Diagnosis, treatment, and temporary remission of disseminated paecilomycosis in a vizsla

Abstract

A case of disseminated paecilomycosis in a three-year-old vizsla is described. Clinical signs of lethargy, weight loss, lymphadenopathy, diarrhea, and vestibulocochlear deficits were exhibited. Dense colonization of bone marrow by the fungus was found early in the disease course. Serial culture of bone-marrow aspirates and in vitro sensitivity testing helped monitor disease progression and guide antifungal therapy. Clinical and laboratory parameters demonstrated marked improvement for a period of 12 weeks. Multisystemic disease with central nervous system involvement was found at necropsy.

Paecilomycosis in Dogs and Horses and a Review of the Literature

“…Among cases of paecilomycosis from the veterinary medical literature, there were 9 dogs, including 7 confirmed and 2 probable. [1][2][3][4][5][6][7][8][9] Of dogs for which age and gender were reported, all (8 dogs) were female, and the reported ages were from 2 to 7 years, with a median of 4.5 years. The breeds included 4 GSDs, a Weimaraner, a Vizsla, a Kelpie, and a mixed breed.…”

Temporary remission of disseminated paecilomycosis in a German shepherd dog treated with ketoconazole : case report

“…Proper identification and sensitivity testing are important because P. varioti is susceptible to most common antifungals including amphotericin B and flucytosine, while P. lilacinus is generally highly resistant to these drugs 2,15,19 . In previous reports, Paecilomyces was found to be highly sensitive to Amphotericin B and flucytsine, with intermediate sensitivity to ketoconazole 9,10 . P. varioti was previously reported to be resistant to miconazole and griseovulvin 9 .…”

“…Results of fungal in vitro sensitivity testing do not always correlate well with in vivo clinical response 2 . Ketoconazole has been used previously in 3 cases of paecilomycosis in dogs 5,9,10 , in 2 cases as the only medical treatment, with 1 dog surviving for 3 weeks 9 . The duration of treatment of the dog in the 2nd report is uncertain 5 .…”

“…This dog died after 26 weeks. In the 3rd case, ketoconazole was combined with amphotericin B for the first 8 weeks, before being substituted by fluconazole because of its ability to cross the blood-ocular and blood-brain barriers 10 . Ketoconazole in this case was chosen empirically based on previously reported efficacy, cost and reduced toxicity with prolonged use.…”

“…Fungal infections have been reported in humans 2,15,19,20 , 8 dogs 5,7,[9][10][11]13,14,18 , a cat 4 and other species 4,10 . Two additional cases of suspected Paecilomyces spp.…”