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We report a systemic mycosis in a German Shepherd dog caused by Geosmithia argillacea. Although this etiologic agent microscopically resembles a Penicillium species, and is histopathologically compatible with members of the genus Aspergillus, morphologic features and molecular characterization clearly separate it from these genera. This appears to be the first report of disseminated disease by this species in humans or animals. In vitro antifungal susceptibility testing suggests resistance to amphotericin B and voriconazole and susceptibility to caspofungin, itraconazole, and posaconazole.

Abstract. The results of general chemistry profiles of canine patients from Angell Memorial Animal Hospital, Boston, Massachusetts, during 1993 were reviewed for low (Ͻ24) serum sodium : potassium (Na:K) ratios. Thirty-seven dogs had low Na:K ratios. The medical records for 34 these patients were available and sufficiently complete to identify conditions that were associated with low Na:K ratios. Of these 34 dogs, 8 (24%) had hypoadrenocorticism, and 14 had renal disease. Twenty-two of the 34 (65%) had Na:K ratios between 24 and 20. Of these 22 dogs, 9 (41%) had renal or urinary tract disease, and 2 (9%) had hypoadrenocorticism. Other diagnoses in this group included pancreatic disease (3), disseminated neoplasia (3), circulatory disturbance (2), pyometra (1), mushroom poisoning (1), and behavior problem (1). Eight of 34 dogs had Na:K ratios between 19.9 and 15. Of these 8 dogs, 4 (50%) had urinary tract disease, 2 had hypoadrenocorticism, 1 had pancreatic disease, and 1 had severe anemia and hypoproteinemia due to severe parasitism. All of the 4 dogs with Na:K ratios Ͻ15 had hypoadrenocorticism, and 1 of these 4 had concurrent renal failure. In all dogs, serum potassium concentration was above the laboratory's reference range, but sodium was below the laboratory's reference range in only 18 dogs (53%). Two of the 8 (25%) dogs with hypoadrenocorticism had serum sodium concentrations within the laboratory's reference range. In this population, low Na:K ratios were invariably associated with hyperkalemia but not always with hyponatremia. Although numerous conditions were associated with a low Na:K ratio, renal disease was the most common. Hypoadrenocorticism was present in only 13% of dogs with Na:K ratios between 24 and 15 but was present in all dogs with Na:K ratios Ͻ15.Diagnosis of hypoadrenocorticism in canine patients is difficult. Clinical signs (weakness, dehydration, bradycardia, and hypotension) are nonspecific. 9,11 The adrenocorticotropin stimulation test (ACTH-st) is recommended for confirmation of the diagnosis. Unfortunately, the ACTH-st is expensive, time consuming, and not always diagnostic. Therefore, suspicion of hypoadrenocorticism is necessary to merit performance of an ACTH-st, and other clinical and clinicopathological findings must be considered in its interpretation.Evaluation of serum electrolyte concentrations is important in identifying patients that might have hypoadrenocorticism. Decreased (Ͻ24) sodium : potassium (Na:K) ratios is a common finding in patients with hypoadrenocorticism, and hypoadrenocorticism is considered among the more likely diagnoses in dogs with an Na:K ratio Ͻ25. 6 However, other disorders, particularly renal and gastrointestinal disease, may cause similar electrolyte imbalances and signs consistent with hypoadrenocorticism. 3,4,8 In an effort to determine the most frequent causes of decreased Na:K ratios, the 1993 medical records of canine patients at Angell Memorial Animal Hospital, Boston, Massachusetts, were examined. Received for publication December 5, 1997....

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