An 8‐year‐old, neutered male Labrador Retriever presented with acute forelimb lameness. Clinical signs progressed over one week. On physical examination, right cubital joint effusion and bilateral axillary lymphadenomegaly were noted, and severe internal lymphadenomegaly was observed ultrasonographically. Granulomatous lymphadenitis with intralesional fungi was noted cytologically, and the dog was ultimately diagnosed with disseminated Talaromyces helicus infection via PCR of a pure isolate. Extensive medical therapy was pursued, and months later, an arthrocentesis was performed due to continued lameness and severe cubital joint effusion. The synovial fluid contained increased numbers of neutrophils, macrophages, and multinucleated giant cells. Frequent fungal hyphae were found both intracellularly and extracellularly. These basophilic organisms were 2‐4 µm in width with internal eosinophilic granules, roughly parallel walls, and occasional to frequent septa. Round to oval yeast‐like forms with thin, clear halos were also occasionally identified. Due to the severity of clinical signs, the right thoracic limb was amputated. Histologic examination of the cubital joint revealed marked granulomatous synovitis, fasciitis, panniculitis, and osteomyelitis, all with intralesional fungi. Talaromyces helicus is a very rare cause of disease, reported only in one other dog. Granulomatous lymphadenitis appears to be a feature of this disease, but this report is the first to describe a significant synovial component.

No abstract

A 7-year-old, neutered male, mixed breed (Poodle-type) dog was presented to the internal medicine service at Affiliated Veterinary Specialists in Gainesville, Florida, for evaluation of a several week history of intermittent, dry coughing that was unresponsive to doxycycline or trimeprazine/prednisolone. A recent onset of bilateral mucoid nasal discharge was noted, and at the time of presentation, both nares were ulcerated and swollen (Figure 1). The dog had no reported travel history. Physical examination revealed generalized lymphadenopathy-peripheral lymph nodes were approximately 2-3 cm and firm upon palpation. No cutaneous lesions were present, aside from the ulcerated nares. A biochemistry panel at that time revealed a decreased albumin concentration (1.8 g/dL, RI 2.3-4.0 g/dL) and increased alkaline phosphatase activity (441 U/L, RI 23-212 U/L). The hypoalbuminemia was attributed to a negative acute phase response, and the increased ALP was attributed to recent prednisolone administration. Prothrombin time and activated partial thromboplastin time were unremarkable. No overt abnormalities were noted on three-view thoracic radiography. Abdominal ultrasonography was within normal limits, with the exception of a moderately enlarged sublumbar lymph node. Fine-needle aspirates of both a submandibular and popliteal lymph node were submitted to the University of Florida for evaluation. On cytologic evaluation of both lymph nodes, numerous organisms were observed (Figure 2). These organisms were typically found within macrophages but also identified extracellularly. The pale to moderately basophilic structures had a very thin, clear halo and were generally round, sometimes oval, and rarely irregular in shape. Most organisms were between 5.5-7.5 µm in diameter.

Laboratory testing is an important part of case management and medical decision-making and begins when the choice is made to perform a diagnostic test. 1 Laboratories strive to produce precise, accurate data. 2-4 However, errors do occur, and factors outside of the laboratory itself can also influence sample results. 5 Errors in laboratory medicine can be divided into preanalytic, analytic, and postanalytic errors. 1,6-8 "Preanalytic" error occurs prior to actual sample testing and can include test selection and ordering, sample

No abstract