Systemic Mycosis in Three Dogs from Nonendemic Regions

Abstract

Three dogs were examined for clinical signs ultimately attributed to systemic fungal infections. One dog was evaluated for chronic, ulcerated dermal lesions and lymphadenomegaly; one dog was examined for acute onset of unilateral blepharospasm; and one dog had diarrhea and hematochezia. Two of the dogs were diagnosed with blastomycosis (one with disseminated disease and the other with the disease localized to the left eye). The third dog was diagnosed with disseminated histoplasmosis. None of the dogs originated from, or had traveled to, typical regions endemic for these fungal diseases. All diagnoses were established from histopathology and either polymerase chain reaction (PCR) or cytology and culture. The two dogs diagnosed with blastomycosis were treated with either itraconazole or ketoconazole with apparent resolution of the infections. The dog with ocular involvement had an enucleation prior to beginning therapy. The dog diagnosed with histoplasmosis was euthanized without treatment. In patients with characteristic clinical features, systemic fungal infections should still be considered as differential diagnoses regardless of their travel history.

Mycotic Infections Acquired outside Areas of Known Endemicity, United States

“…In addition to these apparent increases, blastomycosis has also been documented far outside the known disease-endemic areas. One report describes 2 cases probably acquired in the Pacific Northwest: 1 case of ocular blastomycosis in a golden retriever that had never left Washington state and 1 case of disseminated disease in a Rottweiler mix with no history of travel outside of British Columbia ( Table 1 ) ( 8 ).…”

“…Histoplasma can infect many animal species and has been found in domestic and wild animals far outside the traditional disease-endemic areas, including disseminated disease in a dog with no history of travel outside of western Idaho ( 8 ) and in a northern sea otter found in Alaska ( 17 ). Otters do not migrate, so the authors of that report hypothesized that the infection was acquired from windborne spores or spores carried on the wings, feet, or beaks of migratory birds ( 17 ).…”

Fungal Infections

“…Regions of the United States with greatest prevalence are the Ohio, Missouri, and Mississippi river valleys. 13,14 Route of entry is typically respiratory.…”

The Association Between Hospital Characteristics and Nonresponse in an Organization Survey: An Analysis of the National Healthcare Establishment and Workforce Survey in Malaysia

“…The bias occurs because of systematic differences between those who did and those who did not respond (Draugalis & Plaza, 2009; Halbesleben & Whitman, 2013; Snijkers, 2013). This is an important and challenging issue in the field of survey research because biased estimates can have undesirable consequences; overcoming nonresponse has proven difficult (Pratt, Sellon, Spencer, Johnson, & Righter, 2012). While survey response rates remain a common measure of survey quality, nonresponse bias should also be the focus of survey quality assessment (Johnson & Wislar, 2012; Loft, Murphy, & Hill, 2015).…”