Cerebral Blastomyces dermatitidis infection in a cat

An 8-year-old domestic shorthair cat was evaluated because of signs of depression, circling, and visual deficits. The cat had no cutaneous lesions, and results of an ophthalmologic examination and thoracic radiography were within reference limits. Computed tomography of the brain revealed a mass les...

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Bibliographic Details
Published in:	Journal of the American Veterinary Medical Association Vol. 231; no. 8; pp. 1210 - 1214
Main Authors:	Smith, Jo R, Legendre, Alfred M, Thomas, William B, LeBlanc, Casey J, Lamkin, Cathy, Avenell, James S, Wall, Jonathan S, Hecht, Silke
Format:	Journal Article
Language:	English
Published:	United States 15-10-2007
Subjects:	Amphotericin B - therapeutic use Animals Antifungal Agents - therapeutic use Blastomyces dermatitidis Blastomycosis - diagnosis Blastomycosis - drug therapy Blastomycosis - surgery Blastomycosis - veterinary Brain Diseases - diagnosis Brain Diseases - drug therapy Brain Diseases - surgery Brain Diseases - veterinary Cat Diseases - diagnosis Cat Diseases - drug therapy Cat Diseases - surgery Cats Diagnosis, Differential Male Meningoencephalitis - diagnosis Meningoencephalitis - veterinary Tomography, X-Ray Computed - veterinary Treatment Outcome
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Summary:	An 8-year-old domestic shorthair cat was evaluated because of signs of depression, circling, and visual deficits. The cat had no cutaneous lesions, and results of an ophthalmologic examination and thoracic radiography were within reference limits. Computed tomography of the brain revealed a mass lesion involving the right parietal, temporal, and occipital lobes; the mass was in broad-based contact with the skull and smoothly marginated and had strong homogenous enhancement after contrast agent administration. During craniectomy, samples of the mass were collected for cytologic and histopathologic evaluations and microbial culture. A diagnosis of Blastomyces dermatitidis-associated meningoencephalitis with secondary pyogranulomatous inflammation was made. Amphotericin B (0.25 mg/kg [0.11 mg/lb], IV) was administered on alternate days (cumulative dose, 1.75 mg/kg [0.8 mg/lb]). To minimize the risk of nephrotoxicosis, assessments of serum biochemical variables (urea nitrogen and creatinine concentrations) and urinalyses were performed at intervals. The third dose of amphotericin B was postponed 48 hours because the cat became azotemic. The cat subsequently received fluconazole (10 mg/kg [4.5 mg/lb], PO, q 12 h) for 5.5 months. Six months after discontinuation of that treatment, the cat appeared healthy and had no signs of relapse. Brain infection with B dermatitidis is typically associated with widespread disseminated disease. The cat of this report had no evidence of systemic disease. Blastomycosis of the CNS should be considered as a differential diagnosis for brain lesions in cats from areas in which B dermatitidis is endemic.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-1488
DOI:	10.2460/javma.231.8.1210