Aspergillosis - canine

Question 1

What’s the causative agent of aspergillosis?

Answer 1

saprophytic and ubiquitous filamentous fungi
- opportunistic pathogen

Question 2

What are the 2 distinct form of aspergillosis in dogs?

Answer 2

1. sinonasal aspergillosis
2. systemic aspergillosis

Question 3

What’s the pathogenesis of sinonasal aspergillosis?

Answer 3

inhales, typically dogs are not systemically immunocompromised
- may be due to disequilibrium between pro-inflammatory and anti-inflammatory responses (Th1 vs TH17m T-regs)

Question 4

What are the clinical signs associated with aspergillosis?

Answer 4

• sneezing, reverse sneezing, epistaxis,
• nasal planum depigmentation, ulceration
• facial discomfort, lethargy, decreased appetite

Question 5

How is aspergillosis diagnosed?

Answer 5

need a combination of tests
- endoscopy to visualize the fungal plaques – if found, sampling can be very useful
- imaging = moderate to severe cavitary destruction, thickened reactive bone, thickened mucosa
- cytology: direct smear or blind swab = not useful; brush or squash prep of biopsy = 93 & 100%
-culture = 100% specific
- serology = not useful as a screening test

Question 6

How is aspergillosis treated?

Answer 6

• azole antifungal
• topical or systemic – systemic alone is not recommended
• topical would want to debride as much as possible prior to infusion; can also triphinate and infuse cream
• watch for CNS involvement with infusion if the cribriform plate = broken

Question 7

How is treatment response assessed?

Answer 7

best with endoscopy, after 1m of therapy

Question 8

What’s the long term outcome of aspergillosis?

Answer 8

relapse can still happen
- can have chronic lymphocytic rhinitis or secondary bacterial infection

Question 9

What’s systemic aspergillosis in dogs?

Answer 9

No nasal involvement
- can be seen in intervertebral discs, bones, lungs, kidneys, eyes, LNs, brain, GI
- young German Shepherd dogs

Question 10

What are the c/s of systemic aspergillosis?

Answer 10

depends on the organ affected:
- pain on spinal palpation, lameness, anorexia, weight loss, lethargy, muscle wasting, fever

Question 11

How is systemic aspergillosis diagnosed?

Answer 11

culture (+) plus visualization of fungal hyphae

Question 12

What’s the prognosis?

Answer 12

very poor despite aggressive therapy