Three cases of feline ocular coccidioidomycosis: presentation, clinical features, diagnosis, and treatment

Abstract

Coccidioidomycosis should be considered as a differential diagnosis for cats with a travel history to the southwestern United States that demonstrate periocular swelling, anterior uveitis, or granulomatous chorioretinitis, with or without evidence of systemic disease. Aspiration cytology or biopsy of suspicious conjunctival or skin lesions, if present, may aid in diagnosis. A combination of corticosteroids and fluconazole may be effective in treating ocular coccidioidomycosis, although chorioretinal granulomas may persist and long-term fluconazole therapy may be necessary.

Causes of endogenous uveitis in cats presented to referral clinics in North Carolina

“…While this study focused on neoplastic causes and five main infectious causes, it must be noted that there are multiple other causes of feline uveitis. Cryptococcus neoformans, Histoplasma capsulatum, Blastomyces dermatiditis and Coccidiodes immitis have all been known to cause uveitis in feline patients. In this study, nine patients were tested for fungal disease, and one was diagnosed with cryptococcosis.…”

“…Endogenous causes, which are the most common cause of uveitis in cats, tend to be divided into large categories, including infectious, neoplastic, and immune‐mediated or idiopathic . The most commonly reported infectious agents associated with feline endogenous uveitis are feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), feline coronavirus (FCoV) causing feline infectious peritonitis (FIP), bartonellosis, toxoplasmosis, and systemic fungal infections, including cryptococcosis, histoplasmosis, blastomycosis, and coccidioidomycosis . The most common primary neoplastic cause of uveitis is iris melanoma, followed by trauma associated sarcoma, while the most common metastatic neoplasia is lymphoma …”

Disseminated histoplasmosis with ocular adnexal involvement in seven cats

“…While rare, conjunctival lesions associated with experimental and natural infection with H capsulatum have been reported dogs, 9 rabbits, 10,11 and humans. 12 Additionally, single cases of conjunctival masses and nictitating membrane inflammation have been reported in two cats as ocular manifestations of coccidioidomycosis 13 and cryptococcosis, 14 respectively. Neoplasia such as amelanotic melanoma, squamous cell carcinoma, or lymphoma should be considered differential diagnoses for ocular adnexal lesions, particularly lesions affecting the nictitating membrane.…”

Rare systemic mycoses in cats: blastomycosis, histoplasmosis and coccidioidomycosis

“…Coccidioidomycosis is usually diagnosed by a combination of serology, cytology and/or histopathology. 19,21,22 Table 1 lists the treatment options for these infections.…”

“…15 Ketoconazole or fluconazole have been used most frequently in feline coccidioidomycosis [EBM grade III]. 1,19 In a recent report of cats with ocular coccidioidomycosis, fluconazole was effective, although long term treatment was necessary in one case [EBM grade IV] 21. …”