Sinonasal aspergillosis: Outcome after topical treatment in dogs with cribriform plate lysis

Abstract

BackgroundCribriform lysis has been considered a contraindication for topical treatment of sinonasal aspergillosis (SNA) because of concerns about drug extravasation with resultant neurologic signs or death.Objective/HypothesisTo describe dogs with SNA and cribriform plate lysis treated with topical antifungal medications. Our hypothesis was that the conventional dogma that topical therapy should be avoided in these cases is incorrect.AnimalsNine client‐owned dogs with SNA and lysis of the cribriform plate, lysis of the floor of a frontal sinus or both detected by computed tomography (CT).MethodsA retrospective review of medical records was performed. Dogs that met inclusion criteria (ie, SNA confirmed by at least 1 laboratory test, braincase affected on CT, and topical treatment applied) were included. Size of lesions, ancillary diagnostic test results, topical therapy, and adjuvant PO treatments were recorded. Outcome was determined by phone calls.ResultsFour dogs were alive at the time of the manuscript submission with follow‐up ranging from 188 to 684 days without neurological signs observed. All dogs were discharged without major complication 1‐7 days postoperatively. One dog that had presented with a history of seizures experienced seizure activity 2 months after treatment.Conclusions and Clinical ImportanceTopical therapy did not result in complications in these dogs in which lytic regions as large as 16 × 22 mm2 were noted. Sinonasal aspergillosis associated lysis of the cribriform plate; lysis of the floor of a frontal sinus or both detected on CT is not necessarily a contraindication to topical therapy.

Fungal rhinosinusitis caused byScedosporium apiospermumin a dog in the United Kingdom

“…However, the patient did not develop any neurological signs, and recent literature suggests that topical therapy is still appropriate in cases with cribriform plate lysis. 18 To the authors' knowledge, this is the first case report of S. apiospermum rhinosinusitis infection described in the United Kingdom.…”

“…The lack of repeat imaging examination before topical intervention to restage the disease cannot exclude this scenario. However, the patient did not develop any neurological signs, and recent literature suggests that topical therapy is still appropriate in cases with cribriform plate lysis 18 …”

The sino-nasal warzone: transcriptomic and genomic studies on sino-nasal aspergillosis in dogs

“…The time of infection and their micro-environments also differ. Knowledge of SNA is limited, and most studies have focused on diagnostics and treatment of dogs 5,30,[32][33][34] , on fungal resistance 27 and on the local immune response [6][7][8] . These studies suggested an induction of Th1 response during SNA.…”

“…Proper diagnosis of SNA requires a combination of computed tomography (CT), rhinoscopy, histopathology, cytology, fungal culturing, and serology 2 . Topical administration of azole drugs remains the most widely used and successful treatment for SNA in dogs although reports of its use are limited 2,3,5 . SNA has been associated with upregulation of Th1 cytokines like interleukin (IL)-8 and TNF-α [6][7][8] .…”

Otitis externa canina por Aspergillus niger patogénico: reporte de caso

“…En caninos y felinos se presentan principalmente tres formas de aspergilosis: nasal, pulmonar e infecciones diseminadas. La aspergilosis nasal presenta frecuentemente sinusitis invasiva, ocasionada por las especies A. flavus, A. fumigatus y A. niger (Ballber et al, 2018;Belda et al, 2018). La de tipo pulmonar es de rara presentación y es causada por similares especies, además de A. versicolor (Maniam et al, 2017), mientras que la forma diseminada es una infección infrecuente, pero potencialmente fatal en perros, siendo las especies más aisladas A. terreus, A. deflectus y A. caninus (Kano et al, 2019;Yang et al, 2019), seguido en menor frecuencia por A. fumigatus (Brocal et al, 2019).…”