Clinical Signs, Imaging Features, Neuropathology, and Outcome in Cats and Dogs with Central Nervous System Cryptococcosis from California

Abstract

Background: Cryptococcus spp. is a fungal pathogen with a predilection for the central nervous system (CNS). Objectives: To compare the clinical, advanced imaging, and neuropathologic findings in dogs and cats with CNS cryptococcosis, and to evaluate outcome of treatment in these animals.Animals: Twenty-six cats and 21 dogs with CNS cryptococcosis. Methods: Medical records were reviewed for clinical findings and results of CNS imaging. Archived cerebrospinal fluid and CNS tissue specimens were reviewed for pathology. Findings in cats were compared with those in dogs and the effects of variables on survival were determined by survival curve analysis.Results: When present, pain was localized to the cervical region in dogs and was generalized or localized to the thoracolumbar spine or pelvic limbs in cats. Magnetic resonance imaging (MRI) findings were variable but correlated with CNS histopathological findings of meningitis, meningitis with gelatinous pseudocyst formation, and granulomatous mass lesions. Peripherally enhancing brain lesions were seen only in cats. Histopathologically, the inflammatory response was milder in cats compared with dogs. Remissions of !1 year occurred in 32% of treated animals. Altered mentation was associated with negative outcome. Glucocorticoid use after diagnosis was associated with improved survival in the first 10 days.Conclusions and Clinical Importance: Lesions seen on MRI reflected neuropathological findings and were similar to those reported in human patients. The immune response to infection may differ between cats and dogs, or relate to the infecting cryptococcal species. Long-term (46 month median survival time) survival may be possible in animals surviving !4 days after diagnosis.

Doenças micóticas em gatos no Rio Grande do Sul

“…Um trabalho que avaliou onze amostras de criptococose cerebral em gatos observou que em nove animais a inflamação era discreta (Sykes et al 2010). Isso pode ser explicado pela presença da sua cápsula, que possui propriedades que dificultam a fagocitose de macrófagos e neutrófilos e ainda interfere na migração de neutrófilos para os tecidos (Lester et al 2011).…”

Cryptococcus gattii-Induced Infections in Dogs from Southern Brazil

“…Although infections due to C. gattii are frequent and increasing in dogs from North America [5,11,12,14,15] and Australia [16,17], there is little information relative to the occurrence of this fungus in dogs from Brazil, with only one report of C. gattii cryptococcosis [18]. Conversely, human cryptococcosis is endemic with a distinct regionalized occurrence in Brazil; cases due to C. neoformans are widespread and occur throughout the entire country, while C. gattii-associated cryptococcosis is predominant within the northeastern region, with sporadic cases occurring in Southern Brazil [8].…”

Cryptococcus gattii Infections

“…Eye involvement, characterized by chorioretinitis and blindness, is not uncommon. Single or multiple cryptococcomas can occur in the brain and spinal cord (181). Unlike in koalas and horses (see below), lung manifestations, including pyothorax, are uncommon (180).…”

“…These aspects are not reviewed, but the salient features of C. gattii infection in various animals are presented. Case reports and moderate-to-large case series of C. gattii in cats abound (37,169,(171)(172)(173)(176)(177)(178)(179)(180)(181)(182). A review of the major studies where the etiologic cryptococcal species were reported indicates that there are no clinical features which reliably distinguish disease caused by C. neoformans from that due to C. gattii.…”