Small Animal Dermatology, 3rd edition

CHAPTER 35 MYCOSES, DEEP 523

symptoms include anorexia, lymphadenopathy, endocarditis and myocarditis,

testicular enlargement, and prostatomegaly (Figures 35.9–35.11)

Cats: respiratory symptoms, ocular inflammation, weight loss.

 Cutaneous lesions consist of ulcerated nodules or plaques, subcutaneous abscesses,

draining tracts, or large firm papules

DIFFERENTIAL DIAGNOSIS

 Pneumonia/respiratory disease

 Neoplasia (bone, respiratory)

 Cardiac disease

 Other systemic mycosis (e.g., coccidioidomycosis, histoplasmosis, blastomycosis)

 Bacterial infection (including osteomyelitis)

 Neurologic disease (e.g., rickettsial, granulomatous meningoencephalitis, bacterial

meningoencephalitis, neoplasia)

 Distemper

 Immune-mediated disease

DIAGNOSTICS

 Complete blood count and serum chemistry: mild nonregenerative anemia,

eosinophilia, neutrophilic leukocytosis, hyperglobulinemia, hypoalbuminemia,

azotemia, hypercalcemia secondary to granuloma formation.

 Urinalysis: low specific gravity and proteinuria with inflammatory glomerulonephri-

tis inC. immitis; blastomyces yeasts may be found in the urine of dogs with prostatic

involvement.

 Imaging:
Cryptococcosis: tissue density (granuloma) behind the soft palate in cats or

dense material filling the nasal passage with bone destruction on radiographs;

CT or MRI for brain and nasal lesions

Coccidioidomycosis: pulmonary interstitial infiltrates, bone osteolysis on radio-

graphs; CT or MRI for brain or CNS granulomas

Blastomycosis: pulmonary generalized interstitial to nodular infiltrate with

nonuniform distribution (differentiates from pneumonia), tracheobronchial

lymphadenopathy, lytic and proliferative focal bone lesions on radiographs.

 CSF culture and measurement of capsular antigen (cryptococcosis).

 Serology:
Cryptococcosis: latex agglutination or ELISA for capsular antigen in serum or

CSF; highly sensitive (90–100%) and specific (97–100%); magnitude correlates

with severity of infection; may be positive with colonization; titers greater than

1:32 diagnostic for infection

Coccidioidomycosis: serologic tests by ELISA or agar gel immunodiffusion

(AGID) for antibody toC. immitis