Cryptococcus gattiiinfection in a Spanish pet ferret (Mustela putorius furo) and asymptomatic carriage in ferrets and humans from its environment

Abstract

A domestic ferret (Mustela putorius furo) was presented with lymphadenopathy and acute bilateral blindness. Cytologic evaluation and biopsy of an affected lymph node revealed pyogranulomatous lymphadenitis with intralesional yeast consistent with Cryptococcus sp. Subsequent studies demonstrated Cryptococcus gattii serotype B VGI/AFLP4 as the causative agent. The ferret was treated with fluconazole and prednisone. After one month of therapy, an improvement of the clinical symptoms was detected although blindness persisted. Seven months after presentation, the disease progressed to a severe neurologic condition, and it was euthanized. Postmortem exam revealed disseminated cryptococcosis with prominent neurologic involvement. Nasal swabs of other ferrets and humans from the same household revealed that two ferrets and two humans to be asymptomatic carriers of the same strain of cryptococcus as the necropsied ferret. These findings stress the importance of veterinary diagnostic work with pets and epidemiological investigations for disease prevention in them and in their owners.

Selected Emerging Diseases in Ferrets

“…In a case of chorioretinitis, the ferret was treated with oral prednisone. 13,14 This ferret was also treated with fluconazole at the same time, but when he was euthanized 7 months after treatment he had signs of systemic cryptococcosis.…”

“…Reported exposures include living outdoors in a hutch, 6,8 contact with pigeons and finches, 8 digging outside, 7 leash walks outside, 15 and outdoor play areas. 13,14 The incubation period can range from 2 to 13 months, so previous travel to an endemic area is another potential risk factor. 2 There are 3 cases of ferrets with cryptococcosis living with other ferrets or humans that had the same species of Cryptococcus, either as asymptomatic carriers or with disease themselves.…”

Cryptococcus gattii Infections

“…Infection in immunocompetent children in southern and southeastern Brazil has also been reported (223,224,256). Among 16,192 episodes of cryptococcosis (due to both C. neoformans and C. gattii) in predominantly HIV-infected persons in South Africa from 2005 to 2007 (232), a bimodal distribution of infection was noted, with a peak in children Ͻ1 year old and a second peak in those aged 5 to 10 years. Although most pediatric infections were due to C. neoformans, children were significantly more likely than adults to be infected with C. gattii (9% versus 3%; P Ͻ 0.001).…”

“…Granulomatous skin nodules on the neck or body and retrobulbar lesions also occur (172,191). At least five confirmed cases of cryptococcosis due to C. gattii in ferrets, including cases from Spain, have been reported, two of which were autochthonous cases (192,193); lesions were present in the nasopharynx, lung, lymph nodes, CNS, and bone.…”

Diagnosis of Liver Disease in Domestic Ferrets (Mustela Putorius)

“…Cryptococcus There are several reports of disseminated Cryptococcosis in ferrets. [54][55][56] When they developed generalized Cryptococcosis, clinical signs and findings are limited to lower respiratory tract disease with pneumonia, pleurisy, and mediastinal lymph node involvement or infection in a segment of intestine with subsequent spread to mesenteric lymph nodes. C bacillisporus (formerly C neoformans var grubii) accounted for the infections in ferrets.…”