Cryptococcosis in a Cat

Paula Elisa Brandão Guedes, Thaís Nascimento de Andrade Oliveira, Julian Andrade dos Santos, Mario Sérgio Lima de Lavor, Fabiana Lessa Silva, Luci Ana Fernandes Martins, Renata Santiago Alberto Carlos

Abstract


Background: Cryptococcosis is a mycosis that primarily affects domestic cats and is caused by fungi of the genus Cryptococcus, resulting in cutaneous, ocular, respiratory, and neurological manifestations. Diagnosis is based on the microscopic evaluation of the lesions and isolation of the causative agent. The aim of this study was to describe a case of feline cryptococcosis diagnosed by cytology and treated at the Veterinary Hospital of the State University of Santa Cruz (HV-UESC). 

Case:A 5-year-old uncastrated male cat was taken to the HV-UESC small animal clinic, owing to a gradual increase in the volume of the nasal plane spanning over a year, accompanied by respiratory distress. Upon physical examination, the animal was found to have regular nutritional status, dehydration, hypocorous mucosae, and enlarged popliteal lymph nodes. In addition, multifocal areas of ulceration on the body as well as increased volume in the nasal plane (clown nose) were observed. Peripheral blood samples were collected for complete blood count and biochemical analysis. Due to clinical suspicion of fungal lesions, fine needle aspiration of the nasal lesion was performed and cytological slides were sent to the HV-UESC histopathology laboratory. Probable diagnoses included rhinosporidiosis, cryptococcosis, and histoplasmosis. The animal was subjected to thoracic radiography in the imaging division of the HV-UESC. Blood counts revealed thrombocytopenia (130,000/mm3) and biochemical tests presented hypoproteinemia (3.2 g/dL), with hypoalbuminemia (1.52 g/dL); however, chest radiography did not show pulmonary alterations. Results of cytological analysis indicated pyogranulomatous inflammation associated with intracellular organisms, demonstrating a pathogen morphology similar to that of Cryptococcus spp. Before the diagnosis, itraconazole 5 mg/kg (1 capsule, twice a day for 30 days) and fipronil (1 ampoule 0.5 mL, on the back) were prescribed. Follow-up after 40 days showed a slight improvement in cutaneous lesions and respiration, and no other abnormalities were observed. At the follow-up, the owner disclosed that medication could not be administered at the prescribed frequency because of the animal often ran away from home and stayed without prescription. Due to unsatisfactory response to the first treatment, the dosage of itraconazole1 was increased to 10 mg/kg (1 capsule, twice a day, for 30 days) with a new regimen and follow-up after 15 days. However, the owner did not make a follow-up visit. A year later, after several attempts to contact the owner, we were notified that the treatment had been discontinued and the cat still presents with lesions. Discussion: Although cryptococcosis is not endemic, the cat roamed freely on the streets and may have been infected by inhaling the microorganism spores present in the environment. The clinical signs exhibited by the animal were consistent with the findings associated with Cryptococcus spp. infection in cats, especially the "clown nose" lesion. The cat, besides being dehydrated at the time of care, had a regular nutritional status. Cytology, the only diagnostic technique used in this case through which it was possible to visually identify the fungus, was definitive for the diagnosis of cryptococcosis. Although the prescribed treatment is one of the most indicated in such cases, it was not effective, possibly due to inadequate administration. The length of infection, discontinuation of therapy, and absence of follow-ups for clinical reassessment certainly contributed to an unfavorable prognosis.



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References


Aranha A.R. & Zappa V. 2009. Criptococose. Revista Científica Eletrônica de Medicina Veterinária. VII(12): 1-4.

Canavari C., Vargas G.H., Tinucci-Costa M. & Camplesi A.C. 2017. Criptococose: revisão de literatura. Revista Electrónica de Veterinária. 18(9): 1-5.

Castro N.B., Rolim V.M., Nascimento L.C., Silveira A.F.V., Argenta F.F., Ferreiro L., Driemeier D. & Sonne L. 2017. Doenças micóticas em gatos no Rio Grande do Sul. Pesquisa Veterinária Brasileira. 1313-1321.

Correa J.M.X., Oliveira N.G.S.G., Silva F.L., Michel A.F.R.M., Lavor M.S.L., Silva E.B. & Carlos R.S.A. 2017. O diagnóstico preciso muda o prognóstico do paciente felino com carcinoma de células escamosas? Medvep - Revista Científica de Medicina Veterinária - Pequenos Animais. 15(46): 54-60.

Cowell R.L., Tyler R.D., Meinkoth J.H. & DeNicola D.B. 2009. Principais agentes infecciosos. In: Cowell R.L., Tyler R.D., Meinkoth J.H. & DeNicola D.B. (Eds). Diagnóstico Citológico e Hematologia de Cães e Gatos. 3.ed. São Paulo: Editora MedVet, pp.47-67.

Danesi P., Furnari C., Granato A., Schivo A., Otranto D., Capelli G. & Cafarchia C. 2014. Molecular identity and prevalence of Cryptococcus spp. nasal carriage in asymptomatic feral cats in Italy. Medical Mycology. 52: 667-673.

Faria R.O., Nascente P.N., Meinerz A.R.N., Cleff M.B., Antunes T.A., Silveira E.S., Nobre M.O., Meireles M.C.A. & Mello J.R.B. 2010. Ocorrência de Cryptococcus neoformans em excretas de pombos na Cidade de Pelotas, Estado do Rio Grande do Sul. Revista da Sociedade Brasileira de Medicina Tropical. 43: 198-200.

Lima G.H., Alves E.H.A. & Oliveira D.M. 2017. Diagnóstico de criptococose nasal em felino por meio da citologia aspirativa por agulha fina (PAAF) na região noroeste do Ceará. Ciência Animal. 27(2): 26-29.

Marcasso R.A., Sierra S., Arias M. V. B., Mônica V., Bracarense A.P.F.R.L., Yakamura A.A.M., de Biasi F., Lopes B.A., Amude A.M. & Cortês D.E.A. 2005. Criptococose no sistema nervoso de cães - relato de três casos. Semina: Ciências Agrárias. 26(2): 229-238.

Pereira M.F., Santos B.M., Silva V.C.L., Pereira H.N.S., Silva L.B.G., Paiva B.H.A., Barros R.B., Dias M.B.M.C., Neves A.K.R. & Oliveira A.A.F. 2013. Aspectos clínicos e anatomopatológicos da criptococose nasal com disseminação sistêmica em cão: relato de caso. Medicina Veterinária. 7(2): 7-15.

Reolon A., Perez L.R.R. & Mezzari A. 2004. Prevalência de Cryptococcus nos pombos urbanos na cidade de Porto Alegre, Rio Grande do Sul. Jornal Brasileiro de Patologia e Medicina Laboratorial. 40(5): 293-298.

Sanchini L., Reading M., Williams T. & Archer J. 2017. Unusual clinical presentation of cryptococcosis in an immunocompetent cat. Veterinary Record Case Reports. e000524. doi: 10.1136/vetreccr-2017-000524.

Santos C.M., Tonial A.L., Duarte V.R., Favscho A.R.M., Ferreira E.C. & Aquino D.R.R.R.A. 2018. Exposição de felinos a agentes infecciosos de interesse zoonótico. Análise molecular em gatos de Campo Grande, MS, Brasil. Brazilian Journal of Animal and Environmental Research. 1(1): 115-124.

Vieille P., Cruz R., León P., Cáceres N. & Giusiano G. 2018. Isolation of Cryptococcus gattii VGIII from feline nasal injury. Medical Mycology Case Reports. 22: 55-57.




DOI: https://doi.org/10.22456/1679-9216.95918

Copyright (c) 2019 Paula Elisa Brandão Guedes, Thaís Nascimento de Andrade Oliveira, Julian Andrade dos Santos, Mario Sérgio Lima de Lavor, Fabiana Lessa Silva, Luci Ana Fernandes Martins, Renata Santiago Alberto Carlos

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