First case of feline leishmaniosis caused by Leishmania infantum genotype E in a cat with a concurrent nasal squamous cell carcinoma

Abstract

Case summaryThis is the first clinical report of feline viscerocutaneous leishmaniosis caused by Leishmania infantum genotype E associated with an invasive squamous cell carcinoma (SCC) in a domestic cat from Portugal. Initially, the cat presented a single cutaneous lesion in the right nostril. A fine-needle aspiration was performed and Leishmania amastigotes were observed without the presence of cells compatible with neoplasia. Systemic treatment with allopurinol was started. One year later, the cat presented a crateriform non-encapsulated and badly delineated mass in the nasal planum, with naso-oral fistulation and nasal destruction. Histologically, the skin mass consisted on an ulcerative plaque-like lesion with a nasal SCC. Leishmania infantum MON-1 parasites were detected by histopathology, culture and PCR of the skin mass, submandibular and popliteal lymph nodes, liver and spleen. Restriction enzyme analysis revealed genotype E, previously identified in humans and dogs living in the same region.Relevance and novel informationThis is, to the best of our knowledge, the first clinical report of feline viscerocutaneous leishmaniosis caused by L infantum genotype E. The detection and isolation of parasites from a cat that are genetically identical to the ones obtained from humans and dogs with visceral leishmaniosis highlights the need to clarify whether cats play a role in the epidemiology of this parasitic zoonosis. From a clinical point of view, this case reinforces the importance of including leishmaniosis in the differential diagnoses of feline pathology, especially in cats with cutaneous lesions.

Feline leishmaniosis: Is the cat a small dog?

“…Less frequent and less severe clinical presentations could currently be unreported and we are presumably underestimating the clinical relevance of FeL. As it is reported in CanL, skin or mucocutaneous lesions are the most common reason for veterinary consultation and finding on physical examination in cats with leishmaniosis (Bardagi et al, 2016;Basso et al, 2016;Brianti et al, 2015;Dedola et al, 2015;Maia et al, 2015;Pennisi et al, 2015aPennisi et al, , 2016Saridomichelakis and Koutinas, 2014). Moreover, diverse macroscopic skin lesions can occur in the same dogs or cats.…”

“…Sick dogs with severe clinical disease, high blood parasitemia and antibody level, lack in specific IFN-γ production by ex vivo stimulated whole blood (Solano-Gallego et al, 2016b). Cats with L. infantum-associated clinical disease have high blood parasitemia and low to very high antibody levels but relationship between antibody titer and severity of disease and also their specific IFN-γ production were not investigated (Bardagi et al, 2016;Basso et al, 2016, p. 20;Brianti et al, 2015;Dedola et al, 2015;Maia et al, 2015;Pennisi et al, 2015aPennisi et al, , 2016Pimenta et al, 2015). However, longitudinal studies confirmed that progression to disease is associated in cats with increasing antibody titers as it occurs in CanL (Foglia Manzillo et al, 2013;Maroli et al, 2007).…”

“…However, the review of 89 reported cases of FeL where cats were serologically tested for FIV and Feline Leukemia Virus (FeLV) provides a 30.3% prevalence of FIV coinfection in cats with FeL and only four cats with FeLV co-infection (three of them also FIV positive) were detected (Bardagi et al, 2016;Basso et al, 2016;Brianti et al, 2015;Britti et al, 2005;Caracappa et al, 2008;Coelho et al, 2010;Dalmau et al, 2008;Dedola et al, 2015;Fileccia, 2012;Grevot et al, 2005;Hervás et al, 1999;Ibba, 2009;Laruelle-Magalon and Toga, 1996;Leiva et al, 2005;Marcos et al, 2009;Migliazzo et al, 2015;Ozon et al, 1998;Pennisi et al, 2013;Pimenta et al, 2015;Pocholle et al, 2012;Poli et al, 2002;Richter et al, 2014;Rüfenacht et al, 2005;Sanches et al, 2011;Verneuil, 2013;Vides et al, 2011). Other FeL cases reported in FIV negative cats were diagnosed in animals affected by immune-mediated diseases (and treated with immunosuppressive drugs), neoplasia, or diabetes mellitus (Bardagi et al, 2016;Basso et al, 2016;Caracappa et al, 2008;Laruelle-Magalon and Toga, 1996;Leiva et al, 2005;Maia et al, 2015;Marcos et al, 2009;Maroli et al, 2007;Migliazzo et al, 2015;Rüfenacht et al, 2005) and impaired immuno-competence is overall suspected in about half clinical cases of FeL. In...…”

“…Currently, in areas endemic for L. infantum, FeL is less frequently reported than CanL. Case reports published in recent years provided information on the most common clinical signs and clinico-pathological abnormalities associated with FeL (Bardagi et al, 2016;Basso et al, 2016;Brianti et al, 2014;Dedola et al, 2015;Maia et al, 2015;Pennisi et al, 2015aPennisi et al, , 2016Pimenta et al, 2015). However, coinfections or comorbidities are frequently detected in these cats and they can contribute to a misrepresentation of clinical FeL albeit lesions associated with the presence of the parasite have been detected in skin, lymph nodes, spleen, bone marrow, liver, oral mucosa, stomach, large bowel, kidney, nasal exudate, lung, eye (Pennisi, 2015).…”

“…Feline leishmaniosis (FeL) 3 caused by Li appears as an emerging feline disease, in fact in the past two decades it was more and more frequently reported in endemic areas and sporadically seen also in nonendemic areas in rehomed cats (Rüfenacht et al, 2005;Richter et al, 2014;Pennisi et al, 2015a;Maia et al, 2015;Basso et al, 2016;Pimenta et al, 2015). However, the increased level of medical care given to cats contributed to the «emergence» of FeL as well as availability of more sensitive diagnostic tools and progress in understanding parasite-host-vector interactions (Cantacessi et al, 2015).…”