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Shubitz LF, Schlacks S, Vishkautsan P, Butkiewicz CD, Worthing KA. Posaconazole treatment of refractory coccidioidomycosis in dogs. J Vet Intern Med 2021; 35:2772-2777. [PMID: 34658074 PMCID: PMC8692207 DOI: 10.1111/jvim.16282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background The majority of dogs with coccidioidomycosis recover with administration of fluconazole or itraconazole, although some cases are refractory or the dogs do not tolerate administration of these medications. Objectives The objective was to describe the treatment outcomes and therapeutic monitoring of 8 dogs with refractory coccidioidomycosis treated with posaconazole. Animals Eight dogs with refractory coccidioidomycosis. Methods Retrospective case series. Medical records from Veterinary Specialty Center of Tucson were searched to identify dogs with refractory coccidioidomycosis that were treated with posaconazole. Clinical information and the results of monitoring trough serum posaconazole concentrations were retrieved. Results Eight dogs with refractory coccidioidomycosis were treated with 2.5 to 10 mg/kg per day of posaconazole. Six of 8 dogs recovered or developed clinical remission while administered posaconazole. Thirteen serum concentrations from 8 dogs tested were >1 μg/mL (range, 1.52 to >6 μg/mL) and the drug was well‐tolerated by 7 dogs. One dog required dosage reductions and treatment was ultimately discontinued because of hepatotoxicosis. Conclusions and Clinical Importance Posaconazole should be considered as a treatment option for dogs with refractory coccidioidomycosis. Monitoring of indicators of liver function or injury along with therapeutic drug monitoring is recommended to tailor dosage in the event of hepatic toxicosis.
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Affiliation(s)
- Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, Tucson, Arizona, USA.,Veterinary Specialty Center of Tucson, Tucson, Arizona, USA
| | | | | | | | - Kate A Worthing
- University of Arizona College of Veterinary Medicine, Oro Valley, Arizona, USA
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2
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Dellière S, Rivero-Menendez O, Gautier C, Garcia-Hermoso D, Alastruey-Izquierdo A, Alanio A. Emerging mould infections: Get prepared to meet unexpected fungi in your patient. Med Mycol 2020; 58:156-162. [PMID: 31111906 DOI: 10.1093/mmy/myz039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/01/2019] [Accepted: 04/05/2019] [Indexed: 01/19/2023] Open
Abstract
Invasive fungal diseases are increasing issues in modern medicine, where the human immunodeficiency virus (HIV) pandemic and the wider use of immunosuppressive drugs generate an ever-growing number of immunocompromised patients with an increased susceptibility to uncommon fungal pathogens. In the past decade, new species have been reported as being responsible for disseminated and invasive fungal diseases in humans. Among them, the following genera are rare but seem emerging issues: Scopulariopsis, Hormographiella, Emergomyces, Westerdykella, Trametes, Actinomucor, Saksenaea, Apophysomyces, and Rhytidhysteron. Delay in diagnosis, which is often the case in these infections, jeopardizes patients' prognosis and leads to increased mortality. Here we summarize the clinical and biological presentation and the key features to identify these emerging pathogens and we discuss the available antifungal classes to treat them. We focused on Pubmed to recover extensively reported human invasive cases and articles regarding the nine previously cited fungal organisms. Information concerning patient background, macroscopic and microscopic description and pictures of these fungal organisms, histological features in tissues, findings with commonly used antigen tests in practice, and hints on potential efficient antifungal classes were gathered. This review's purpose is to help clinical microbiologists and physicians to suspect, identify, diagnose, and treat newly encountered fungi in hospital settings.
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Affiliation(s)
- Sarah Dellière
- Université de Paris, Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Olga Rivero-Menendez
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Cécile Gautier
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Alexandre Alanio
- Université de Paris, Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France.,Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France.,Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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3
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Alonzi C, Ellis J, Corbetta D, Grau‐Roma L, Valls F. Disseminated phaeohyphomycosis in a dog with seizures and suspected hyperadrenocorticism in the United Kingdom. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Consuelo Alonzi
- Dick White Referrals (DWR)Station farm, London road, Six Mile BottomNewmarketCambridgeshireUK
- Anderson Moores Veterinary SpecialistsThe GranaryBunstead Barns, Poles laneHursleyWinchesterUK
| | - J Ellis
- Western Australian Veterinary Emergency and SpecialtyBeeliar driveSuccessWAAustralia
| | - D Corbetta
- School of Veterinary Medicine and ScienceThe University of NottinghamSutton Bonington CampusLeicestershireUK
| | - L Grau‐Roma
- School of Veterinary Medicine and ScienceThe University of NottinghamSutton Bonington CampusLeicestershireUK
| | - F Valls
- Dick White Referrals (DWR)Station farm, London road, Six Mile BottomNewmarketCambridgeshireUK
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Elad D. Disseminated canine mold infections. Vet J 2019; 243:82-90. [DOI: 10.1016/j.tvjl.2018.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 10/12/2018] [Accepted: 11/27/2018] [Indexed: 01/24/2023]
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Dedeaux A, Grooters A, Wakamatsu-Utsuki N, Taboada J. Opportunistic Fungal Infections in Small Animals. J Am Anim Hosp Assoc 2018; 54:327-337. [DOI: 10.5326/jaaha-ms-6768] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Opportunistic fungal infections have long been recognized as rare causes of disease in immunocompetent dogs and cats. Recently, the escalating use of multiagent immunosuppression protocols (especially those that include cyclosporine) has resulted in an increased number of patients with opportunistic fungal infection encountered by small animal practitioners and has altered the typical case phenotype. Based on histologic and cytologic features such as pigmentation, hyphal diameter, and distribution in tissue, these opportunistic mycoses can be placed into categories such as phaeohyphomycosis, hyalohyphomycosis, and eumycotic mycetoma. This review aims to summarize the clinical presentations, methods for diagnosis, treatment recommendations, and prognosis for both immunocompetent and immunosuppressed patients with opportunistic fungal infections. An example case description is included to illustrate the most common current clinical presentation.
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Affiliation(s)
- Andrea Dedeaux
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Amy Grooters
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Nobuko Wakamatsu-Utsuki
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Joseph Taboada
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
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Therapy of Non-Dermatophytic Mycoses in Animals. J Fungi (Basel) 2018; 4:jof4040120. [PMID: 30380772 PMCID: PMC6308939 DOI: 10.3390/jof4040120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 12/13/2022] Open
Abstract
This review focuses on aspects of antimycotic therapy specific to veterinary medicine. In the first part, drug availability, limited mostly by economic consideration but also by clinical applicability and specific adverse effects, is described for polyenes, 5 fluorocytosine, azoles, echinocandins and terbinafine. In the second part, current knowledge and experience in the treatment of selected fungal infections are overviewed. These mycoses include disseminated mold infections in small animals (dogs and cats) and avian species, upper respiratory tract infections of small animals (sino-nasal and sino-orbital aspergillosis) and horses (guttural pouch mycosis), eumycetoma, infections caused by dimorphic fungi, (blastomycosis, histoplasmosis, coccidioidomycosis, paracoccidioidomycosis and sporothrichosis) and by yeasts and yeast-like microorganism (Cryptococcus spp. and Malassezia pachydermatis).
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Lipovy B, Kocmanova I, Holoubek J, Hanslianova M, Bezdicek M, Rihova H, Suchanek I, Brychta P. The first isolation of Westerdykella dispersa in a critically burned patient. Folia Microbiol (Praha) 2018; 63:479-482. [DOI: 10.1007/s12223-018-0590-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/07/2018] [Indexed: 11/25/2022]
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Kawalilak LT, Chen AV, Roberts GR. Imaging characteristics of disseminated Geosmithia argillacea causing severe diskospondylitis and meningoencephalomyelitis in a dog. Clin Case Rep 2015; 3:901-6. [PMID: 26576269 PMCID: PMC4641471 DOI: 10.1002/ccr3.372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/24/2015] [Accepted: 08/13/2015] [Indexed: 11/23/2022] Open
Abstract
A 4-year-old male castrated Labrador Retriever presented for severe spinal pain. Radiographs and magnetic resonance imaging showed evidence of diskospondylitis and meningoencephalomyelitis. Blood culture revealed a Geosmithia argillacea fungal infection after DNA sequencing, initially misdiagnosed as Penicillium species. Geosmithia argillacea should be considered as a differential for disseminated fungal diskospondylitis.
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Affiliation(s)
- Lukas T Kawalilak
- Veterinary Clinical Sciences, Washington State University99164-7010, Pullman, Washington
| | - Annie V Chen
- Veterinary Clinical Sciences, Washington State University99164-7010, Pullman, Washington
| | - Greg R Roberts
- Veterinary Clinical Sciences, Washington State University99164-7010, Pullman, Washington
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First report of Westerdykella dispersa as a cause of an angioinvasive fungal infection in a neutropenic host. J Clin Microbiol 2014; 52:4407-11. [PMID: 25232159 DOI: 10.1128/jcm.02012-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Angioinvasive fungal infections (AFIs) are an important cause of morbidity and mortality among immunocompromised patients. However, clinicomicrobiological characteristics and treatment of many AFI agents remain poorly defined. We report the first human case of infection with Westerdykella dispersa, an emergent cause of AFI, which was successfully treated in a neutropenic pediatric patient.
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