Generalized calcinosis cutis associated with disseminated paecilomycosis in a dog

Abstract

A 4-year-old spayed female mixed breed dog was referred to the Michigan State University, Veterinary Teaching Hospital (MSU-VTH) with vomiting, lethargy and anorexia of 2 weeks duration. Abdominal radiographs and ultrasonography showed hepatosplenomegaly. Cytological evaluation of ultrasound-guided fine needle aspirates of the liver and spleen revealed fungal organisms and pyogranulomatous inflammation; fungal culture documented Paecilomyces variotii infection. The dog received antifungal therapy and supportive care. Multiple firm plaque-like skin lesions, predominantly involving the inguinal region, developed 18 days after initial presentation and were diagnosed histopathologically as calcinosis cutis. While generalized calcinosis cutis has been reported in three dogs with blastomycosis and one dog with leptospirosis, the association with disseminated Paecilomyces spp. infection is novel.

Calcinosis cutis in dogs: histopathological and clinical analysis of 46 cases

“…Metastatic calcification describes calcium salts that precipitate within normal tissues as a consequence of underlying systemic calcium or phosphorous imbalance . This is most often seen in dogs in the context of impaired renal function, but has also been reported with systemic blastomycosis and paecilomycosis . Iatrogenic CC occurs secondary to percutaneous absorption or injection of calcium‐containing products into the skin .…”

Resolution of iatrogenic calcinosis cutis in a dog through topical application of DMSO

“…Even though its cause is not clear,1 treatments with glucocorticoids seem to result in calcinosis cutis in dogs. However, it is still unclear whether the mineral storage is dependent on the dose or a combination of factors.…”

Clinical, Morphological, and Molecular Characterization of Penicilliumcanissp. nov., Isolated from a Dog with Osteomyelitis

“…P. verruculosum, P. purpurogenum, and several penicillia not identified to the species level have been reported in dogs with fungal osteomyelitis (2,6,7,(10)(11)(12). The prognosis in these cases is poor, with most dogs succumbing to disease or undergoing euthanasia shortly after diagnosis (2,7,(9)(10)(11)(12). Although clinically stable disease during aggressive combination antifungal therapy has been reported rarely, cures are unlikely (2).…”

“…Cases incited by Geosmithia argillacea (subsequently characterized in the genus Rasamsonia and reidentified by Houbraken et al as Rasamsonia piperina [13,14]), Paecilomyces species, Phialosimplex species, Aspergillus terreus, and other unclassified species of the genera Penicillium and Aspergillus have been reported, with infections caused by aspergilli being the most common (2,(6)(7)(8)(9)(10)(11)(12)(15)(16)(17)(18). The exact species is questionable in some reports, as isolates were identified on the basis of morphological features without concurrent molecular sequencing (2,(6)(7)(8)(9). The majority of infections were reported in German shepherd dogs (GSD), a breed presumed to have a hereditary immunologic defect (2,7,11,12,18,19).…”

“…Opportunistic filamentous fungal infections of dogs are infrequently reported (2,(6)(7)(8)(9)(10)(11)(12). Clinical manifestations often include some combination of bone or back pain, respiratory disease, neurologic abnormalities, renal disease, hepatic disease, draining wounds, and uveitis.…”