Systemic candidiasis in a dog

Clinicopathological and diagnostic imaging findings in a dog with neurocandidiasis

Neurocandidiasis is systemic candidiasis with central nervous system involvement. This case report describes the clinical presentation, diagnostic test results, and histopathology of a dog with neurocandidiasis. A 3-year-old German shepherd dog was presented for a 3-day history of abnormal mentation, neck pain, and ataxia. Magnetic resonance imaging (MRI) scan of the brain revealed multifocal, small, round, intra-axial lesions within the forebrain. Examination of the cerebrospinal fluid revealed severe neutrophilic inflammation. Extensive testing for infectious diseases was negative. The dog was administered immunosuppressive doses of corticosteroids. The dog's clinical signs improved transiently but got worse 12 days after starting the treatment. Repeat MRI scan revealed multiple, intra-axial, target-like nodular lesions scattered throughout the brain parenchyma. In the temporal muscles, nodules were seen. Cytology of the fine needle aspirates of the nodules in the temporal muscles revealed a neutrophilic inflammation with hyalohyphomycosis. Postmortem examination was compatible with a severe systemic fungal infection. Candida albicans was isolated from the brain, kidney, and heart.

The pathology of canine mammary candidiasis with embolic dissemination in a dog

Candidiasis is a fungal disease caused by Candida albicans or other members of the genus Candida. Descriptions of candidiasis are comparatively reduced in veterinary relative to human medicine, with no cases of mammary candidiasis being identified in pet animals. This report presents the cytological, pathological, and molecular findings of mammary candidiasis with embolic dissemination in a postpartum dog. A 1-year-old, female Shih-tzu dog that had recently given birth was admitted to a veterinary teaching hospital in Southern Brazil after repeated episodes of intermittent mammary disease and a neurological syndrome. The dog was euthanized due to worsened clinical status and poor prognosis despite adequate clinical therapy and was submitted for routine post-mortem evaluation to determine the cause of the neurological manifestations. Cytological analysis of purulent mastitis identified intralesional fungal hyphae. Gross evaluation revealed multiple masses within the kidneys, liver, myocardium, pancreas, and brain. Routine histopathology and histochemistry identified fungal nephritis, hepatitis, myocarditis, pancreatitis, and encephalitis associated with intralesional fungal hyphae, frequently with fungal emboli and vasculitis. Pure cultures of C. albicans were obtained from fragments of the masses observed at the myocardium and kidneys, with the typical germ tube of C. albicans being identified by microscopic evaluation. A PCR assay that targeted the ITS1 and 4 generic regions of fungi, amplified the desired amplicon, and direct sequencing confirmed C. albicans. Immunohistochemical and molecular assays designed to identify common infectious disease pathogens of dogs did not confirm the participation of canine distemper virus, canine parvovirus, or canine adenovirus in the target tissues of this dog. These findings suggest that this dog suffered an initial cutaneous lesion, that probably served as portal of entry to the mammary gland, resulting in mammary candidiasis with subsequent embolic dissemination to multiple organs. This report represent the first description of mammary candidiasis in pet animals and probably one of the few pathological descriptions of mammary candidiasis in domestic animals. In this case, the cause of the fungal infection was probably associated with factors intrinsic to abdominal surgery, pregnancy, and the utilization of antibiotics.

Doenças do sistema nervoso central em cães

RESUMO: São descritas doenças do sistema nervoso central (SNC) em cães diagnosticadas no sertão da Paraíba. Os registros de necropsia de 1.205 cães foram revisados. Em 354 casos (29,38%) foram registrados história clínica de alterações do sistema nervoso. Duzentos e noventa e seis casos tiveram diagnóstico definitivo e 58 foram inconclusivos. As doenças infecciosas foram observadas em 59,60% (211/354) de casos que representam a principal causa de distúrbios neurológicos; 53% dos casos (186/354) foram representadas por doenças virais; 3,11% (11/354) foram de etiologia parasitária, 2,54% (9/354) foram causadas por bactérias e 1,41% (5/354) por fungos. Os agentes físicos representaram a segunda causa mais importante de transtornos do SNC com 9,89% (35/354) e os tumores a terceira causa com 5,93% (21/354). Outras alterações pouco frequentes foram alterações metabólicas secundárias a insuficiência hepática ou renal, representando 2,54% (9/354). Casos raros de hidrocefalia congênita foram observados, 1,41% (5/354). Os casos de manifestações neurológicas associadas a alterações vasculares, degenerativas e inflamatórias não infecciosas, muitas das quais uma causa específica não foi estabelecida representaram 4,24% (15/354); Estavam dentro das seguintes categorias de doenças: Infartos isquêmicos e hemorrágicos (6/15), necrose vascular fibrinoide (5/15), doença do disco intervertebral (2/15), meningoencefalite granulomatosa (1/15) e granuloma de colesterol (1/15). Os distúrbios do sistema nervoso central representam uma importante causa de morte ou eutanásia em cães na região semiárida da Paraíba. Os sinais clínicos variaram de acordo com o agente envolvido, localização e distribuição das lesões. O conhecimento dos principais agentes que pode afetar o SNC canino é importante ao fazer uma lista de diagnóstico diferencial.

Disseminated Candidiasis in a Young, Previously Healthy, Dog and Review of Literature

Background

The reports on disseminated candidiasis in dogs so far describe at least one predisposing factor. This case report, however, highlights candidiasis in a dog without any known predisposition.

Patient

A 1.5-year-old intact female Hovawart dog was presented with subcutaneous nodules and polyuria/polydipsia. An excisional biopsy revealed a chronic pyogranulomatous and necrotizing inflammation with mycotic structures. The patient became febrile and lethargic, and developed lameness.

Methods

A physical examination, blood tests, urinalysis, thoracic radiographs, abdominal ultrasonography of the abdomen, fine-needle aspiration biopsies, and a culture of a subcutaneous nodule aspirate were obtained. Selected sections of multiple organs were collected for routine histology postmortem. The isolate and a subcutaneous mass were subjected to molecular identification and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF–MS) analysis.

Results

Clinical, laboratory, and radiological findings were consistent with a granulomatous chronic systemic inflammation. Cytology and histology showed a pyogranulomatous and necrotizing inflammation with myriads of intra- and extra-cellular yeasts and extracellular hyphae. Culture yielded numerous yeast colonies, which appeared Candida albicans–like, but showed a negative serum test and a low identification in API 20 C AUX. Nucleic acid sequences showed homology with the C. albicans-type strain CBS 562. Multilocus sequence typing (MLST) resulted in a new type with designation DST121. The identification of the isolates was confirmed by MALDI-TOF–MS analysis.

Conclusion and Clinical Importance

Future MLST typing and investigation of virulence can provide further evidence whether this MLST-type is associated with clinical cases of disseminated candidiasis without an apparent predisposing condition.

Management of Candida guilliermondii joint infection in a dog

Background

Candida spp. are dimorphic fungi in the family Cryptococcaceae. Infections with Candida spp. are usually rare conditions in dogs, but immunocompromised patients have a higher risk for developing invasive candidal infections.

Case presentation

A 5-year-old male Boxer, positive to Leishmania infantum, was referred to the Veterinary Teaching Hospital of the Department of Veterinary Medicine, University of Perugia, Italy for examination of a non-weight bearing left hind limb lameness of a duration of at least 3 months. During this period, treatment involved systemic anti-inflammatory medications and intra-articular corticosteroid administration. On presentation, clinical examination and radiographic findings were suggestive of cranial cruciate ligament deficiency. To support this diagnosis a stifle arthroscopy was performed: it confirmed a partial rupture of cranial cruciate ligament. Samples culture of synovial fluid and membrane was routinely collected as well, and revealed Candida guilliermondii joint infection. Treatment for the C. guilliermondii joint infection involved systemic anti-fungal therapy, joint lavage and intra-articular administration of antifungal drugs. Lameness improved markedly during this treatment, but lameness did not resolve completely, probably due to cranial cruciate ligament deficiency. Tibial tuberosity advancement (TTA) was chosen in order to treat stifle instability and was performed 4 weeks following cessation of treatment of the C. guilliermondii joint infection. Six month after TTA the dog showed a completely recovery with no lameness.

Conclusions

To the authors’ knowledge, this is the first case of Candida spp. joint infection reported in dogs. The cause of the progression of the joint C. guilliermondii infection remains unclear but it may be associated with leishmaniasis or intra-articular corticosteroid injections. Treatment with systemic and intra-articular anti-fungal therapies was successful. In the evaluation of hind limb lameness in a chronically immunocompromised dog, it would be advisable to consider also an intra-articular Candida spp. infection.

Isolation and comparative investigation of vaginal mycoflora in feline population of urban and dairy cattle herds

OBJECTIVE

The aim of this work was to identify the predominant fungal species present at vaginal site in different healthy cats including households, stray and cats in industrial dairy cattle herds.

MATERIALS AND METHODS

Fungal isolates of vaginal fluids of 100 cats were collected using the sterilized cotton swabs from discharges of vagina. The isolates were identified according to their morphological characteristics and biochemical profile. Were included 34%, 33% and 33% households, stray cats and cats of industrial dairy cattle herds of Mashhad-Iran, respectively. They were short hair cats.

RESULT

Vaginal fungi were isolated from 69% of feline population. Fungal isolates were obtained from vagina of 22%, 25% and 22% of households, stray cats and cats of industrial dairy cattle herds, respectively. There were no significant differences among the cats. The highest fungal agent was recovered in cats of 1-2 years old. Twenty two different isolates were recovered in this study. The most frequently recovered species samples were Penicillum spp. (11%) followed by Aspergillus section Nidulanti (4%). However, the vagina of healthy cats could be contaminated by 2-4 different fungal agents.

CONCLUSION

It is concluded that fungal infections can occur in vaginal cavity of different healthy kinds of cats.

Gastrointestinal granuloma due to Candida albicans in an immunocompetent cat

A 3.5 year-old cat was admitted to the University of Melbourne Veterinary Teaching Hospital for chronic vomiting. Abdominal ultrasonography revealed a focal, circumferential thickening of the wall of the duodenum extending from the pylorus aborally for 3 cm, and an enlarged gastric lymph node. Cytology of fine-needle aspirates of the intestinal mass and lymph node revealed an eosinophilic inflammatory infiltrate and numerous extracellular septate acute angle branching fungal-type hyphae. Occasional hyphae had globose terminal ends, as well as round to oval blastospores and germ tubes. Candida albicans was cultured from a surgical biopsy of the duodenal mass. No underlying host immunodeficiencies were identified. Passage of an abrasive intestinal foreign body was suspected to have caused intestinal mucosal damage resulting in focal intestinal candidiasis. The cat was treated with a short course of oral itraconazole and all clinical signs resolved.

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The first case of intestinal candidiasis in a cat.

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A focal intestinal fungal granuloma caused vomiting and weight loss.

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Candida albicans was isolated from the granuloma.

Disseminated Protothecosis Associated With Diskospondylitis in a Dog

A 6 yr old female Labrador retriever was evaluated for an acute onset of difficulty walking and a head tilt. Initial physical examination revealed bilateral retinal detachment, a left-sided head tilt, positional rotary nystagmus, and lumbar hyperpathia. Pertinent preliminary diagnostic findings included systemic hypertension, bony lysis and adjacent sclerosis of the vertebral endplates of the first and second lumbar vertebrae, and positive urine and blood cultures for a yeast identified as Candida spp. Concerned about disseminated candidiasis after subsequent subretinal aspirates confirmed the presence of a yeast-like organism, therapy with voriconazole was initiated. Because of progressive clinical deterioration and the poor prognosis for recovery, the dog was eventually euthanized. Postmortem histological examination of tissues, including the affected vertebral endplates, revealed numerous intralesional algae compatible with Prototheca spp. To the authors' knowledge, this report is the first to document a case of protothecal diskospondylitis with possible concurrent candidiasis in a dog. Although typically associated with signs referable to the gastrointestinal tract, this report underscores the importance of not excluding protothecosis as a differential diagnosis when such signs are absent. Lastly, the use of voriconazole appears ineffective for reversing the clinical course of late-stage disseminated protothecosis.

Ocorrência de micoses e pitiose em animais domésticos: 230 casos

Para determinar as principais micoses e oomicoses que acometeram animais domésticos na área de abrangência do Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM), foi realizado um estudo retrospectivo em 9.487 protocolos de necropsias e 20.199 exames histopatológicos (totalizando 29.686 casos), realizados no LPV-UFSM, entre janeiro de 1990 e dezembro de 2012. Do total de protocolos analisados, 230 apresentaram micoses ou pitiose (oomicose), sendo 179 casos (78%) de micoses e 51 casos (22%) de pitiose. Os protocolos foram revisados para determinar os principais achados referentes à epidemiologia, sinais clínicos e às alterações macroscópicas e microscópicas. Em dois casos (0,8%) não foi possível determinar o gênero ou o grupo do fungo observado. As principais doenças diagnosticadas, em ordem decrescente de prevalência, foram: pitiose, candidíase, aspergilose, zigomicose, dermatofitose, malasseziose, criptococose, megabacteriose e esporotricose. Outras doenças diagnosticadas numa única ocorrência cada foram histoplasmose e pneumocistose. Os equinos foram os mais acometidos pela pitiose e os animais de companhia (cães e gatos) foram os mais acometidos pelas micoses.

Bacterial and fungal colonisation of peripheral intravenous catheters in dogs and cats

OBJECTIVES

The purposes of this study were to determine the prevalence of intravenous catheter colonisation in a routine clinical setting, to identify pathogens involved and to explore factors associated with an increased risk of colonisation.

METHODS

A prospective study of 100 peripherally placed intravenous catheters from 13 cats and 78 dogs was conducted. The distal two-thirds were removed and submitted for bacterial and fungal cultures. Antimicrobial susceptibility of each isolate was determined.

RESULTS

Nineteen peripheral catheters were positive for microbiologic culture from 14 animals. Twenty organisms were isolated among which Staphylococcus species was the most common. Isolates displayed lower levels of resistance against the antimicrobial agents amoxicillin-clavulanate, cephalosporins and gentamicin than against other agents tested. Major risk factors predisposing to catheter-related colonisation included dextrose infusion, duration of catheter placement, local complications and immunosuppressive diseases or drugs.

CLINICAL SIGNIFICANCE

In a routine clinical setting, the prevalence of microbial colonisation of peripheral intravenous catheters is comparable to that found in an intensive care unit. However, consequences on morbidity and mortality rates differ.

Abdominal aortic aneurysm associated with systemic fungal infection in a German shepherd dog

A 2 yr old spayed female German shepherd presented with a chief complaint of acute onset paraparesis and weight loss. At presentation, the dog was pyrexic, nonambulatory, and had generalized muscle wasting. Neurolocalization was consistent with a thoracolumbar spinal cord lesion. An abdominal ultrasound was performed and revealed a focal dilation (4 cm) of the terminal aorta with evidence of blood stasis consistent with an aortic aneurysm. The dog was euthanized shortly after admission to the hospital and a post mortem examination was performed. Fungal organisms were identified in the aortic aneurysm as well as from the thoracic vertebrae, mesenteric lymph nodes, axillary lymph nodes, spleen, kidneys, liver, lungs, and heart. Although the morphology was consistent with Candida spp., immunohistochemistry and PCR could not definitively identify the causative organism. Mycotic aortic aneurysms are a rare finding in humans and have not been previously reported in the dog. To the authors' knowledge, this is the first known report of an aortic aneurysm associated with systemic fungal infection in a dog.

The anatomical distribution and antimicrobial susceptibility of yeast species isolated from healthy dogs

The aim of this work was to identify the predominant yeast species present at different anatomical sites in healthy dogs and to determine their in vitro antimicrobial susceptibility using a broth microdilution assay. Samples were collected from the preputial, vaginal, oral and perianal mucosae and the isolates cultured were identified according to their morphological characteristics and biochemical profile. Malassezia pachydermatis was the most commonly isolated yeast, followed by Candida parapsilosis, Candida tropicalis, Candida albicans, Saccharomyces cerevisiae and Rhodotorula spp. Minimum inhibitory concentrations of the azole derivatives ketoconazole, itraconazole and fluconazole against Candida spp. were 0.03-16 microg/mL, 0.06 to >16 microg/mL and 0.5-64 microg/mL, respectively and Candida isolates were sensitive to caspofungin and amphotericin B. Although all isolates of M. pachydermatis were sensitive to itraconazole, fluconazole, ketoconazole and amphotericin B, they were found to be resistant to caspofungin. The study has highlighted that Candida spp., M. pachydermatis, S. cerevisiae and Rhodotorula spp. are part of the normal canine surface microbiota and some of these organisms exhibit in vitro resistance to commonly used antimicrobials.

Molecular phylogenetic analysis of a geographically and temporally matched set of Candida albicans isolates from humans and nonmigratory wildlife in central Illinois

This study explored whether wildlife species serve as the reservoir for human Candida albicans strains in a given geographic area. C. albicans isolates were collected from nonmigratory wildlife admitted to the University of Illinois Wildlife Medical Clinic. A geographically and temporally matched set of C. albicans oral isolates was collected from healthy human volunteers. Multilocus sequence typing was used to assign strains to genetic clades. Clade 1 isolates, particularly diploid sequence type 69 (DST 69), were most common in humans. Clade 1 strains were less frequently recovered from wildlife, while clade 8 strains, particularly DST 90, were overrepresented in the wildlife collection. All instances where a wildlife and human isolate shared the same DST occurred within clade 1. Clade distributions between human and wildlife isolates were significantly different, demonstrating population isolation between the groups. These differences may indicate limited strain transfer between groups or differential selection of C. albicans isolates in humans and wildlife. Wildlife strains had an amphotericin B MIC significantly lower than that of human isolates; strains with increased susceptibility were from several clades. C. albicans isolates were collected from domestic animals to provide comparisons with human and wildlife data sets. C. albicans isolation from canine and feline oral and anal swabs was infrequent; companion animal isolates were closely related to clade 1 human isolates. Collectively, the data suggest a greater likelihood of C. albicans transfer from humans to animals than from animals to humans. The nontransient human population may maintain the connection between geography and the C. albicans genetic groups recovered from humans.

Systemic candidiasis in a dog, developing spondylitis

A 4-year-old male Shiba dog initially presented with pain of an undetermined origin and hypersensitivity to touch. Seven days later, the dog developed ataxia, hind-leg weakness and knuckling. The dog died on 20 days after presentation. Postmortem examination revealed a mass in the body of thoracic vertebra. Histopathologically, the mass consisted of granulomatous inflammation, including fungal organisms that were immunohistochemically positive for Candida albicans. Similar granulomatous lesions were observed in the systemic lymph nodes, kidneys, pancreas, spleen, prostate gland, thyroid glands and heart. This case was diagnosed as systemic candidiasis with spondylitis.

Systemic candidiasis in an apparently immunocompetent dog

Members of the family Candida spp. are ubiquitous dimorphic fungi that normally inhabit the alimentary, upper respiratory, and genital mucosae of mammals. Cell-mediated immunity appears to be an important limitation to the pathologic spread of these fungi. Prolonged immunosuppression, cytotoxic chemotherapy causing neutropenia, diabetes mellitus, long-term glucocorticoid therapy, and prolonged antimicrobial therapy have resulted in an increased incidence of both localized and disseminated candidiasis. This report describes a systemic Candida spp. infection in a dog with no obvious underlying deficiency in host resistance. Cytopathology, histopathology, transmission electron microscopy, and immunohistochemical staining were used to determine the etiology of the causative agent.