Treatment of Conidiobolomycosis with Fluconazole in Two Pregnant Mares

Abstract

A n 8-year-old Arabian mare in her 7th month of gestation was examined because of a unilateral serosanguinous nasal discharge of 4 weeks duration. The mare was in good condition, rectal temperature was 99.8ЊF (37.7ЊC), heart rate was 50 beats/min, respiratory rate was 30 breaths/ min, and no abnormal lung sounds were detected. CBC and serum biochemistry values were within reference ranges. Radiographic examination of the skull revealed an 8-cmlong soft-tissue density within the right nasal passage. Endoscopic examination of the nasal passages and soft palate revealed diffuse granulamatous masses in the right nasal passage involving primarily the nasal septum.Cytologic examination of an impression smear of tissue obtained by biopsy of a mass revealed numerous columnar epithelial cells and eosinophils with scattered plasma cells, lymphocytes, and neutrophils and no evidence of infectious agents. Scattered fungal hyphae surrounded by thick radiating collars of eosinophilic amorphous material were apparent during histologic examination. Microbiologic culture of the biopsy tissue identified Conidiobolus coronatus.The mare was treated initially using antigen from C coronatus broth culture. a Clinical signs persisted, and the granulomatous masses had not regressed when the mare was examined 4 weeks after vaccination. Fluconazole (2 mg/kg PO q12h) was then administered at a dosage used for treatment of candidiasis in humans. After the mare had been treated with fluconazole for 2 weeks, respiratory noise and unilateral nasal discharge had resolved, and endoscopic examination of masses within the nasal passages revealed a marked decrease in size. Endoscopic examinations of the nasal passages were performed every 2 weeks. After 8 weeks of treatment with fluconazole, the granulomatous lesions were not apparent during endoscopic examination of the nasal passages, and treatment with fluconazole was discontinued. An apparently normal foal was born 4 weeks later.A 7-year old Arabian mare in her 10th month of gestation had a 10-day history of bilateral serosanguinous nasal discharge and harsh respiratory sounds originating in the pharyngeal region. The mare was in good physical condition, rectal temperature was 98.3ЊF (36.8ЊC), heart rate was 40 beats/min, and respiratory rate was 20 breaths/min. CBC and serum biochemistry values were within normal reference ranges. Radiographic examination of the skull did not reveal abnormalities. Numerous granulamatous lesions in the nasal passages and on the soft palate were seen during endoscopic examination. Cytologic examination of an impression smear of the tissue obtained by biopsy of a nasal mass revealed numerous columnar epithelial cells and neutrophils, with scattered eosinophils. There was no evidence of infectious agents. Fibrinohemorrhagic material admixed with neutrophils, eosinophils, scattered plasma cells, and macrophages were seen during histologic examination. A few thin-walled, infrequently septated hyphal fragments with peripheral basophilic staining were surrounded by de...

Distribution of voriconazole in seven body fluids of adult horses after repeated oral dosing

“…, 2004), itraconazole (Foley & Legendre, 1992; Davis & Legendre, 1994; Korenek et al. , 1994), fluconazole (Reilly & Palmer, 1994; Taintor et al. , 2004; Higgins et al.…”

Disseminated Conidiobolus incongruus in a dog: A case report and literature review

“…Complete and aggressive surgical excision is considered the gold standard treatment; however, the location of infective tissues may preclude surgical intervention. Many different antifungals, such as amphotericin B, ketoconazole, itraconazole and potassium iodide, have been used alone or in combination with marginal success [2,5,12,13,15,20]. Long-term therapy is recommended for several months and recurrence is common.…”

Fungal Skin Diseases

“…Fluconazole was effective for the treatment of sinonasal cryptococcosis in one horse 78 and conidiobolomycosis in two pregnant mares. 64 Both mares delivered normal foals.…”

“…9,10,63,65 In other cases, surgical excision or debulking may be followed by chemotherapy as dictated by in vitro susceptibility tests (amphotericin B, azoles, inorganic iodides). 64,65 Immunotherapy using phenolized vaccines prepared from Pythium cultures were of no benefit in horses with basidiobolomycosis and conidiobolomycosis. In general, systemic iodides are used as a first-line agent to treat basidiobolomycosis and conidiobolomycosis (see p.…”