Blastomycosis in Dogs

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Blastomycosis in Dogs

• L. Joseph Wheat
• MiraVista Diagnostics, and
• Alfred M. Legendre
• University of Tennessee Dept of Veterinary
  Medicine

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Epidemiology

• Proximity to water
• Outdoor activities
• Beaver dams
• Small outbreaks
• Microfoci

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Fungal Stain
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Clinical Findings Involved Tissue

• Involved tissues
• Lung 85
• Lymph nodes 65
• Eye 41
• Skin 26
• Bone 24
• Cutaneous 13
• Testes/GU 11
• Brain 4

• Clinical findings
• Fever 62
• Respiratory 49
• Skin lesions 49
• Depression 48
• Anorexia 44
• Ocular 43
• Weight-loss 37
• CNS 6

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Radiographic Findings

• Radiographic findings
• Nodulo interstit 39
• Lymphadenop 29
• Interstitial 22
• Alveolar 9
• Mass 9
• Pleural 8
• Normal 6
• N115, LSU

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Cutaneous and Bone Lesions
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Other Common Manifestations
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Sensitivity of Cytology

• Tissue
• Node or abscess 52
• Eye 7
• Tracheal wash 6
• Biopsy 9
• Bone, node, sub-cutaneous

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Antigen Detection
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Antigen and Serology

• Antigen pos
• Urine 94
• Serum 87
• Antibody 76

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Antigen and Antibody Clearance
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Antigenuria During Relapse
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Sensitivity for Diagnosis

• Cytology 71-94
• Antigen 94
• Culture 10-20
• Serology 41-83

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Approach to Early Diagnosis

• Tracheal washing
• Aspirate/biopsy lesions
• Antigen-urine, tracheal aspirates, other fluids
• Serology

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Outcome of Treatment
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Improvement in Management

• Hightened awareness
• Early diagnosis
• Antigen, cytology, serology
• AmB and Itra for severe disease
• Itra drug level monitoring
• Treatment more 4-6 months
• Monitoring antigen until negative
• Suppressive therapy if relapse

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Summary

• Early diagnosis important
• Histopathology
• Urinary antigen
• Amphotericin B and itraconazole
• Initially for severe cases
• Itraconazole treatment of choice
• Determine blood level
• Four to six months and until antigenuria clears
• Suppressive therapy if relapse