Feline histoplasmosis: fluconazole therapy and identification of potential sources of Histoplasma species exposure

Abstract

Feline histoplasmosis is a systemic fungal infection often treated with itraconazole, which can be cost-prohibitive for some clients. Additionally, although the clinical disease in cats has been documented, sources of Histoplasma species spore exposure in cats have yet to be thoroughly investigated. The objectives of this study were to compare the outcomes of cats with histoplasmosis treated with fluconazole to those treated with itraconazole, and to evaluate possible sources of exposure for affected cats. Medical records from feline patients with confirmed histoplasmosis (n = 32) at Kansas State University were systematically reviewed and follow-up was performed by owner telephone interview. Cats treated with fluconazole (n = 17) had similar mortality and recrudescence rates when compared with cats treated with itraconazole (n = 13). Thus, fluconazole may be a viable alternative therapy for the treatment of feline histoplasmosis. Eleven cats were housed strictly indoors and possible sources of exposure reported for these cats included potted plants (5/11) and unfinished basements (6/11).

Feline histoplasmosis: a case of supraorbital involvement

“…Hematological findings in cat's histoplasmosis indicated neutropenia, thrombocytopenia, anemia or any combination of those alterations (Davies e Troy, 1996;Reinhart et al, 2012). In this report the only abnormality found was monocytosis, one of the most common hematological changes in dogs and cats histoplasmosis (Brömel e Sykes, 2005).…”

“…Pathogenesis of histoplasmosis may suggest that outdoor cats have a higher risk for developing disease because of exposure to contaminated soil, but infection in strictly indoor animals has been reported and related to potted plants (Reinhart et al, 2012). The incubation period of histoplasmosis ranges from 12 to 16 days (Taboada, 2005).…”

“…Hence, we chose to combine amphotericin in the treatment since combined antifungal drugs can be more effective (Powers, 2004;Lloret et al, 2013). Although the majority of cats treated today for histoplasmosis receive azole drugs as a first line of therapy, other antifungal drugs, only or combined, may have a role in optimized treatment (Reinhart et al, 2012). The subcutaneous route for the treatment with amphotericin B in our case was preferred for being less nephrotoxic (O'Brien et al, 2006).…”

“…In Brazil, several micro-epidemics have been reported in people living in the Brazilian states of Rio de Janeiro, São Paulo, Minas Gerais, Paraíba, Bahia and Amazonas (Zancopé-Oliveira et al, 2005;Passos et al, 2014;Rocha-Silva et al, 2014). In relation to feline histoplasmosis little information is available in this country.…”

“…Clinical signs may include cough, dyspnea, exercise intolerance, weight loss, lymphadenopaty, fever and others (Reinhart et al, 2012). The organs most commonly affected in cats are lungs, liver, lymph nodes, eyes, and bone marrow (Brömel e Sykes, 2005).…”