Candidate prognostic indicators in cats with histoplasmosis treated with antifungal therapy

Abstract

Objectives The aim of this study was to retrospectively identify candidate prognostic indicators in cats with histoplasmosis treated with antifungal therapy. Methods Medical records of cats diagnosed with histoplasmosis were reviewed. Candidate prognostic indicators were assessed for an association with survival to hospital discharge and survival to 1 and 6 months after diagnosis. Potential indicators included easily obtained data at the time of the initial hospital visit derived from cat signalment, historical information, physical examination, laboratory data, form of disease and initial treatment. Results Approximately 88% of cats survived to discharge, with 77% and 67% surviving to 1 and 6 months, respectively. Clinical variables significantly associated with death at more than one outcome time point included the presence of dyspnea, adventitial lung sounds, fungemia, neurologic disease, neutropenia, lymphopenia, multiple cytopenias (anemia, neutropenia, thrombocytopenia), hyperbilirubinemia and increased creatinine kinase activity. Cats that did not survive were more likely to have received corticosteroids, oxygen supplementation and required hospitalization. In addition, cats that did not survive required significantly longer hospitalization. There was no significant difference between initial antifungal drug and survival. Conclusions and relevance Potential prognostic indicators were associated with more severe respiratory, hepatic, hematologic or neurologic disease. Prospective investigation concerning clinical indicators of disease severity of these body systems is indicated.

A monoclonal antibody‐based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats

“…Inhalation of spores (microconidia) found in dust and soil is the most common means of infection. Organs that are commonly affected include the lung, liver, spleen, lymph nodes, bone marrow, bones, and joints . Affected cats often display vague clinical signs such as weight loss, anorexia, and lethargy or weakness .…”

“…Organs that are commonly affected include the lung, liver, spleen, lymph nodes, bone marrow, bones, and joints . Affected cats often display vague clinical signs such as weight loss, anorexia, and lethargy or weakness . Even in endemic areas, diagnosis is commonly delayed .…”

“…Affected cats often display vague clinical signs such as weight loss, anorexia, and lethargy or weakness . Even in endemic areas, diagnosis is commonly delayed . Diagnosis most commonly is confirmed by finding H. capsulatum organisms in cytopathologic or histopathologic samples .…”

“…Even in endemic areas, diagnosis is commonly delayed . Diagnosis most commonly is confirmed by finding H. capsulatum organisms in cytopathologic or histopathologic samples . Treatment includes prolonged administration of antifungal drugs .…”

Histoplasmose pulmonar grave em um gato doméstico: tratamento com Anfotericina B e Itraconazol

“…DISCUSSÃO Na radiografia torácica de animais com histoplasmose costuma-se visualizar alteração no parênquima pulmonar, principalmente o padrão intersticial, muito embora o comprometimento alveolar também possa ser identificado e corroborado a um prognóstico grave. A dispneia e a presença de ruídos pulmonares constituem as manifestações respiratórias mais frequentemente observadas e são associadas a um mau prognóstico da doença [1,4,17].…”