Fungal Dz

Question 1

What are some infectious causes of draining tracts?

Answer 1

(Fungal → blasto, histo; bacterial → Actinomyces, Nocardia, Mycobacterium)

Question 2

What should you do if you have a patient with severe inflammatory disease and protein in their urine?

Answer 2

(Recheck urine protein after inflammation is under control to make sure it was prerenal, if still protein in urine may want to work up for renal proteinuria)

Question 2

What are some sterile inflammatory causes of draining tracts?

Answer 2

(Foreign bodies, eosinophilic granulomas, and sterile nodular panniculitis)

Question 3

What are some of the common sites you will find skin lesions associated with blasto infections?

Answer 3

(Nasal planum, face, and nail beds; possible lesions are draining tracts, subq and dermal masses, subq abscesses, and ulcers)

Question 4

(T/F) If you have a dog with confirmed blastomycosis, you should take radiographs no matter if they have respiratory signs or not.

Answer 4

(T, up to 85% of dogs with blasto have pulmonary lesions and possibly no respiratory signs, want to make sure they don’t have any or if they do, that they clear with treatment)

Question 5

Describe the lesions associated with bone and blasto infections and where they typically crop up.

Answer 5

(Bone blasto lesions are typically osteolytic with periosteal proliferation and soft tissue swelling that occurs in the appendicular skeleton, more commonly distal to the stifle and/or elbow)

Question 6

How can blasto be diagnosed?

Answer 6

(Cytopathology/histopathology and/or urine antigen testing)

Question 7

What are potential side effects of itraconazole?

Answer 7

(Hepatotoxicity, V/D, ulcerative dermatitis, vasculitis, erythema multiforme, and toxic epidermal necrolysis)

Question 8

If you have a dog with bone lesions associated with a blasto infection, which drug would you choose to use?

Answer 8

(Itraconazole → penetrates bone well)

Question 9

If you have a dog with ocular and/or CNS lesions associated with a blasto infection, which drug would you choose to use?

Answer 9

(Fluconazole → penetrates CNS/eye well)

Question 10

What are potential side effects of fluconazole?

Answer 10

(Hepatotoxicity, V/D, haircoat color changes, and alopecia)

Question 11

What organ toxicity is associated with the use of amphotericin B?

Answer 11

(Nephrotoxicity)

Question 12

Cats/dogs (choose) are very susceptible to histo infections.

Answer 12

(Cats)

Question 13

Is large bowel or small bowel infiltration with histo more common?

Answer 13

(Large bowel → diarrhea, tenesmus, hematochezia; small bowel a possibility though → weight loss, diarrhea, vomiting, melena)

Question 14

What results from bone marrow infiltration with histo?

Answer 14

(Severe pancytopenia)