Infection of the subcutis of the nose in a cat caused by <i>Mucor</i> species: Successful treatment using posaconazole

Wray, Jon; Sparkes, Andrew H; Johnson, Elizabeth

doi:10.1016/j.jfms.2008.06.001

Cited by 27 publications

(19 citation statements)

References 22 publications

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“…17 Although there is a single case report of a cat with subcutaneous nasal Mucor species infection that responded to oral posaconazole alone, there are no such reports in cats with Cladophialophora species infection. 31 A cat with a pulmonary granuloma containing Cladophialophora species was treated with posaconazole for 7 months after surgical removal of the granuloma but relapsed within 4 weeks after the drug was discontinued. 7 Malachite green is a triphenylmethane chemical dye used in the fish and dye industries that possesses antifungal, antiparasitic and antibacterial activity.…”

Section: Discussionmentioning

confidence: 99%

Novel treatment using topical malachite green for nasal phaeohyphomycosis caused by a new Cladophialophora species in a cat

Brooks

Walton

Shmalberg

et al. 2018

Journal of Feline Medicine and Surgery Open Reports

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Case summaryA 1.5-year-old castrated male domestic shorthair cat presented with a 2 month history of progressive nasal swelling and hyporexia. Minimal improvement prior to referral was achieved with a course of antibiotics and glucocorticoids. Cytology of an ulcerative lesion on the dorsal aspect of the nose was consistent with a diagnosis of phaeohyphomycosis. The cat achieved static disease for 6 weeks following initiation of itraconazole but developed epistaxis at 9 weeks. CT of the head demonstrated nasal and frontal sinus involvement. Nasal biopsy and culture identified infection with a Cladophialophora species not previously reported to cause disease. Initial response to a combination of itraconazole and terbinafine was noted, but owing to severe thrombocytopenia this combination was discontinued. Voriconazole was used but discontinued because of adverse side effects. Posaconazole treatment was offered throughout the clinical course but rejected owing to financial constraints and an uncertain response to medical therapy. Rhinotomy with debulking of diseased tissue and topical malachite green treatment was performed. Following the procedure itraconazole was continued and the cat has had no recurrence for over 1 year.Relevance and novel informationInfections by Cladophialophora species have been reported in veterinary species, including cats. The specific fungal organism isolated from this cat has not been previously reported to cause disease in humans or animals and has only been described in the mangroves of Brazil. Furthermore, this is the first report to describe the use of topical malachite green as a treatment for refractory phaeohyphomycosis.

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Section: Discussionmentioning

confidence: 99%

Novel treatment using topical malachite green for nasal phaeohyphomycosis caused by a new Cladophialophora species in a cat

Brooks

Walton

Shmalberg

et al. 2018

Journal of Feline Medicine and Surgery Open Reports

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“…Successful treatment with posaconazole has been reported in 2 cats with fungal disease in which other antifungal treatment had failed . Those cases involved a Mucor subcutis infection of the nose and invasive orbital aspergillosis.…”

Section: Discussionmentioning

confidence: 99%

“…Successful treatment with posaconazole has been reported in 2 cats with fungal disease in which other antifungal treatment had failed. 12,13 Those cases involved a Mucor subcutis infection of the nose and invasive orbital aspergillosis. For the cat with aspergillosis, antifungal susceptibility testing for the organism was completed and showed that posaconazole was the most effective treatment.…”

Section: Discussionmentioning

confidence: 99%

Posaconazole Pharmacokinetics in Healthy Cats after Oral and Intravenous Administration

Mawby

Whittemore

Fowler

et al. 2016

Veterinary Internal Medicne

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BackgroundPosaconazole is the most active available azole antifungal drug, but absorption and pharmacokinetics are not available to guide dosing regimens in cats.ObjectiveTo determine the pharmacokinetics of posaconazole in cats given an IV solution and PO suspension.AnimalsSix healthy, adult research cats.MethodsAfter a 12‐hour fast, each cat received 15 mg/kg of posaconazole PO suspension with food. Four cats also received 3 mg/kg IV posaconazole after a 7‐day washout period. Plasma was collected at predetermined intervals for analysis using high‐pressure liquid chromatography (HPLC). Concentration data were analyzed using a 2‐compartment pharmacokinetic analysis for IV administration data and a 1‐compartment analysis with first‐order input for PO administration data using Phoenix® software.5 ResultsAfter IV dosing, volume of distribution (V SS) was 1.9 (0.3) L/kg (mean, standard deviation), terminal half‐life (T ½) was 57.7 (28.4) hours, and clearance was 28.1 (17.3) mL/kg/h. After PO dosing, peak concentration (C MAX) was 1.2 (0.5) μg/mL and T ½ was 38.1 (15.0) hours. Bioavailability of PO suspension was 15.9% (8.6). No adverse effects were observed with either route of administration.Conclusion and Clinical ImportanceDespite low PO absorption, these data allow for simulation of PO dosage regimens that could be explored in clinical studies. Two regimens can be considered to maintain targeted trough concentrations of 0.5–0.7 μg/mL as extrapolated from studies in humans: (1) 30 mg/kg PO loading dose followed by 15 mg/kg q48h, or (2) 15 mg/kg PO loading dose followed by 7.5 mg/kg q24h.

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“…), and in a cat with infection of the subcutis of the nose caused by Mucor species (Wray et al . ). Hepatotoxicity can occur, but rarely results in hepatic failure (Courtney et al .…”

Section: Introductionmentioning

confidence: 97%

Treatment of refractory sino‐nasal aspergillosis with posaconazole and terbinafine in 10 dogs

Stewart¹,

Bianco²

2017

J of Small Animal Practice

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Infection of the subcutis of the nose in a cat caused by Mucor species: Successful treatment using posaconazole

Cited by 27 publications

References 22 publications

Novel treatment using topical malachite green for nasal phaeohyphomycosis caused by a new Cladophialophora species in a cat

Novel treatment using topical malachite green for nasal phaeohyphomycosis caused by a new Cladophialophora species in a cat

Posaconazole Pharmacokinetics in Healthy Cats after Oral and Intravenous Administration

Treatment of refractory sino‐nasal aspergillosis with posaconazole and terbinafine in 10 dogs

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