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Schmertmann LJ, Wardman A, Setyo L, Kan A, Meyer W, Malik R, Krockenberger MB. Identification of the environmental source of infection for a domestic ferret with cryptococcosis. J Vet Diagn Invest 2019; 31:828-835. [PMID: 31551015 DOI: 10.1177/1040638719876968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cryptococcosis, caused by the Cryptococcus gattii and C. neoformans species complexes, is an environmentally acquired mycosis affecting a broad range of host species. Among 9 communally housed ferrets, a 5-y-old castrated male ferret domiciled in an outdoor enclosure in Sydney, Australia was diagnosed with sinonasal cryptococcosis. Clinical signs resolved during 18 mo of itraconazole therapy, but the ferret was eventually euthanized because of splenic hemangiosarcoma. At postmortem, microscopic foci of persistent cryptococcosis were detected. The diagnosis raised concerns that the owners and other ferrets were exposed to a common environmental source of infection, thus prompting an investigation. Soil samples, swabs of a hollow eucalypt log (used for behavioral enrichment), and nasal swabs from 8 asymptomatic ferrets were collected. Nasal exudate (obtained at diagnosis) and tissues (collected at postmortem) were available from the clinical case. Bird seed agar culture resulted in a heavy growth of Cryptococcus spp. from one environmental site (the log), one nasal swab, and nasal exudate and tissues from the clinical case. All other samples were culture-negative. Sub-cultured isolates from the log were a mixture of C. gattii molecular type VGI and C. neoformans molecular type VNI. Ferret isolates were a similar mixture of C. gattii VGI (all disease isolates) and C. neoformans VNI (nasal-colonizing isolate). Multilocus sequence typing further revealed the ferret isolates as identical to environmental isolates collected from the log, confirming the log as the source of clinical disease and nasal colonization. The log was removed to prevent further exposure to a high environmental load of Cryptococcus spp.
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Affiliation(s)
- Laura J Schmertmann
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alison Wardman
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Laura Setyo
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alex Kan
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Wieland Meyer
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Richard Malik
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Mark B Krockenberger
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
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Abstract
Case summary Two 13-year-old domestic shorthair cats were diagnosed with unilateral right
adrenocortical carcinomas (ACCs) and primary hyperaldosteronism (PHA). Both
had polyuria, polydipsia and weight loss, and developed severe anaemia from
an episode of acute adrenal haemorrhage. In one case, this occurred during
hospitalisation and treatment of severe muscle weakness with cervical
ventroflexion, while the other cat had acute collapse at home. A diagnosis
of PHA was confirmed in both cases based on measurement of plasma
aldosterone and renin activity. In one case, basal progesterone was also
measured and was elevated. On ultrasonography and CT in one case,
haemorrhage into the right retroperitoneal space was identified. Unilateral
adrenalectomy was performed in both cases and there was no evidence of
venous tumoral invasion in either. On histopathology of the excised adrenal
glands both were ACCs with tumour necrosis, and one had extensive
intratumoral haemorrhage. Both cats were diagnosed with International Renal
Interest Society stage 2 or 3 chronic kidney disease postoperatively; one
survived for 18 months and the other was well 8 months postoperatively. Relevance and novel information Acute adrenal haemorrhage secondary to adrenal neoplasia has been reported in
only one other cat, in which tumour type and function were not specified.
Acute adrenal haemorrhage can occur as a consequence of tumour necrosis and
rupture and can cause severe hypovolaemia and anaemia in cats with primary
hyperaldosteronism.
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Affiliation(s)
- Nicolle Kirkwood
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Lara Boland
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Laurencie Brunel
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Alison Wardman
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Vanessa R Barrs
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
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