ABSTRACT
A esporotricose é uma zoonose causada por fungos do gênero Sporothrix. Os gatos doentes têm importante potencial zoonótico e frequentemente revelam uma apresentação disseminada da doença. O objetivo deste relato de caso é descrever as características clínicas e anatomopatológicas de um caso de esporotricose felina refratária ao tratamento com apresentação clínica cutânea disseminada e sistêmica. Um felino macho de 3 anos de idade foi tratado para esporotricose com itraconazol e obteve resolução completa das lesões cutâneas. Porém, um ano após alta clínica, o animal apresentou aumento e ulceração da região nasal. Após cultura fúngica positiva para Sporothrix spp foi instituído tratamento com itraconazol 100mg associado ao iodeto de potássio 20mg por via oral diariamente e transcorrido 3 meses de tratamento, foi observada piora progressiva do sinais clínicos com disseminação de lesões para outras regiões do corpo. O animal foi submetido à eutanásia e encaminhado para necrópsia no Serviço de Anatomia Patológica da Faculdade de Veterinária da Universidade Federal Fluminense. Amostras da língua, pulmão, fígado, baço, rim, cérebro, linfonodo e pele foram coletadas para evidência de disseminação do agente fúngico e avaliação de alterações microscópicas. A coloração de metenamina de prata de Grocott foi utilizada para facilitar a visualização de leveduras sugestivas de Sporothrix spp
Sporotrichosis is a zoonosis caused by fungi of the genus Sporothrix. Sick cats have an significant zoonotic potential and often show a widespread presentation of the disease. The purpose of this case report is to describe the clinical and anatomopathological characteristics of a case of feline sporotrichosis refractory to treatment with disseminated and systemic cutaneous clinical presentation. A 3-year-old male feline was treated for sporotrichosis with itraconazole and achieved complete resolution of the skin lesions. However, one year after clinical discharge, the animal presented an increase and ulceration of the nasal region. After a positive fungal culture for Sporothrix spp, treatment with itraconazole 100mg associated with potassium iodide 20mg was instituted orally daily and after 3 months of treatment, a progressive worsening of the symptoms was observed with the spread of lesions to other regions of the body. The animal was euthanized and sent for necropsy at the Pathological Anatomy Service of the Veterinary Faculty of Universidade Federal Fluminense. Samples of the tongue, lung, liver, spleen, kidney, brain, lymph node, and skin were collected for evidence of spread of the fungal agent and evaluation of microscopic changes. Grocott silver methenamine staining was used to facilitate the visualization of yeasts suggestive of Sporothrix spp in histological sections. Yeasts were visualized in samples of skin, tongue, lymph node, kidney, liver, spleen, and brain. In the present report, the spread of Sporothrix spp to different organs signals the need for a thorough investigation of severe cases of feline sporotrichosis for the proper treatment.
Subject(s)
Animals , Cats , Autopsy/veterinary , Sporotrichosis/classification , Immunodeficiency Virus, Feline , Leukemia Virus, Feline , ZoonosesABSTRACT
A esporotricose é uma zoonose causada por fungos do gênero Sporothrix. Os gatos doentes têm importante potencial zoonótico e frequentemente revelam uma apresentação disseminada da doença. O objetivo deste relato de caso é descrever as características clínicas e anatomopatológicas de um caso de esporotricose felina refratária ao tratamento com apresentação clínica cutânea disseminada e sistêmica. Um felino macho de 3 anos de idade foi tratado para esporotricose com itraconazol e obteve resolução completa das lesões cutâneas. Porém, um ano após alta clínica, o animal apresentou aumento e ulceração da região nasal. Após cultura fúngica positiva para Sporothrix spp foi instituído tratamento com itraconazol 100mg associado ao iodeto de potássio 20mg por via oral diariamente e transcorrido 3 meses de tratamento, foi observada piora progressiva do sinais clínicos com disseminação de lesões para outras regiões do corpo. O animal foi submetido à eutanásia e encaminhado para necrópsia no Serviço de Anatomia Patológica da Faculdade de Veterinária da Universidade Federal Fluminense. Amostras da língua, pulmão, fígado, baço, rim, cérebro, linfonodo e pele foram coletadas para evidência de disseminação do agente fúngico e avaliação de alterações microscópicas. A coloração de metenamina de prata de Grocott foi utilizada para facilitar a visualização de leveduras sugestivas de Sporothrix spp nos cortes histológicos. Leveduras foram visualizadas em amostras de pele, língua, linfonodo, rim, fígado, baço e cérebro. No presente relato a disseminação do Sporothrixspp para diversos órgãos sinaliza a necessidade de uma minuciosa investigação dos casos graves de esporotricose felina para o tratamento adequado.
Sporotrichosis is a zoonosis caused by fungi of the genus Sporothrix. Sick cats have an significant zoonotic potential and often show a widespread presentation of the disease. The purpose of this case report is to describe the clinical and anatomopathological characteristics of a case of feline sporotrichosis refractory to treatment with disseminated and systemic cutaneous clinical presentation. A 3-year-old male feline was treated for sporotrichosis with itraconazole and achieved complete resolution of the skin lesions. However, one year after clinical discharge, the animal presented an increase and ulceration of the nasal region. After a positive fungal culture for Sporothrix spp, treatment with itraconazole 100mg associated with potassium iodide 20mg was instituted orally daily and after 3 months of treatment, a progressive worsening of the symptoms was observed with the spread of lesions to other regions of the body. The animal was euthanized and sent for necropsy at the Pathological Anatomy Service of the Veterinary Faculty of Universidade Federal Fluminense. Samples of the tongue, lung, liver, spleen, kidney, brain, lymph node, and skin were collected for evidence of spread of the fungal agent and evaluation of microscopic changes. Grocott silver methenamine staining was used to facilitate the visualization of yeasts suggestive of Sporothrix spp in histological sections. Yeasts were visualized in samples of skin, tongue, lymph node, kidney, liver, spleen, and brain. In the present report, the spread of Sporothrix spp to different organs signals the need for a thorough investigation of severe cases of feline sporotrichosis for the proper treatment.
Subject(s)
Animals , Cats , Autopsy/veterinary , Sporotrichosis/veterinary , Sporothrix/pathogenicity , Cats/physiology , Itraconazole/therapeutic use , Immunodeficiency Virus, Feline , Leukemia Virus, FelineABSTRACT
Three unusual clinical forms of sporotrichosis described in this paper will be a primer for the clinicians for an early diagnosis and treatment, especially in its unusual presentations. Case 1, a 52-year-old man, developed sporotrichosis over pre-existing facial nodulo-ulcerative basal cell carcinoma of seven-year duration, due to its contamination perhaps from topical herbal pastes and lymphocutaneous sporotrichosis over right hand/forearm from facial lesion/herbal paste. Case 2, a 25-year-old woman, presented with disseminated systemic-cutaneous, osteoarticular and possibly pleural (effusion) sporotrichosis. There was no laboratory evidence of tuberculosis and treatment with anti-tuberculosis drugs (ATT) did not benefit. Both these cases were diagnosed by histopathology/culture of S. schenckii from tissue specimens. Case 3, a 20-year-old girl, had multiple intensely pruritic, nodular lesions over/around left knee of two-year duration. She was diagnosed clinically as a case of prurigo nodularis and histologically as cutaneous tuberculosis, albeit, other laboratory investigations and treatment with ATT did not support the diagnosis. All the three patients responded well to saturated solution of potassium iodide (SSKI) therapy. A high clinical suspicion is important in early diagnosis and treatment to prevent chronicity and morbidity in these patients. SSKI is fairly safe and effective when itraconazole is not affordable/ available.