全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Successful Long-Term Use of Itraconazole for the Treatment of Aspergillus Diskospondylitis in a Dog

DOI: 10.1155/2013/907276

Full-Text   Cite this paper   Add to My Lib

Abstract:

A 5-year-old spayed female German shepherd dog was admitted with a history of generalized stiffness. Neurologic examination revealed mild paraparesis with multifocal spinal pain. Spinal radiographs and magnetic resonance imaging revealed diskospondylitis at L6-7 and multiple sites throughout the thoracolumbar spine. Biopsy of the intervertebral disk at L6-7 revealed a positive culture for Aspergillus species, and the dog was placed on itraconazole indefinitely. Clinical signs were significantly improved after two weeks of itraconazole. The dog was reevaluated 8 years later for unrelated reasons. No spinal pain was detected. Spinal radiographs revealed a fused L6-7 disk space and collapsed and sclerotic disk spaces at multiple sites. Itraconazole was tolerated by the dog with normal yearly liver enzyme values. To our knowledge, this is the first reported case of successful long-term use of itraconazole for the treatment of Aspergillus diskospondylitis in a dog. 1. Introduction Diskospondylitis is an infection of the intervertebral disk with concurrent osteomyelitis in adjacent vertebral endplates. The most common cause of diskospondylitis is hematogenous spread of bacteria or fungi from urinary tract infections, dental infections, or endocarditis [1, 2]. Migrating foreign bodies, such as grass awns, have also been incriminated as a source of infection. Staphylococcus aureus is the most common cause of canine diskospondylitis. Aspergillus is a fungus that is ubiquitous in the environment and an opportunistic pathogen. Aspergillus terreus is the most common species associated with disseminated aspergillosis [2]. Female German shepherd dogs are the most commonly affected breed with disseminated aspergillosis. It is speculated that German shepherd dogs have a hereditary immune defect that plays a significant role in the pathogenesis [1, 3]. In disseminated cases, it is not uncommon to find radiographic changes consistent with multiple sites of diskospondylitis [3, 4]. Aspergillosis can be localized to the spine only. There have been four published canine cases of Aspergillus diskospondylitis, without the presence of systemic involvement, in the veterinary literature [1, 5, 6]. All four cases were seen in German shepherd dogs; these dogs were euthanized due to poor prognosis or neurologic deterioration. The purpose of this report is to describe a case of nondisseminated Aspergillus diskospondylitis in a dog that was successfully treated with long-term itraconazole. 2. Case Presentation A 5-year-old (41.2-kg) spayed female German shepherd dog was evaluated for

References

[1]  W. L. Berry and A. L. Leisewitz, “Multifocal Aspergillus terreus discospondylitis in two German shepherd dogs,” Journal of the South African Veterinary Association, vol. 67, no. 4, pp. 222–228, 1996.
[2]  J. Lavely and D. Lipsitz, “Fungal infections of the central nervous system in the dog and cat,” Clinical Techniques in Small Animal Practice, vol. 20, no. 4, pp. 212–219, 2005.
[3]  M. J. Day, W. J. Penhale, C. E. Eger et al., “Disseminated aspergillosis in dogs,” Australian Veterinary Journal, vol. 63, no. 2, pp. 55–59, 1986.
[4]  R. M. Schultz, E. G. Johnson, E. R. Wisner, N. A. Brown, B. A. Byrne, and J. E. Sykes, “Clinicopathologic and diagnostic imaging characteristics of systemic Aspergillosis in 30 dogs,” Journal of Veterinary Internal Medicine, vol. 22, no. 4, pp. 851–859, 2008.
[5]  R. A. Weitkamp, “Aspergilloma in two dogs,” Journal of the American Animal Hospital Association, vol. 18, no. 3, pp. 503–506, 1982.
[6]  A. M. Wolf and G. C. Troy, “Deep mycotic disease,” in Textbook of Veterinary Internal Medicine; Diseases of the Dog and Cat, S. Ettinger and E. C. Feldman, Eds., pp. 439–444, Saunders, Philadelphia, Pa, USA, 4th edition, 1995.
[7]  S. S. Jang, T. E. Dorr, E. L. Biberstein, and A. Wong, “Aspergillus deflectus infection in four dogs,” Journal of Medical and Veterinary Mycology, vol. 24, no. 2, pp. 95–104, 1986.
[8]  J. Pastor, M. Pumarola, R. Cuenca, and S. Lavin, “Systemic aspergillosis in a dog,” Veterinary Record, vol. 132, no. 16, pp. 412–413, 1993.
[9]  S. E. Kelly, S. E. Shaw, and W. T. Clark, “Long-term survival of four dogs with disseminated Aspergillus terreus infection treated with itraconazole,” Australian Veterinary Journal, vol. 72, no. 8, pp. 311–313, 1995.
[10]  M. J. Dallman, T. L. Dew, L. Tobias, and R. Doss, “Disseminated aspergillosis in a dog with diskospondylitis and neurologic deficits,” Journal of the American Veterinary Medical Association, vol. 200, no. 4, pp. 511–513, 1992.
[11]  G. L. Wood, D. C. Hirsh, and R. R. Selcer, “Disseminated aspergillosis in a dog,” Journal of the American Veterinary Medical Association, vol. 172, no. 6, pp. 704–707, 1978.
[12]  S. J. Butterworth, F. J. Barr, G. R. Pearson, and M. J. Day, “Multiple discospondylitis associated with Aspergillus species infection in a dog,” Veterinary Record, vol. 136, no. 2, pp. 38–41, 1995.
[13]  A. C. Kaufman, C. E. Greene, B. A. Selcer, M. E. Styles, and E. A. Mahaffey, “Systemic aspergillosis in a dog and treatment with hamycin,” Journal of the American Animal Hospital Association, vol. 30, no. 2, pp. 132–136, 1994.
[14]  L. Hurov, G. Troy, and G. Turnwald, “Diskospondylitis in the dog: 27 cases,” Journal of the American Veterinary Medical Association, vol. 173, no. 3, pp. 275–281, 1978.
[15]  M. H. Shamir, N. Tavor, and T. Aizenberg, “Radiographic findings during recovery from discospondylitis,” Veterinary Radiology and Ultrasound, vol. 42, no. 6, pp. 496–503, 2001.
[16]  I. Carrera, M. Sullivan, F. Mcconnell, and R. Gon?alves, “Magnetic resonance imaging features of discospondylitis in dogs,” Veterinary Radiology and Ultrasound, vol. 52, no. 2, pp. 125–131, 2011.
[17]  L. Stern, R. McCarthy, R. King, and K. Hunt, “Imaging diagnosis—discospondylitis and septic arthritis in a dog,” Veterinary Radiology and Ultrasound, vol. 48, no. 4, pp. 335–337, 2007.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133