detected in 91.3% of Group 1 cats. The Se of IgA detection was 78.3% and Sp was 96.9% for Group 2, 85.7% for Group 3 and 88.8% for Group 2 and 3 combined. Assay Se for IgG was 100% and Sp was 92.2%. Using combined IgA and IgG results at cutoffs optimized for Sp for IgA and Se for IgG and combined controls (Groups 2 and 3), Se for diagnosis was 100% and Sp was 91.4%. Conclusion and Clinical Importance Most cats with URTA have serum As‐IgA antibodies that can be detected by ELISA. Paired measurement of serum As‐IgA and IgG shows no benefit for diagnosis of feline URTA over IgG alone.
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Affiliation(s)
- A Taylor
- Faculty of Veterinary Science, University of Sydney, Sydney, NSW, Australia
| | - I Peters
- TDDS ltd., The Innovation Centre, University of Exeter, Devon, UK
| | - N K Dhand
- Faculty of Veterinary Science, University of Sydney, Sydney, NSW, Australia
| | - J Whitney
- Faculty of Veterinary Science, University of Sydney, Sydney, NSW, Australia
| | - L R Johnson
- School of Veterinary Medicine, University of California, Davis, CA
| | - J A Beatty
- Faculty of Veterinary Science, University of Sydney, Sydney, NSW, Australia
| | - V R Barrs
- Faculty of Veterinary Science, University of Sydney, Sydney, NSW, Australia.
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Whitney JL, Krockenberger MB, Day MJ, Beatty JA, Dhand NK, Barrs VR. Immunohistochemical Analysis of Leucocyte Subsets in the Sinonasal Mucosa of Cats with Upper Respiratory Tract Aspergillosis. J Comp Pathol 2016; 155:130-140. [PMID: 27576043 DOI: 10.1016/j.jcpa.2016.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/22/2016] [Accepted: 08/01/2016] [Indexed: 12/25/2022]
Abstract
Leucocyte populations in the sinonasal mucosa of cats with and without upper respiratory tract aspergillosis were compared using immunohistochemistry and computer-aided morphometry. Inflammation was identified in the nasal mucosa of all affected cats, comprising predominantly of lymphoplasmacytic infiltration of the lamina propria associated with epithelial proliferation and degeneration. There was intense and diffuse expression of class II antigens of the major histocompatibility complex, associated with sites of hyphal invasion with hyperplasia and ulceration of the epithelium adjacent to fungal elements. Significantly more CD79b(+) cells, total lymphocytes, immunoglobulin (Ig)-expressing cells and MAC387(+) cells infiltrated the epithelium and more IgG(+) cells and total Ig-expressing cells infiltrated the lamina propria in affected cats compared with controls. Importantly, the inflammatory profile in affected cats was not consistent with the T helper (Th)1 and Th17 cell-mediated response that confers protective acquired immunity against invasive aspergillosis in dogs and people and in murine models of the infection. This finding may help to explain the development of invasive aspergillosis in systemically immunocompetent cats.
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Affiliation(s)
- J L Whitney
- University of Sydney, Faculty of Veterinary Science, School of Life and Environmental Sciences, Sydney, Australia.
| | - M B Krockenberger
- University of Sydney, Faculty of Veterinary Science, School of Life and Environmental Sciences, Sydney, Australia
| | - M J Day
- School of Veterinary Sciences, University of Bristol, Langford, North Somerset, UK
| | - J A Beatty
- University of Sydney, Faculty of Veterinary Science, School of Life and Environmental Sciences, Sydney, Australia
| | - N K Dhand
- University of Sydney, Faculty of Veterinary Science, School of Life and Environmental Sciences, Sydney, Australia
| | - V R Barrs
- University of Sydney, Faculty of Veterinary Science, School of Life and Environmental Sciences, Sydney, Australia
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Leite-Filho R, Fredo G, Lupion C, Spanamberg A, Carvalho G, Ferreiro L, Driemeier D, Pavarini S, Sonne L. Chronic Invasive Pulmonary Aspergillosis in Two Cats with Diabetes Mellitus. J Comp Pathol 2016; 155:141-144. [DOI: 10.1016/j.jcpa.2016.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/10/2016] [Accepted: 06/22/2016] [Indexed: 11/26/2022]
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Tamborini A, Robertson E, Talbot JJ, Barrs VR. Sinonasal aspergillosis in a British Shorthair cat in the UK. JFMS Open Rep 2016; 2:2055116916653775. [PMID: 28491427 PMCID: PMC5362982 DOI: 10.1177/2055116916653775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2016] [Indexed: 12/02/2022] Open
Abstract
Case summary A 13-year-old, castrated male, British Shorthair cat presented for investigation of chronic, intermittent, bilateral epistaxis and stertor. CT revealed severe asymmetric bilateral intranasal involvement with extensive turbinate lysis, increased soft tissue attenuation and lysis of the sphenopalatine bone and cribriform plate. On retroflexed pharyngoscopy, a plaque-like mass occluded the choanae. Rostral rhinoscopic examination revealed extensive loss of nasal turbinates, necrotic tissue and mucosal fungal plaques in the left nasal cavity. The right nasal cavity was less severely affected. The nasal cavities were debrided extensively of plaques and necrotic tissue. Aspergillus fumigatus was isolated on fungal culture, and species identity was confirmed using comparative sequence analysis of the partial β-tubulin gene. On histopathology of nasal biopsies, there was ulcerative lymphoplasmacytic and neutrophilic rhinitis, and fungal hyphae were identified on nasal mucosa, consistent with a non-invasive mycosis. The cat was treated with oral itraconazole after endoscopic debridement, but signs relapsed 4.5 months from diagnosis. Residual left nasal fungal plaques were again debrided endoscopically and oral posaconazole was administered for 6 months. Fourteen months from diagnosis, the cat remains clinically well with mild intermittent left nasal discharge secondary to atrophic rhinitis. Relevance and novel information This is the first case of rhinoscopically confirmed sinonasal aspergillosis to be diagnosed in a cat in the UK. Endoscopic confirmation of resolution of infection is useful in cases where mild nasal discharge persists after treatment.
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Affiliation(s)
| | | | - Jessica J Talbot
- Faculty of Veterinary Science, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006 Australia
| | - Vanessa R Barrs
- Faculty of Veterinary Science, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006 Australia
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Barrs VR, Beatty JA, Dhand NK, Talbot JJ, Bell E, Abraham LA, Chapman P, Bennett S, van Doorn T, Makara M. Computed tomographic features of feline sino-nasal and sino-orbital aspergillosis. Vet J 2014; 201:215-22. [PMID: 24685469 DOI: 10.1016/j.tvjl.2014.02.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/27/2014] [Accepted: 02/10/2014] [Indexed: 12/16/2022]
Abstract
Feline upper respiratory tract aspergillosis (URTA) occurs as two distinct anatomical forms, namely, sino-nasal aspergillosis (SNA) and sino-orbital aspergillosis (SOA). An emerging pathogen, Aspergillus felis, is frequently involved. The pathogenesis of URTA, in particular the relationship between the infecting isolate and outcome, is poorly understood. In this study, computed tomography was used to investigate the route of fungal infection and extension in 16 cases (SNA n = 7, SOA n = 9) where the infecting isolate had been identified by molecular testing. All cases had nasal cavity involvement except for one cat with SNA that had unilateral frontal sinus changes. There was a strong association between the infecting species and anatomic form (P = 0.005). A. fumigatus infections remained within the sino-nasal cavity, while cryptic species infections were associated with orbital and paranasal soft-tissue involvement and with orbital lysis. Cryptic species were further associated with a mass in the nasal cavity, paranasal sinuses or nasopharynx. Orbital masses showed heterogeneous contrast enhancement, with central coalescing hypoattenuating foci and peripheral rim enhancement. Severe, cavitated turbinate lysis, typical of canine SNA, was present only in cats with SNA. These findings support the hypothesis that the nasal cavity is the portal of entry for fungal spores in feline URTA and that the route of extension to involve the orbit is via direct naso-orbital communication from bone lysis. Additionally, a pathogenic role for A. wyomingensis and a sinolith in a cat with A. udagawae infection are reported for the first time.
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Affiliation(s)
- V R Barrs
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia.
| | - J A Beatty
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia
| | - N K Dhand
- Farm Animal and Veterinary Public Health, Faculty of Veterinary Science, University of Sydney, Sydney, NSW 2570, Australia
| | - J J Talbot
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia
| | - E Bell
- University of Melbourne Veterinary Clinic and Hospital, Werribee, Vic. 3030, Australia
| | - L A Abraham
- University of Melbourne Veterinary Clinic and Hospital, Werribee, Vic. 3030, Australia
| | - P Chapman
- Veterinary Speciality and Emergency Centre, Levittown, 301 Veterans Highway, Philadelphia, PA, 19056, USA
| | - S Bennett
- Department of Veterinary Clinical Sciences, Murdoch University, Murdoch, WA 6150, Australia
| | - T van Doorn
- Department of Applied and Industrial Mycology, CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - M Makara
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia
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Talbot JJ, Johnson LR, Martin P, Beatty JA, Sutton DA, Billen F, Halliday CL, Gibson JS, Kidd S, Steiner JM, Ujvari B, Barrs VR. What causes canine sino-nasal aspergillosis? A molecular approach to species identification. Vet J 2014; 200:17-21. [PMID: 24559745 DOI: 10.1016/j.tvjl.2014.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 01/07/2014] [Accepted: 01/13/2014] [Indexed: 11/29/2022]
Abstract
On the basis of phenotypic identification methods, Aspergillus fumigatus is reported as the most commonly identified aetiological agent of canine sino-nasal aspergillosis (SNA). However, definitive identification of Aspergillus spp. using phenotypic features alone is unreliable. The aim of this study was to determine the molecular identities of fungal species causing SNA in dogs. Genomic DNA was extracted from 91 fungal isolates from 90 dogs diagnosed with SNA in Australia, the USA and Belgium, and the ITS1-5.8S-ITS2 ribosomal DNA and partial β-tubulin regions were sequenced. Eighty-eight of 91 (96.7%) isolates were identified as A. fumigatus and 3/91 (3.3%) belonged to Aspergillus section Nigri spp. (Aspergillus tubingensis: 2/91; Aspergillus uvarum: 1/91). These findings confirm that A. fumigatus is the most common aetiological agent of canine SNA. This is the first report to document a pathogenic role for A. tubingensis and A. uvarum in dogs.
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Affiliation(s)
- Jessica J Talbot
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
| | - Lynelle R Johnson
- Department of Medicine and Epidemiology, University of California, Davis, CA, USA
| | - Patricia Martin
- Veterinary Pathology Diagnostic Services, Faculty of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
| | - Julia A Beatty
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
| | - Deanna A Sutton
- Department of Pathology, University of Texas Health Science Center at San Antonio School of Medicine, San Antonio, TX, USA
| | - Frédéric Billen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Catriona L Halliday
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Justine S Gibson
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Sarah Kidd
- Mycology Unit, SA Pathology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Jörg M Steiner
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Beata Ujvari
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
| | - Vanessa R Barrs
- Valentine Charlton Cat Centre, Faculty of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia.
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Hartmann K, Lloret A, Pennisi MG, Ferrer L, Addie D, Belák S, Boucraut-Baralon C, Egberink H, Frymus T, Gruffydd-Jones T, Hosie MJ, Lutz H, Marsilio F, Möstl K, Radford AD, Thiry E, Truyen U, Horzinek MC. Aspergillosis in cats: ABCD guidelines on prevention and management. J Feline Med Surg 2013; 15:605-10. [PMID: 23813825 PMCID: PMC11148965 DOI: 10.1177/1098612x13489223] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
OVERVIEW Aspergillosis is a sporadic mycosis that occurs worldwide in mammals and birds and leads to a usually chronic, and only rarely acute, disease that mainly affects the nasal cavity and sinuses. INFECTION Aspergillus species infections are commonly associated with predisposing local or systemic factors. Local disease can spread and involve the central nervous system or the lungs. Some Aspergillus species can also disseminate, causing systemic infections. In contrast to dogs, in which (nasal) aspergillosis is relatively common, aspergillosis is rare in cats, but considered an emerging infection. CLINICAL SIGNS There are two clinical forms of aspergillosis in cats, the sinonasal form (characterised by signs of chronic nasal infection) and the newly emerging, more invasive sino-orbital form (characterised by signs of orbital and surrounding tissue invasion). Sino-orbital involvement has been described now in approximately half of the reported cases. DISEASE MANAGEMENT Treatment should consist of local and systemic antifungal therapy.
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Abstract
Nasal masses in the koala (Phascolarctos cinereus) are not uncommon and can be challenging to diagnose and treat. Differential diagnoses for nasal masses in the koala are cryptococcal granulomas, nasal polyps, nasal adenocarcinoma, and osteochondromatosis. This report describes successful surgical approaches for two adult koalas with nasal masses and includes photodocumentation and description of the anatomy of the koala nasal passages from the postmortem transverse sectioning of a normal koala head. Surgical removal of the nasal masses in these koalas resulted in a rapid resolution of clinical signs.
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Evaluation of serum galactomannan detection for diagnosis of feline upper respiratory tract aspergillosis. Vet Microbiol 2012; 162:180-5. [PMID: 23031342 DOI: 10.1016/j.vetmic.2012.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 08/28/2012] [Accepted: 09/06/2012] [Indexed: 11/21/2022]
Abstract
Measurement of serum galactomannan (GM), a polysaccharide fungal cell-wall component, is a non-invasive test for early diagnosis of invasive aspergillosis in humans. Feline upper respiratory tract (URT) aspergillosis is an emerging infectious disease in cats. Diagnosis requires biopsy for procurement of tissue specimens for cytological or histological detection of fungal hyphae and for fungal culture. The aim of this study was to evaluate serum GM measurement as a non-invasive diagnostic test for URT aspergillosis in cats. A one-stage, immunoenzymatic sandwich ELISA was used to detect serum GM in 4 groups of cats; Group 1 (URT aspergillosis) - confirmed URT aspergillosis (n=13, sinonasal aspergillosis (SNA) n=6 and sino-orbital aspergillosis (SOA) n=7), Group 2 (URT other) - other URT diseases (n=15), Group 3 (β-lactam) - cats treated with β-lactam antibiotics for non-respiratory tract disease (n=14), Group 4a - healthy young cats (≤ 1 y of age, n=28), Group 4b - healthy adult cats (>1 y of age, n=16). One cat with SNA and two cats with SOA caused by an Aspergillus fumigatus-mimetic species, tested positive for serum GM. For a cut-off optical density index of 1.5, the overall sensitivity and specificity of the assay was 23% and 78% respectively. False positive results occurred in 29% of cats in Group 3 and 32% of cats in Group 4a. Specificity increased to 90% when Groups 3 and 4a were excluded from the analysis. Overall, serum GM measurement has a poor sensitivity but is a moderately specific, non-invasive screening test to rule out infection in patients with suspected feline upper respiratory tract aspergillosis.
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Reed N, Gunn-Moore D. Nasopharyngeal disease in cats: 2. Specific conditions and their management. J Feline Med Surg 2012; 14:317-26. [PMID: 22511474 PMCID: PMC11132258 DOI: 10.1177/1098612x12444998] [Citation(s) in RCA: 13] [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
PRACTICAL RELEVANCE Nasopharyngeal disease is a common presenting problem in feline medicine. CLINICAL CHALLENGES The management of feline nasopharyngeal disease can be challenging at a number of levels. In many cases, a specific diagnosis may remain elusive. Some conditions may not be curable so owners need to understand the requirement for long-term management. In addition, treatment may be compromised by poor patient compliance. AUDIENCE This review, which is directed at any clinicians involved in the management of cats with nasopharyngeal disease, discusses acute rhinitis (cat 'flu) and a variety of conditions causing chronic rhinosinusitis/chronic nasopharyngeal disease. The intention is to assist treatment decision making by reviewing the most appropriate therapies from the options available for these patients. EVIDENCE BASE The information presented in this article is based on peer-reviewed publications and the clinical experience of the authors.
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Affiliation(s)
- Nicki Reed
- Royal (Dick) School of Veterinary Studies, Division of Veterinary Clinical Sciences, University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, Scotland, UK.
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Sinonasal and sino-orbital aspergillosis in 23 cats: Aetiology, clinicopathological features and treatment outcomes. Vet J 2012; 191:58-64. [DOI: 10.1016/j.tvjl.2011.02.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 01/26/2011] [Accepted: 02/02/2011] [Indexed: 12/13/2022]
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Foy DS, Trepanier LA. Antifungal treatment of small animal veterinary patients. Vet Clin North Am Small Anim Pract 2011; 40:1171-88. [PMID: 20933143 DOI: 10.1016/j.cvsm.2010.07.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Antifungal therapy has progressed significantly with the development of new drugs directed at various processes in fungal cell metabolism. Within veterinary medicine, treatment options for systemic mycoses remain limited to amphotericin B, ketoconazole, fluconazole, and itraconazole. However, newer triazoles, echinocandins, and lipid-based formulations of amphotericin B are now approved for use in humans. This article provides a comprehensive review of the antifungal medications available for veterinary patients, and includes a brief discussion of the newer, presently cost-prohibitive, antifungal therapies used for systemic mycoses in humans.
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Affiliation(s)
- Daniel S Foy
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA.
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Invasive mould infections of the naso-orbital region of cats: a case involving Aspergillus fumigatus and an aetiological review. J Feline Med Surg 2010; 12:714-23. [PMID: 20800212 DOI: 10.1016/j.jfms.2010.07.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2010] [Indexed: 12/31/2022]
Abstract
UNLABELLED CASE AND CONTEXT: This report describes a cat diagnosed with sinonasal-orbital Aspergillus fumigatus infection using advanced imaging, histopathology and culture. Aetiology, clinical aspects and treatment of this rare and devastating infection are discussed with reference to a literature review of invasive mould (ie, filamentous fungal) infections involving tissues of the naso-orbital region of cats. PRESENTATIONS Invasive fungal infections can present with different localisations (nasal passages, sinuses, orbits, subcutaneous space, palate, etc) depending on the species involved and its means of introduction into the tissues. Localised subcutaneous lesions (swellings, ulcerations, masses, nodules, etc), without concomitant signs of nasal/orbital disease, generally result from traumatic injuries and subsequent inoculation of fungal spores into the subcutaneous space. In contrast, naso-ocular involvement and concurrent signs of nasal disease (nasal discharge, sneezing, masses protruding from the nostrils) generally result from inhalation of spores, with subsequent spread of infection into the nasal planum or penetration of overlying bone and invasion of the subcutaneous space. Aspergillus species typically show such an invasion mechanism and frequently affect orbital tissues. Dematiaceous fungi (ie, filamentous fungi with brown/black hyphae) are reported to cause solitary, less invasive, slowly developing lesions, probably as a result of traumatic injuries with inoculation of fungal propagules. Accordingly, the subcutaneous space is more frequently primarily involved. TREATMENT AND OUTCOME Whatever the mould species, reported treatment options include surgery and a series of antifungal drugs. The outcome is frequently poor, especially for Aspergillus infections, although various measures can be taken to maximise the chances of success, as discussed in this report.
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Malik R, O'Brien C, Whitehead M. The fight against some formidable fungal foes. J Feline Med Surg 2010; 12:669-71. [PMID: 20800207 DOI: 10.1016/j.jfms.2010.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Smith LN, Hoffman SB. A case series of unilateral orbital aspergillosis in three cats and treatment with voriconazole. Vet Ophthalmol 2010; 13:190-203. [DOI: 10.1111/j.1463-5224.2010.00780.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Letters to the Editor. J Am Vet Med Assoc 2010; 236:162. [DOI: 10.2460/javma.236.2.162] [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]
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