Eumycetoma and disseminated phaeohyphomycosis in a Sumatran tiger

2021 ◽  
pp. 104063872110389
Author(s):  
Amanda R. Schaff ◽  
Sylvia Ferguson ◽  
Kristen Phair ◽  
Rachel Ferris ◽  
Alexandra Goe
Keyword(s):  
Chronic Kidney Disease ◽  
Tissue Sample ◽  
Postmortem Examination ◽  
Fungal Culture ◽  
Panthera Tigris ◽  
Aggressive Treatment ◽  
Deep Tissue ◽  
Fungal Hyphae ◽  
Axillary Mass ◽  
Disseminated Disease

A 16-y-old female Sumatran tiger ( Panthera tigris sumatrae) was evaluated for hyporexia. Examination revealed chronic kidney disease and a large subcutaneous axillary mass with draining tracts that contained numerous small black grains. Histologic examination revealed the presence of intralesional fungal hyphae. Persistent hyporexia and pyogranulomatous disease, as well as progressive cachexia and azotemia occurred despite treatment, and euthanasia was performed. Disseminated phaeohyphomycosis was diagnosed on postmortem examination, additionally affecting various lymph nodes, the nasal cavity, mesenteric adipose tissue, abdominal aorta, pericardium, and kidney. Fungal culture from a deep-tissue sample isolated a pure growth of Curvularia sp., a dematiaceous opportunistic fungus able to cause eumycetomas and/or phaeohyphomycosis. Phaeohyphomycosis is a rare but emerging condition, not previously reported as disseminated disease in an exotic carnivore, to our knowledge. Aggressive systemic antifungal treatment was unsuccessful, likely complicated by diagnostic challenges and concurrent renal disease. The presence of a swelling with abundant grains exiting draining tracts should direct clinicians to the diagnosis of a mycetoma, warranting early and aggressive treatment.

scholarly journals 271. Fungal Diagnostic Studies in Histoplasmosis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S150-S150
Author(s):  
Gayathri Krishnan ◽  
Margaret Power ◽  
J Ryan Bariola ◽  
Ryan K Dare
Keyword(s):  
Fungal Pathogens ◽  
Cross Reaction ◽  
High Rate ◽  
Fungal Culture ◽  
Patient Demographics ◽  
Immunosuppressive Medications ◽  
Chi Squared ◽  
A Prospective Study ◽  
Disseminated Disease ◽  
Antigen Testing

Abstract Background Histoplasmosis (histo) is a common cause of invasive fungal infection in endemic regions and accurate diagnosis is difficult without direct tissue culture or pathology. Indirect fungal antigen testing for various fungal pathogens is typically performed to assist with diagnostic workup though cross-reaction can lead to difficulty interpreting results. We aimed to evaluate the prevalence of positive antigen testing for non-Histoplasma fungal pathogens in patients with proven invasive histo. Methods We performed a retrospective review of adult patients with proven invasive histo from 2010–2018 at our institution. For inclusion purposes, histo was confirmed by either fungal culture and/or cytology. Patient demographics, clinical characteristics and results of fungal antigen testing for Histoplasma, Blastomyces, Aspergillus, Cryptococcus and β-d-glucan were evaluated. Two different urine Histoplasma antigen assays were used during the study period. Results 57 (31%) of 182 patients diagnosed with histo during the study period had culture or cytology evidence of disease and were included in all further analysis. Thirty-two (56%) of these patients were male, 35 (61.4%) were Caucasian and the mean age was 50.1 years. HIV (20; 35%) and being on immunosuppressive medications (21, 37%) were common in this population. The majority of cases were classified as disseminated histo (40, 70%) followed by acute pulmonary (10; 18%) and chronic pulmonary (7, 12%) disease. Results of fungal antigen testing are documented in the table. Chi-squared analysis was performed. Conclusion There is a frequent cross reaction of non-Histoplasma fungal tests in patients with histo. In our review, there was a high rate of cross reaction with Blastomyces antigen, which can be confusing in regions where both pathogens coexist. Elevation of β-d-glucan was high in these patients. Urine Histoplasma antigen sensitivity was higher with MiraVista testing for disseminated disease in our review. While noninvasive fungal tests are helpful in diagnosis of these infrequent infections, clinicians must still maintain knowledge of the clinical differences between these fungal pathogens and be aware of the limitations of these tests. A prospective study is needed to better define differences between individual Histoplasma tests. Disclosures All authors: No reported disclosures.

scholarly journals Temporary remission of disseminated paecilomycosis in a German shepherd dog treated with ketoconazole : case report

2001 ◽  
Vol 72 (2) ◽  
Author(s):  
M.J. Booth ◽  
J.J. Van der Lugt ◽  
A. Van Heerden ◽  
J.A. Picard
Keyword(s):  
Case Report ◽  
Clinical Signs ◽  
Initial Diagnosis ◽  
Fungal Culture ◽  
German Shepherd ◽  
Laboratory Parameters ◽  
German Shepherd Dog ◽  
Fungal Hyphae ◽  
Carpal Joint

Disseminated mycosis caused by Paecilomyces varioti in a female German shepherd dog presented with chronic forelimb lameness is described. Radiographs of the swollen carpal joint revealed geographic lysis of the radial epiphysis. Diagnosis was based on cytological demonstration of fungal hyphae and chlamydiospores, as well as fungal culture of fluid obtained by arthrocentesis. Temporary remission was characterised by markedly improved clinical signs and laboratory parameters, following treatment with ketoconazole. The dog was euthanased 9 months after the initial diagnosis, following the diagnosis of multifocal discospondylitis. This appears to be the longest described period of temporary remission obtained with treatment in dogs with paecilomycosis. Clinical, clinicopathological and necropsy findings of this disease in another German shepherd dog are briefly described.

scholarly journals Increasing Incidence of Blastomycosis Infection in Vermont

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S84-S85 ◽  
Author(s):  
Porntip Kiatsimkul
Keyword(s):  
Medical Center ◽  
The United States ◽  
Common Disease ◽  
Invasive Infection ◽  
Fungal Culture ◽  
Disseminated Infection ◽  
South Central ◽  
Urine Antigen ◽  
Number Of Patients ◽  
Disseminated Disease

Abstract Background Blastomycosis is an invasive infection caused by the ubiquitous fungus Blastomyces. The clinical presentation ranges from limited cutanenous infections to pneumonia and disseminated disease. Endemic areas in the United States include: midwestern, south-central, and southeastern states; yearly incidence is <0.3 cases per 100,000. Diagnosis is based on recovery of the organism on fungal culture. A urine antigen test is available for the detection of blastomycosis which has a sensitivity of 92.9% and specificity of 79.3%. Anecdotally, an increasing number of patients are presenting to the University of Vermont Medical Center (UVMMC) with disseminated blastomycosis – an area in which the fungus is rare. We hoped to determine the incidence of blastomycosis in Vermont over a 10-year period and examine the sensitivity of the urine antigen in our patient population. Methods After IRB approval, medical record numbers of all patients who had BD-glucan, blastomyces urine antigen, culture, or pathology positive for blastomyces during a 10-year period (2006–2016) were obtained. Chart review completed for all patients with diagnosis of blastomycosis. Data collected on demographic characteristics: zip code, comorbidities, site of infection, HIV, BD-glucan, blastomyces urine antigen, fungal culture, and treatment duration. Results Forty-one blastomycosis cases were found; 39 cases in Vermont residents. The incidence rate Vermont was 0.7 cases per 100,000. Mean age was 49 years, 60% of patients were male. Most patients had pulmonary (37%) or disseminated infection (37%). 17% of patients had localized cutaneous disease, bone and joint infection (7%) or CNS disease (2%). Urine antigen was positive in 78% overall, and in 90% with disseminated infection. Three deaths, none attributed to blastomycosis. Conclusion Vermont appears to have a higher incidence than what has been reported in the US overall. This increase may have to do with better reporting and testing rather than a true increase in disease. Most common disease presentation was localized pulmonary or disseminated disease. Urine antigen sensitivity ranged from 78% (overall) to 90% (disseminated disease). This appears consistent with what has been reported in other studies, but is lower than the overall reported sensitivity. Disclosures All authors: No reported disclosures.

scholarly journals Microscopic, cultural and molecular evidence of disseminated invasive aspergillosis involving the lungs and the gastrointestinal tract

2006 ◽  
Vol 55 (7) ◽  
pp. 961-964 ◽  
Author(s):  
R. S. Jayshree ◽  
M. Shafiulla ◽  
J. George ◽  
J. K. David ◽  
P. P. Bapsy ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Invasive Aspergillosis ◽  
Aspergillus Flavus ◽  
Molecular Evidence ◽  
Dna Analyses ◽  
Random Amplification ◽  
Fungal Hyphae ◽  
Gastrointestinal Aspergillosis ◽  
Disseminated Disease ◽  
First Time

A patient with acute promyelocytic leukaemia developed invasive aspergillosis post chemotherapy during a pancytopenic episode, clinically involving the lungs and the gastrointestinal tract. Dichotomously branched septate fungal hyphae were demonstrated microscopically in stools and sputa. Cultures of the samples yielded Aspergillus flavus, which were identical by RFLP and random amplification of polymorphic DNA analyses and antifungal MICs, proving disseminated disease. To the best of the author's knowledge, this is the first time that boluses of fungal hyphae have been demonstrated microscopically in the stools of a patient with gastrointestinal aspergillosis.

scholarly journals Canine sporotrichosis: report of 15 advanced cases

2018 ◽  
Vol 38 (3) ◽  
pp. 477-481 ◽  
Author(s):  
Mariana B. Mascarenhas ◽  
Natália L. Lopes ◽  
Thiago G. Pinto ◽  
Thiago S. Costa ◽  
André P. Peixoto ◽  
...  
Keyword(s):  
Rio De Janeiro ◽  
Skin Diseases ◽  
Sporothrix Schenckii ◽  
The Body ◽  
Nasal Discharge ◽  
Fungal Culture ◽  
Dimorphic Fungus ◽  
Cutaneous Lesions ◽  
Distal Aspect ◽  
Disseminated Disease

ABSTRACT: Sporotrichosis is a chronic, granulomatous and usually lymphocutaneous infection of animals and humans, caused by a dimorphic fungus, Sporothrix schenckii complex. The disease in dogs is considered rare, however, in the last years a crescent registration of cases was observed in Brazil, especially in the city of Rio de Janeiro. Fifteen dogs with ulcerated cutaneous lesions were seen at the Dermatology Service in the Small Animal’s Hospital at Universidade Federal Rural do Rio de Janeiro, between January 2014 and October 2015. Most lesions were located on the head, mainly the nose. Lesions were even seen on the chest, disseminated on the body and on the limbs. Three dogs (20%) exhibited the cutaneous-lymphatic form, with lesions initially on the distal aspect of one leg and ascending via lymphatics up the leg to the trunk and head. It was not ruled out the disseminated form in at least 3 dogs (20%). They had consistent signs of generalized or disseminated disease exhibiting respiratory symptoms (nasal discharge, sneezing, stertorous breathing), anorexia and weight loss. Draining tracts and cellulitis were very common. Some had large areas of skin necrosis with exposure of muscle and bone. Definitive diagnosis was obtained by cytological examination of exudates, histological examination, and/or isolation of S. schenckii complex by fungal culture. Because of the severity of the lesions that mimic other disorders like neoplasms or autoimmune skin diseases, and due to the difficulties of getting an accurate diagnosis, this study describes 15 advanced cases of canine sporotrichosis.

scholarly journals ​Pulmonary Mucormycosis in Layer Birds: A Case Report

2021 ◽  
Author(s):  
V. Samatha ◽  
B.B. Manasa ◽  
V. Rama Devi ◽  
K. Satheesh
Keyword(s):  
Case Report ◽  
Periodic Acid ◽  
Giant Cells ◽  
Postmortem Examination ◽  
Veterinary Science ◽  
Pulmonary Mucormycosis ◽  
Fungal Hyphae ◽  
Veterinary Pathology

The present paper reports a case of pulmonary mucormycosis in a 19 wk layer bird that was presented for necropsy to the Department of Veterinary Pathology, NTR College of Veterinary Science, Gannavaram. Mycotic pneumonia in poultry is commonly due to Aspergillus spp and due to others like Mucor spp is very rare. On postmortem examination, the lungs were enlarged, consolidated with multiple greyish white nodules. Histologically, the lung sections revealed pyogranulomatous lesions with branched aseptate hyphae in center of necrosed area that was surrounded by heterophils, macrophages, lymphocytes and multi nucleated giant cells. These fungal hyphae were broad and a few showing right angle and/or irregular branching characteristic of Zygomyces spp. with periodic acid Schiffs reagent

Chromatophoroma in a Siamese fighting fish (Betta splendens)

2019 ◽  
Vol 7 (2) ◽  
pp. e000840 ◽  
Author(s):  
Chelsea Ciambrone ◽  
Laura R Chen ◽  
Debra A Tokarz ◽  
Gregory A Lewbart
Keyword(s):  
North Carolina ◽  
Needle Aspiration ◽  
Siamese Fighting Fish ◽  
Postmortem Examination ◽  
Betta Splendens ◽  
State University ◽  
Aggressive Treatment ◽  
Fine Needle ◽  
North Carolina State University ◽  
The North

An adult male blue Siamese fighting fish (Betta splendens) presented to the North Carolina State University College of Veterinary Medicine with a cranial mass located dorsal to his right eye. A fine-needle aspiration was performed followed by supportive care. Due to the patient’s small size aggressive treatment was not elected. The mass continued to expand over a course of five months until the patient was found deceased, and a postmortem examination was performed. Histopathology determined the mass to be a chromatophoroma of the iridophoroma or leucophoroma subtypes. This is the first documentation of a chromatophoroma in B splendens.

scholarly journals 267. Fungal Culture Diagnostic Stewardship: An Avenue for Antimicrobial Stewardship in the Immunocompromised Host

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S148-S148
Author(s):  
Pooja Gurram ◽  
Kirtivardhan Vashistha ◽  
John C O’Horo ◽  
Aditya Shah
Keyword(s):  
Antimicrobial Stewardship ◽  
Candida Species ◽  
Fungal Infections ◽  
Immunocompromised Host ◽  
Common Species ◽  
Aspergillus Species ◽  
Fungal Culture ◽  
Penicillium Species ◽  
Fungal Organisms ◽  
Disseminated Disease

Abstract Background Bronchoalveolar lavage (BAL) is a widely used procedure in the diagnosis of pneumonia in critically ill and immunocompromised hosts. Fungal smears and cultures are commonly performed on these samples. We evaluated the yield of various fungi, including but not limited to Candida species, Aspergillus species, Penicillium species, isolated from BAL specimens at our institution to determine the yield of this test and its impact on decision making. Methods We identified adult immunocompromised patients who underwent “Bronchoscopy with Immunocompromised Host Protocol (ICH),” which consists of an exhaustive list of diagnostic tests for various pathogenic organisms, over a one year period from January 1, 2017 to December 31, 2017. We reviewed if positive fungal cultures led to a change in management and if this was appropriate. Results 582 patients underwent bronchoscopy with ICH protocol. There were 285/582 (48.9%) positive fungal cultures of which 177 (62%) grew Candida species. The most common species was Candida albicans (142/177, 80%). 53(18%) were Aspergillus species of which Aspergillus fumigatus was the most common (26/53). 16/285 (5.6%) patients underwent intervention based on the results, 14(87.5%) of which were appropriate. 176/177 (99.4%) patients with Candida species in BAL cultures were not treated.10/53 (18. 8%) patients with Aspergillus species in BAL cultures were treated of which 80% were appropriate interventions based on proven/probable invasive fungal infections criteria as were rest of the 6/16 patients with other fungal organisms (Table 4). Patients with Aspergillus species in BAL cultures are 8 times more likely to have an intervention (OR: 8. 7, P = < 0. 0001) while patients with Candida species in BAL cultures are not likely to be intervened upon (OR: 0. 26, P = 0. 0098) (Table 3). Conclusion Although Candida species is commonly isolated in BAL cultures its clinical significance is minimal in the absence of disseminated disease even in immunosuppressed hosts. Evaluating the way that Candida cultures are communicated for respiratory specimens, along with diagnostic stewardship may be a route for antimicrobial stewardship. Consulting ID service early on is essential in assessing the significance of fungal culture data thereby resulting in appropriate changes in management. Disclosures All authors: No reported disclosures.

scholarly journals Histoplasmosis-related Healthcare Use, Diagnosis, and Treatment in a Commercially Insured Population, United States

2019 ◽  
Author(s):  
Kaitlin Benedict ◽  
Karlyn D Beer ◽  
Brendan R Jackson
Keyword(s):  
Outpatient Visit ◽  
Severe Disease ◽  
Antibody Test ◽  
International Classification Of Diseases ◽  
Outpatient Setting ◽  
Fungal Culture ◽  
Treatment Practices ◽  
Classification Of Diseases ◽  
Insurance Claims Data ◽  
Disseminated Disease

Abstract Background Infections with Histoplasma can range from asymptomatic to life-threatening acute pulmonary or disseminated disease. Histoplasmosis can be challenging to diagnose and is widely underrecognized. We analyzed insurance claims data to better characterize histoplasmosis testing and treatment practices and its burden on patients. Methods We used the IBM MarketScan Research Databases to identify patients with histoplasmosis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 115.00–115.99) during 2012–2014. We analyzed claims in the 3 months before to the 1 year after diagnosis and examined differences between patients with probable (hospitalized or >1 outpatient visit) and suspected (1 outpatient visit) histoplasmosis. Results Among 1935 patients (943 probable, 992 suspected), 54% had codes for symptoms or findings consistent with histoplasmosis and 35% had ≥2 healthcare visits in the 3 months before diagnosis. Overall, 646 (33%) had any fungal-specific laboratory test: histoplasmosis antibody test (n = 349 [18%]), Histoplasma antigen test (n = 349 [18%]), fungal smear (n = 294 [15%]), or fungal culture (n = 223 [12%]); 464 (24%) had a biopsy. Forty-nine percent of probable patients and 10% of suspected patients were prescribed antifungal medication in the outpatient setting. In total, 19% were hospitalized. Patients’ last histoplasmosis-associated healthcare visits occurred a median of 6 months after diagnosis. Conclusions Some histoplasmosis patients experienced severe disease, apparent diagnostic delays, and prolonged illness, whereas other patients lacked symptoms and were likely diagnosed incidentally (eg, via biopsy). Low rates of histoplasmosis-specific testing also suggest incidental diagnoses and low provider suspicion, highlighting the need for improved awareness about this disease.

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