Clinicopathologic and Diagnostic Imaging Characteristics of Systemic Aspergillosis in 30 Dogs

Abstract

Background: Systemic aspergillosis is a serious disease of dogs for which the clinical characteristics are poorly described. Objective: To describe the clinical and diagnostic imaging characteristics of dogs with systemic aspergillosis. Animals: Thirty dogs with systemic aspergillosis. Methods: Retrospective case review. Medical records were reviewed for signalment, clinical features, and results of clinicopathologic testing and diagnostic imaging. Diagnosis was confirmed by culture of Aspergillus terreus (n 5 13), Aspergillus deflectus (n 5 11), or other Aspergillus spp. (n 5 6).Results: Compared with the background hospital population, German Shepherd dogs and female dogs were overrepresented (odds ratio [OR] 43, 95% confidence interval [CI] 20-91, P o .0001, and OR 2.9, 95% CI 1.2-6.7, P 5 .02), respectively, with 20 of the 30 dogs being German Shepherd dogs and 77% (23 of 30) of the dogs being female. The median age was 4.5 years (range 2-8 years). Anemia, leukocytosis, hyperglobulinemia, azotemia, hypercalcemia, and hypoalbuminemia were present in 8, 21, 12, 9, 8, and 6 dogs, respectively. Diskospondylitis, osteomyelitis and thoracic lymphadenomegaly were present in 16, 10, and 5 dogs, respectively. Sonographic findings were enlarged hypoechoic lymph nodes (n 5 12), mottled and irregular kidneys with or without masses (n 5 12), pyelectasia, and an aggregate of echogenic material in the renal pelvis (n 5 9). Thirteen dogs were treated with antifungal drugs, with survival times ranging from 0 to 25 months after diagnosis.Conclusions and Clinical Importance: Systemic aspergillosis typically involves young to middle-age female German Shepherd dogs, and there are characteristic abdominal ultrasound findings with the disease process. Infection with A. deflectus was as common as A. terreus, and in rare cases, long-term survival was associated with antifungal therapy.

Emergence of Disseminated Infections Due to Geosmithia argillacea in Patients with Chronic Granulomatous Disease Receiving Long-Term Azole Antifungal Prophylaxis

“…The only case of systemic infection due to G. argillacea has recently been reported in a German shepherd dog, an animal species known to be predisposed to disseminated aspergillosis (12). Of note, in this animal case, discospondylitis and sternal involvement were also described (8).…”

Aspergillus versicolor, a New Causative Agent of Canine Disseminated Aspergillosis

“…Disseminated aspergillosis is a relatively infrequent but potentially fatal disease in dogs. The two most common etiologic agents are A. terreus and A. deflectus, followed by A. fumigatus, A. niger, and A. flavipes in order of decreasing frequency (37). Disseminated A. terreus infection in a dog was first reported in 1978 (45).…”

“…A recent study of systemic aspergillosis in 30 dogs reported a mean age of 4.5 years, with a range of 2 to 8 years and a female-to-male ratio of approximately 3.1:1 (37). The German shepherd dog is the most commonly affected breed; however, other breeds, including the Dalmatian, English setter, pug, Rhodesian ridgeback, springer spaniel, and whippet, have occasionally been affected (21,22,37). Comparative studies of serum immunoglobulin concentrations in healthy dogs indicate that the IgA level in the German shepherd dog is significantly lower than that in other breeds (11,18,43).…”

“…Clinical presentations of disseminated aspergillosis may include diskospondylitis, osteomyelitis, spinal hyperpathia, vestibular abnormalities, ataxia, paraparesis, weight loss, anorexia, uveitis, lameness, renal failure, and respiratory distress (4,6,35,37). Leukocytosis, hyperglobulinemia, azotemia, and hypercalcemia are common clinicopatho- logic features (37).…”

“…Treatment of disseminated aspergillosis is difficult, and the prognosis is usually unfavorable. Retrospective studies indicate that the disease is refractory to amphotericin B treatment (37,45). Long-term treatment of up to 3 years with itraconazole may clear the infection or prolong the survival time (24).…”