Bilateral orbital and nasal aspergillosis in a cat

Abstract

A 12-year-old, 4 kg, castrated male Persian cat was referred with a 2-month history of sneezing and bilateral mucopurulent nasal discharge. Rhinoscopically acquired nasal biopsies at this time revealed bilateral lymphoplasmacytic rhinitis. A tapering dose of oral prednisone caused the complete remission of the clinical signs, but 2 months after discontinuation of the therapy, the rhinitis recurred and the OD became exophthalmic. Computed tomography showed a soft tissue mass in both sides of the nasal cavity, both frontal sinuses, the right orbit, and to a lesser extent the left orbit. A fine needle aspirate of the right orbit revealed pyogranulomatous inflammation and Aspergillus spp. hyphae. Repeat nasal biopsy demonstrated multi-focal necrosis and a mixed inflammatory cell process which now included macrophages and scattered septate fungal hyphae. A few days later the cat became bilaterally blind and a contrast enhancing lesion involving the optic chiasm was found on magnetic resonance imaging. Despite a poor prognosis, therapy consisted of exenteration of the right orbit and trephination of both frontal sinuses before the planned initiation of medical antifungal therapy. Unfortunately, the cat died of cardiac arrest intraoperatively. Aspergillus fumigatus was cultured from both orbits at necropsy. Orbital aspergillosis has been rarely reported in cats and its relationship with lymphoplasmacytic rhinitis is unclear. In this patient lymphoplasmacytic rhinitis or previous antibiotic/corticosteroid therapy may have allowed secondary fungal invasion of the nasal mucosa and subsequently both orbits and the brain. Alternatively, Aspergillus infection may have preceded the lymphoplasmacytic rhinitis.

Computed tomographic features of feline sino-nasal and sino-orbital aspergillosis

“…All cats with SOA had evidence of naso-orbital communication due to lysis of the orbital lamina, identifying direct extension as the likely route of orbital involvement. This is supported by findings on CT, surgery or at post-mortem in other cases, and by the fact that haematogenous spread has not been reported (Barachetti et al, 2009;Barrs et al, 2012;Giordano et al, 2010;Hamilton et al, 2000;Wilkinson et al, 1982). Orbital extension directly from the frontal sinus has been documented in one case (Halenda and Reed, 1997).…”

“…Feline upper respiratory tract aspergillosis (URTA), first described in 1982, (Wilkinson et al, 1982), is being increasingly reported (Barachetti et al, 2009;Barrs et al, 2012;Declercq et al, 2012;Furrow and Groman, 2009;Giordano et al, 2010;Kano et al, 2008;Kano et al, 2013;Karnik et al, 2009;Smith and Hoffman, 2010). Disease occurs over a wide geographic range, including Australia, the USA, the United Kingdom, mainland Europe, and Japan (Barrs et al, 2012;Barrs et al, 2013;Declercq et al, 2012;Goodall et al, 1984;Kano et al, 2013;Smith and Hoffman, 2010;Tomsa et al, 2003).…”

“…Descriptions of computed tomography (CT) findings in cats with URTA are limited to case reports (Barachetti et al, 2009;Furrow and Groman, 2009;Giordano et al, 2010;Halenda and Reed, 1997;Hamilton et al, 2000;Kano et al, 2008;McLellan et al, 2006;Smith and Hoffman, 2010;Whitney et al, 2005), and one case series of mycotic rhinitis that included five cats with URTA but did not distinguish between SNA and SOA or identify the aetiological agents (Karnik et al, 2009). The objectives of this study were to describe the CT features of URTA, to determine whether cats with SOA have concurrent 3 | P a g e involvement of the SNC, and to determine if there was any association between CT features and the form of aspergillosis and/or infecting species.…”

Two Cases of Feline Orbital Aspergillosis Due to <i>Aspergillus udagawae</i> and <i>A. viridinutans</i>

“…Reports of feline cases of orbital aspergillosis are on the rise, and the infection is considered an emerging disease [3,5,7,12]. Aspergillus fumigatus has been the most frequently reported etiologic agent of sino-orbital aspergillosis in cats [5].…”

A clinical report of entangled neonates' umbilical cord with queen's fur in Persian cat

“…Sometimes they are confronted with breathing problems or problems with clogged tear ducts. It seems that a brachycephalic facial conformation of Persian cats may be an important risk factor for the development of sino-nasal aspergillosis [14] . Furthermore, dental malocclusion and deafness in white Persians are reported commonly in this breed [15] .…”