Ultrasonography of a ureteral and bladder fungal granuloma caused byScedosporium apiospermumin a basset hound

Abstract

A 5-year-old, spayed female, Basset Hound was referred for evaluation of a urinary bladder mass. Ultrasonographic images revealed a large, inhomogeneous, hypoechoic mass associated with the dorsal wall of the neck of the urinary bladder and left ureter. Partial cystectomy and left ureteral reimplantation were performed. Histopathology showed a severe inflammatory mass lesion forming multiple granulomas. A DNA sequencing test revealed Scedosporium apiospermum as the causative agent. Susceptibility tests on the isolated strain indicated susceptibility to voriconazole. To the authors' knowledge, this is the first report describing S. apiospermum as a cause of granulomas involving the canine ureterovesicular junction.

Disseminated Scedosporium apiospermum infection in a Maremmano-Abruzzese sheepdog

“…A small number of systemic scedosporiosis caused by Scedosporium apiospermum have been reported in canine species [13,[15][16][17] and the involvement of the urinary tract and reproductive apparatus have been rarely reported [18][19][20]. Interestingly, many disseminated infections in dogs have had no apparent route of entry or predisposing factors [13], and as reported in the present case, the route of infection remains unknown.…”

Scedosporium apiospermum infection presenting as a mural urinary bladder mass and focal peritonitis in a Border Collie

“…In dogs, there has recently been an increasing number of reports of S. apiospermum, which has been implicated in cases of fungal rhinitis [ [17] , [18] , [19] , [20] ], osteomyelitis and discospondylitis [ 8 , 21 ], keratomycosis [ [22] , [23] , [24] ], enteritis and peritonitis [ 4 ], and systemic disease [ 3 , 5 , [25] , [26] , [27] , [28] ]. In the only report describing a case of S. apiospermum causing ureteral and bladder granulomas in a dog, they were unable to identify the portal of entry [ 9 ]. In this case, given the clinical history of multiple traumatic events and an outdoor living style, there were many opportunities for opportunistic infection by S. apiospermum .…”

“…In this case, since the bulk of the disease was excised surgically and this dog was treated as recommended with a full 6 month course with an appropriate antifungal, prognosis is expected to be good. In the only other reported case of S. apiospermum involving the urinary bladder in a dog, the patient was doing well 1.5 years after presentation with resolution of the fungal granuloma after long-term antifungals [ 9 ]. In this case, continued monitoring via abdominal ultrasound to identify any new masses or lesions was recommended as a precaution.…”

“…Judicious selection of antifungals often requires susceptibility testing because Scedosporium is frequently resistant to numerous antifungal agents [ 6 ]. Only one report in the literature describes a case of Scedosporium apiospermum causing ureteral and bladder granulomas in a dog [ 9 ]; however, the portal of entry was not identified. This report documents a unique case of Scedosporium apiospermum infection presenting as a urinary bladder wall mass in addition to a second mass within the cranial peritoneal cavity in a Border Collie that had a history of multiple traumatic injuries over the course of several years.…”

Ultrasonographic detection of apex nodules in the urinary bladder of Scottish Terriers

“…A thickened irregular bladder wall can be present in neoplastic and inflammatory conditions. Mass lesions can also be associated with neoplasia or inflammatory conditions such as granulomas 3–5 . Polypoid cystitis is often associated with multiple polypoid to pedunculated masses, although broad‐based polyps also occur 2,10 .…”