Abstract:
Objectives: Mold Aspergillus spp. is a common contaminant of the nasal mucosa in several
animals and is the etiological agent of dog mycotic rhinitis. This disease, relatively recurrent in
middle-aged dolicocephalic breeds, shows complicated and not always evident pathogenetic
features; besides this, it evolves in chronic shape and sometimes it is associated to
progressive osteolysis phenomena of the surrounding bone structure. The present work
describes a particular clinical case, due to the young age of the dog and the fungal agents
involved.
Methods: An Epagneul Breton female one year old dog showed for several months sneezes
attacks and muco-purulent discharge, sometimes with blood tracks, by the left nostril; it was
treated unsuccessfully with antibiotics and non-steroid anti-inflammatory drugs. After the
clinical examination, an endoscopy of the upper airways was performed, and through it was
visualized and removed a vegetal foreign body in the lower meatus of the left nostril.
Furthermore, the endoscope showed a marked disarchitecture of the turbinates and a conchal
atrophy, associated with yellow-greenish and simil-caseous consistency plaques on the
mucosa, probably traceable to fungal colonies. Specimens of this material were collected for
bacteriological (standard culture media) and mycological (culture on Sabouraud dextrose agar
and CAFC media, biochemical identification by API ID32C system) tests, together with bioptic
samples of the mucosa for histo-pathological examinations. A radiographic study of the skull, to
confirm the bone integrity, was also realized.
Results: Bacteriological examination was positive for Staphylococcus intermedius, while
mycological examination showed the development of two fungal species, the mold Aspergillus
fumigatus and the yeast Cryptococcus laurentii, respectively; branching septate hyphae were
demonstrated on histologic samples. Therefore, a systemic therapy with itraconazole (5 mg/kg
BID per os) was prescribed; than, the dog was submitted to a topic application of 1% solution
of clotrimazole after general anesthesia. Progressive resolution of the clinical findings was
noticed, and an endoscopic investigation was performed after 3 weeks, showing the absence
of fungal colonies. Moreover, a second topic treatment was made, while the itraconazole was
suspended. One month after the end of the therapy, there were no relapses.
Conclusions: The young age of the dog, as well as the positive response to the therapy, allow
to hypothesize that the pathogenicity of A. fumigatus is related to the irritant action of the
vegetal body, that has also brought the animal to cause a trauma to itself in the nostril region
involved; this aspect could explain the fact that C. laurentii, a non pathogen yeast normally
detectable on the mucosa of the first respiratory tract, found the way to grow and produce
colonies. In the absence of hard tissue lesions, the persistent inflammatory stimulus expired
with the extraction of the foreign body, increasing the effectiveness of the therapeutic protocol.
Furthermore, the combinated systemic-topic treatment was useful to shortening the time of
itraconazole administration (normally 6-7 months) and therefore to avoid its collateral effects.
2009
abstract No:
P045
Full conference title:
4th Trends in Medical Mycology
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- TIMM 4th (2012)