Systemic Acremonium species infection in a dog

Summary

A 2-year-old female Magyar Viszla was referred with fever, lethargy, polyuria/polydipsia, and suspected systemic cryptococcosis. At presentation increased rectal temperature and enlarged lymph nodes were detected. Main laboratory abnormalities included lymphocytosis, eosinophilia, and mildly reduced urine specific gravity. Abdominal ultrasound was unremarkable. Lymph node cytology revealed mycotic infection. Acremonium species was isolated from urine as well as from a popliteal lymph node by fungal culture. Therapy with itraconazol (10 mg/kg p. o. q 12 h) was initiated based on susceptibility testing, but dosage had to be reduced by half due to adverse effects. Despite treatment, the dog developed progressive azotemia. Four months after initial presentation, the patient showed anorexia, lethargy, weight loss, diarrhea, vomitus, neurological signs, and severe azotemia and was euthanized. Acremonium species are emerging opportunistic mould fungi that can represent a potential threat for immunocompromised humans. In dogs, only two cases of systemic infection with this fungal species have been reported so far. This case highlights the fact that systemic fungal infections should be considered as a differential in cases of fever and lymphadenopathy.

Zusammenfassung

Eine 2 Jahre alte Magyar-Viszla-Hündin wurde wegen Fieber, Lethargie und Polyurie/Polydipsie sowie Verdacht auf eine systemische Kryptokokkose überwiesen. Bei der klinischen Untersuchung fielen eine erhöhte Körpertemperatur und Lymphadenomegalie auf. Wichtigste abweichende Laborbefunde waren Lymphozytose, Eosinophilie und ein geringgradig reduziertes spezifisches Gewicht des Urins. Die sonographische Untersuchung des Abdomens ergab unauffällige Befunde. Bei der zytologischen Untersuchung eines Aspirats aus einem Popliteallymphknoten wurde eine Pilzinfektion diagnostiziert. In der Pilzkultur von Urin und des Bioptats eines Popliteallymphknotens ließ sich Acremonium sp. nachweisen. Nach Resistenztest folgte eine Therapie mit Itraconazol (10 mg/kg p. o. q 12 h), fortgesetzt in halbierter Dosis aufgrund von Nebenwirkungen. Trotz Behandlung entwickelte der Hund eine progressive Azotämie. Vier Monate nach Erstvorstellung zeigte das Tier Anorexie, Lethargie, Gewichtsverlust, Durchfall, Erbrechen, neurologische Symptome sowie eine schwere Azotämie und wurde euthanasiert. Acremonium-Spezies sind neu aufkommende opportunistische Schimmelpilze, die eine potenzielle Bedrohung für immungeschwächte Menschen darstellen. Beim Hund sind bisher nur zwei Fälle einer systemischen Infektion mit dieser Pilzart beschrieben. Dieser Fall zeigt, dass systemische Pilzinfektionen bei Hunden mit Fieber und Lymphadenopathie differenzialdiagnostisch in Betracht gezogen werden sollten.

Keywords

Fungal disease - infectious disease - mycology - fever - lymphadenopathy

Schlüsselwörter

Pilzerkrankung - Infektionserkrankung - Mykologie - Fieber - Lymphadenopathie

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