Eosinophilic folliculitis in a dog

Background: Canine eosinophilic folliculitis is a dermatological disease of acute onset with development of erosive to ulcerative papular lesions, especially on the nasal bridge, that may cause severe skin abnormalities leading to discomfort and pain to the patient. The aim of this report was to characterize a case of a canine eosinophilic folliculitis with papular, ulcerative and crusting dermatitis on the nasal bridge, papules on eyelid and pinna, with confirmed diagnosis based on aspiration cytology, history and response to immunosuppressive therapy with glucocorticoid. Case: An 1-year-old intact Daschund was attended showing an acute onset (over 4 h) of generalized urticarial reaction and nonpruriginous lesion at the muzzle with mild serosanguineous exudate, which persisted for 96 h when the dog was evaluated. It was observed a papular and ulcerative dermatitis with serosanguineous exudate and hematic crusts at nasal bridge, papules measuring 2 mm in diameter in the medial and lateral canthus of the left eyelid, ulcerative papule with hematic crust in the border of left ear pinna, multifocal papules on the skin, dyskeratosis and generalized hair loss. The patient was anesthetized for blood sampling (CBC and serum biochemistry), lesions fine-needle aspiration, scraping and imprint for cytological examination, bacterial culture and nasal turbinates radiography. Fragments for histopathological evaluation were also collected. Erythrogram and platelet evaluation were unremarkable. Leukogram revealed leukocytosis (neutrophilia, lymphocytosis, monocytosis and eosinophilia). Serum biochemistry revealed hyperalbuminemia and discrete hyperproteinemia; values of alanine aminotransferase, creatinine and globulins were within normal range. In cytological examination, intense cellularity was observed with predominance of eosinophils (60%), neutrophils (35%), macrophages performing cytophagocytosis (5%) and degenerated cells. There was no bacterial growth within 48 h after incubation of nasal bridge lesion swab. There were no abnormalities identified at radiographic evaluation of nasal turbinates. As the patient was already with antibiotic therapy and steroidal anti-inflammatory, it was opted to maintain it, since interruption between the day of examination and laboratory results could cause more prejudice than benefit, corticosteroid dose, however, was readjusted (prednisone 2 mg/kg/per os/every 24h). After 1 week of treatment the owner reported significant improvement of clinical signs without any further complaint. Discussion: Typically, type I hypersensitivity reactions such as insect bites do not exceed clinical signs of erythema, local edema and pruritus, with spontaneous remission of clinical signs within few hours after exposure to the antigen. Eosinophilic folliculitis, however, may cause more severe clinical alterations, such as pain, apathy and hyporexia. Nasal bridge is the predominant site described to be affected in cases of eosinophilic folliculitis, being auricular pinna, thorax and limbs considered atypical presentations which can delay proper diagnosis, since in endemic regions for diseases such as visceral leishmaniasis, infectious etiology may be listed first. Differential diagnosis also includes superficial pyoderma, juvenile cellulitis, pemphigus foliaceus and pharmacodermia. The case described in this report emphasize the importance of an accurate diagnosis as well as an early and adequate treatment in order to promote satisfactory response. Also, highlights inadequate use of antimicrobials as a direct consequence of lack of laboratorial investigation.

Ceftaroline resistance in Staphylococcus pseudintermedius gene mecA carriers / Resistência à ceftarolina em Staphylococcus pseudintermedius portadores do gene mecA

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) being a constant concern, ceftaroline fosamil has been recently approved as a new cephalosporin, active against MRSA, for use in humans; only rare cases of resistance have been reported till date. There is no report of resistance to ceftaroline in Staphylococcus pseudintermedius, which is the main bacterium causing dermatitis and otitis in dogs. To evaluate staphylococcal resistance to ceftaroline, 35 isolates of methicillin-resistant S. pseudintermedius (MRSP), carrying the mecA gene, from 26 dogs with folliculitis and nine dogs with external otitis, underwent disk diffusion test with cefoxitin, oxacillin, and ceftaroline. Tests with cefoxitin and oxacillin showed > 90% sensitivity in methicillin resistance detection. In the disk diffusion test, 97.14% (34/35) were resistant to cefoxitin, 94.29% (33/35) to oxacillin, and 31.43% (11/35) to ceftaroline. Of the ceftaroline-resistant strains, 27.27% (3/11) were obtained from the ears of dogs while the rest (8/11) were from the skin. The current report is the first description of MRSP resistance to ceftaroline.(AU)

Infecções causadas por Staphylococcus aureus resistente à meticilina (MRSA) são uma preocupação médica constante. A ceftarolina fosamila é uma nova cefalosporina ativa contra Staphylococcus aureus resistente à meticilina recentemente aprovada para uso em humanos e raros casos de resistência relatados até agora. Não há relatos de resistência à ceftarolina em Staphylococcus pseudintermedius, principal bactéria causadora de dermatite e otite em cães. Com o objetivo de avaliar a resistência estafilocócica à ceftarolina, 35 amostras de S. pseudintermedius resistentes à meticilina (MRSP), portadoras do gene mecA, provenientes de 26 cães com foliculite e 9 com otite externa foram submetidos ao teste de disco-difusão com cefoxitina, oxacilina e ceftarolina. Os testes realizados com cefoxitina e oxacilina mostraram mais de 90% de sensibilidade na detecção da resistência à meticilina em ambas. No teste da disco-difusão, 97,14% (1/35) foram resistentes à cefoxitina, 94,29% (3/35) à oxacilina e 31,43% (11/35) à ceftarolina. Das cepas resistentes às ceftarolina, 27,27 (3/11) foram provenientes de ouvido de cães e as demais (8/11), provenientes da pele, sendo essa primeira descrição de resistência de MRSP à ceftarolina na literatura atual.(AU)

Ceftaroline resistance in Staphylococcus pseudintermedius gene mecA carriers / Resistência à ceftarolina em Staphylococcus pseudintermedius portadores do gene mecA

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) being a constant concern, ceftaroline fosamil has been recently approved as a new cephalosporin, active against MRSA, for use in humans; only rare cases of resistance have been reported till date. There is no report of resistance to ceftaroline in Staphylococcus pseudintermedius, which is the main bacterium causing dermatitis and otitis in dogs. To evaluate staphylococcal resistance to ceftaroline, 35 isolates of methicillin-resistant S. pseudintermedius (MRSP), carrying the mecA gene, from 26 dogs with folliculitis and nine dogs with external otitis, underwent disk diffusion test with cefoxitin, oxacillin, and ceftaroline. Tests with cefoxitin and oxacillin showed > 90% sensitivity in methicillin resistance detection. In the disk diffusion test, 97.14% (34/35) were resistant to cefoxitin, 94.29% (33/35) to oxacillin, and 31.43% (11/35) to ceftaroline. Of the ceftaroline-resistant strains, 27.27% (3/11) were obtained from the ears of dogs while the rest (8/11) were from the skin. The current report is the first description of MRSP resistance to ceftaroline.(AU)

Infecções causadas por Staphylococcus aureus resistente à meticilina (MRSA) são uma preocupação médica constante. A ceftarolina fosamila é uma nova cefalosporina ativa contra Staphylococcus aureus resistente à meticilina recentemente aprovada para uso em humanos e raros casos de resistência relatados até agora. Não há relatos de resistência à ceftarolina em Staphylococcus pseudintermedius, principal bactéria causadora de dermatite e otite em cães. Com o objetivo de avaliar a resistência estafilocócica à ceftarolina, 35 amostras de S. pseudintermedius resistentes à meticilina (MRSP), portadoras do gene mecA, provenientes de 26 cães com foliculite e 9 com otite externa foram submetidos ao teste de disco-difusão com cefoxitina, oxacilina e ceftarolina. Os testes realizados com cefoxitina e oxacilina mostraram mais de 90% de sensibilidade na detecção da resistência à meticilina em ambas. No teste da disco-difusão, 97,14% (1/35) foram resistentes à cefoxitina, 94,29% (3/35) à oxacilina e 31,43% (11/35) à ceftarolina. Das cepas resistentes às ceftarolina, 27,27 (3/11) foram provenientes de ouvido de cães e as demais (8/11), provenientes da pele, sendo essa primeira descrição de resistência de MRSP à ceftarolina na literatura atual.(AU)

Eficácia da cefovecina sódica no tratamento da foliculite superficial bacteriana canina / Efficacy of sodium cefovecin in the treatment of canine bacterial superficial folliculitis / Eficacia de la cefovecina sódica en el tratamiento de la foliculitis superficial bacteriana canina

A foliculite superficial bacteriana é uma doença dermatológica comum, sendo causada na maioria das vezes pelo Staphylococcus pseudintermedius, um agente da microbiota dos cães. Foram avaliados de forma retrospectiva 1.817 casos de cães com foliculite superficial bacteriana (primária ou secundária) tratados com cefovecina sódica (8 mg/kg, SC), a cada 14 dias, conforme a necessidade clínica. Verificou-se que 68,5% dos cães (1.246/1.817) requereram apenas uma dose de cefovecina, 28% (507/1.817), duas doses e 3,5% (64/1.817), três doses. No geral, a resposta ao tratamento foi considerada satisfatória em 96% (1.744/1.817), e falha em 4% (73/1.817) dos casos, não sendo observados efeitos adversos nos animais tratados. Concluiu-se que a cefovecina representa um tratamento eficaz, seguro e conveniente para a foliculite superficial bacteriana em cães.

Superficial bacterial folliculitis is a common dermatologic disease that is caused mainly by Staphylococcus pseudintermedius, a pathogen from the dog skin microbiota. We retrospectively evaluated 1,817 clinical cases of dogs with superficial bacterial folliculitis (primary or secondary) treated with sodium cefovecin (8 mg/kg, SQ) every 14 days, according to clinical need. 68.5% of dogs required a single dose of cefovecin (1,246/1,817); 28% of the animals (507/1,817) required two doses and 3.5% (64/1,817) demanded three doses. Overall, responses were considered satisfactory in 96% (1,744/1,817) of cases. Lack of efficacy was detected in 4% (73/1817) of cases, and side effects were not observed in any treated dog. We concluded that cefovecin is an efficacious, safe and convenient treatment for superficial bacterial folliculitis in dogs.

La funiculitis bacteriana superficial es una enfermedad dermatológica común causada principalmente por Staphylococcus pseudintermedius, una bacteria que forma parte de la microbiota de la piel del perro. Se realizó un análisis retrospectivo de 1.817 casos clínicos de perros con funiculitis bacteriana superficial (primaria o secundaria) que fueron tratados con cefovecina sódica aplicada, según el criterio del veterinario, a una dosis de 8 mg/kg por vía subcutánea durante 14 días. el 68,5% de los perros (1.246/1.817) necesitaron sólo una dosis de cefovecina, el 28% (507/1.817) requirió 2 dosis y el 3,5% (64/1.817) requirió 3 dosis. En términos generales, las respuestas se consideraron satisfactorias en e196% (1.744/1.817) de los casos. La falta de eficacia se detectó en el 4% (73/1.817) de los casos, y no se observaron efectos secundarios en ninguno de los pacientes estudiados. Se concluyó que la cefovecina es un tratamiento eficiente, seguro y conveniente para el tratamiento de la folicullitis superficial bacteriana en perros.

Eficácia da cefovecina sódica no tratamento da foliculite superficial bacteriana canina / Efficacy of sodium cefovecin in the treatment of canine bacterial superficial folliculitis / Eficacia de la cefovecina sódica en el tratamiento de la foliculitis superficial bacteriana canina

A foliculite superficial bacteriana é uma doença dermatológica comum, sendo causada na maioria das vezes pelo Staphylococcus pseudintermedius, um agente da microbiota dos cães. Foram avaliados de forma retrospectiva 1.817 casos de cães com foliculite superficial bacteriana (primária ou secundária) tratados com cefovecina sódica (8 mg/kg, SC), a cada 14 dias, conforme a necessidade clínica. Verificou-se que 68,5% dos cães (1.246/1.817) requereram apenas uma dose de cefovecina, 28% (507/1.817), duas doses e 3,5% (64/1.817), três doses. No geral, a resposta ao tratamento foi considerada satisfatória em 96% (1.744/1.817), e falha em 4% (73/1.817) dos casos, não sendo observados efeitos adversos nos animais tratados. Concluiu-se que a cefovecina representa um tratamento eficaz, seguro e conveniente para a foliculite superficial bacteriana em cães.(AU)

Superficial bacterial folliculitis is a common dermatologic disease that is caused mainly by Staphylococcus pseudintermedius, a pathogen from the dog skin microbiota. We retrospectively evaluated 1,817 clinical cases of dogs with superficial bacterial folliculitis (primary or secondary) treated with sodium cefovecin (8 mg/kg, SQ) every 14 days, according to clinical need. 68.5% of dogs required a single dose of cefovecin (1,246/1,817); 28% of the animals (507/1,817) required two doses and 3.5% (64/1,817) demanded three doses. Overall, responses were considered satisfactory in 96% (1,744/1,817) of cases. Lack of efficacy was detected in 4% (73/1817) of cases, and side effects were not observed in any treated dog. We concluded that cefovecin is an efficacious, safe and convenient treatment for superficial bacterial folliculitis in dogs.(AU)

La funiculitis bacteriana superficial es una enfermedad dermatológica común causada principalmente por Staphylococcus pseudintermedius, una bacteria que forma parte de la microbiota de la piel del perro. Se realizó un análisis retrospectivo de 1.817 casos clínicos de perros con funiculitis bacteriana superficial (primaria o secundaria) que fueron tratados con cefovecina sódica aplicada, según el criterio del veterinario, a una dosis de 8 mg/kg por vía subcutánea durante 14 días. el 68,5% de los perros (1.246/1.817) necesitaron sólo una dosis de cefovecina, el 28% (507/1.817) requirió 2 dosis y el 3,5% (64/1.817) requirió 3 dosis. En términos generales, las respuestas se consideraron satisfactorias en e196% (1.744/1.817) de los casos. La falta de eficacia se detectó en el 4% (73/1.817) de los casos, y no se observaron efectos secundarios en ninguno de los pacientes estudiados. Se concluyó que la cefovecina es un tratamiento eficiente, seguro y conveniente para el tratamiento de la folicullitis superficial bacteriana en perros.(AU)

Pseudomicetoma dermatofítico / Dermatophytic pseudomycetoma

O pseudomicetoma dermatofítico tem sido relatado nos gatos, cães, eqüinos, assim como no homem. Écaracterizado por nódulos cutâneos ou subcutâneos resultante de uma foliculite e furunculose granulomatosacausada por um dermatófito. Na ampla maioria dos casos, o agente isolado é Microsporum canis. Os dermatófitos invadem as camadas mais profundas da derme ou hipoderme, onde ocorre a formação de abcessos que pode se tornar uma inflamação granulomatosa. Essa invasão se dá através de folículosinfectados, por ruptura da parede folicular. Pode-se observar perifoliculite e, ocasionalmente foliculite,furunculose, dermatite perivascular com hiperqueratose ortoqueratosa e paraqueratosa da epiderme efolículos pilosos. São mais comuns em gatos de pêlo longo especialmente da raça persa. Neste trabalhoserá relatado o caso de Pseudomicetoma dermatofítico felino, em uma gata persa, 13 anos de idade, atendida no Hospital Veterinário Clinivet. As lesões caracterizavam-se por nódulos, lesões multi-fisturisadas,tumores irregulares em região medial de membro pélvico e torácico, característica dermo-subcutânea,associado a exsudato sanguino- purulento e grumos. Presença de grãos de aspecto branco amarelado.Histologicamente, as lesões eram características de Dermatite piogranulomatosa severa por múltiplosagregados irregulares de hifas pleomórficas (pseudomicetoma dermatofítico).

Dermatophytic pseudomycetoma has been reported in cats, dogs, horses, and humans. It is characterizedby cutaneous or subcutaneous nodules resulting from a folliculitis and furunculosis granulomatouscaused by a dermatophyte. In the vast majority of cases, the agent isolated is Microsporum canis. Dermatophytes invade the deeper layers of the dermis or hypodermis, where there is the formation of abscesses that can become a granulomatous inflammation. This invasion occurs through infectedfollicles by follicular wall rupture. It can be observed perifoliculitis and occasionally folliculitis, furunculosis,perivascular dermatitis with hyperkeratosis and ortoqueratosa paraqueratosa the epidermisand hair follicles. They are more common in long-haired cats especially the Persian breed. This paperwill report the case of feline dermatophytic pseudomycetoma in a Persian cat, 13 years old, at the Veterinary Hospital Clinivet. The lesions were characterized by nodules, multiples cracks, irregular tumorsin the medial region of the pelvic limb and thoracic, dermal-subcutaneous characteristic associatedwith purulent and sanguinary exudate and lumps. Presence grain appearance yellowish white. Histologically,the lesions were characteristic of severe dermatitis pyogranulomatous for multiple irregular aggregates of pleomorphic hyphae (dermatophytic pseudomycetoma).

Pseudomicetoma dermatofítico / Dermatophytic pseudomycetoma

O pseudomicetoma dermatofítico tem sido relatado nos gatos, cães, eqüinos, assim como no homem. Écaracterizado por nódulos cutâneos ou subcutâneos resultante de uma foliculite e furunculose granulomatosacausada por um dermatófito. Na ampla maioria dos casos, o agente isolado é Microsporum canis. Os dermatófitos invadem as camadas mais profundas da derme ou hipoderme, onde ocorre a formação de abcessos que pode se tornar uma inflamação granulomatosa. Essa invasão se dá através de folículosinfectados, por ruptura da parede folicular. Pode-se observar perifoliculite e, ocasionalmente foliculite,furunculose, dermatite perivascular com hiperqueratose ortoqueratosa e paraqueratosa da epiderme efolículos pilosos. São mais comuns em gatos de pêlo longo especialmente da raça persa. Neste trabalhoserá relatado o caso de Pseudomicetoma dermatofítico felino, em uma gata persa, 13 anos de idade, atendida no Hospital Veterinário Clinivet. As lesões caracterizavam-se por nódulos, lesões multi-fisturisadas,tumores irregulares em região medial de membro pélvico e torácico, característica dermo-subcutânea,associado a exsudato sanguino- purulento e grumos. Presença de grãos de aspecto branco amarelado.Histologicamente, as lesões eram características de Dermatite piogranulomatosa severa por múltiplosagregados irregulares de hifas pleomórficas (pseudomicetoma dermatofítico). (AU)

Dermatophytic pseudomycetoma has been reported in cats, dogs, horses, and humans. It is characterizedby cutaneous or subcutaneous nodules resulting from a folliculitis and furunculosis granulomatouscaused by a dermatophyte. In the vast majority of cases, the agent isolated is Microsporum canis. Dermatophytes invade the deeper layers of the dermis or hypodermis, where there is the formation of abscesses that can become a granulomatous inflammation. This invasion occurs through infectedfollicles by follicular wall rupture. It can be observed perifoliculitis and occasionally folliculitis, furunculosis,perivascular dermatitis with hyperkeratosis and ortoqueratosa paraqueratosa the epidermisand hair follicles. They are more common in long-haired cats especially the Persian breed. This paperwill report the case of feline dermatophytic pseudomycetoma in a Persian cat, 13 years old, at the Veterinary Hospital Clinivet. The lesions were characterized by nodules, multiples cracks, irregular tumorsin the medial region of the pelvic limb and thoracic, dermal-subcutaneous characteristic associatedwith purulent and sanguinary exudate and lumps. Presence grain appearance yellowish white. Histologically,the lesions were characteristic of severe dermatitis pyogranulomatous for multiple irregular aggregates of pleomorphic hyphae (dermatophytic pseudomycetoma). (AU)

Foliculite bacteriana em equinos: relato de cinco casos / Bacterial folliculitis in horses: report of five cases

Relatam-se cinco casos de foliculite bacteriana por Bacillus sp em equinos. Após início do verão, os equinos manifestaram doença dermatológica caracterizada pelo aparecimento de papúlas, pústulas, áreas alopecicas, além da formação de crostas. As crostas eram facilmente removidas revelando eritema, ulceração, exsudação purulenta e sensibilidade dolorosa. Foliculite bacteriana foi diagnosticada com base no histórico, sinais clínicos, exame dermatológico detalhado e resultados da cultura microbiológica. O tratamento consistiu em banhos diários com solução a base de iodo-povidona e administração sistêmica de antibiótico. Vinte dias após o inicio do tratamento, houve regressão completa das lesões.

Five cases of bacterial folliculitis by Bacillus sp in horses are reported. After the early summer, the horses showed skin disease characterized by the appearance of papules, pustules, areas of alopecia, and formation of crusts. The crusts were easily removed, revealing an erythematosus and ulcerated area with purulent material under the crusts and pain sensitivity. Bacterial Folliculitis was diagnosed based on history, clinical signs, dermatological evaluation and results of microbiological culture. Treatment consisted of baths with an iodine-povidine solution and systemic antibiotic administration. Twenty days after treatment, there was complete regression of lesions.