Abstract
A female, 1.5 years old, mixed‑breed dog, was presented for left hind limb lameness. Radiographs revealed an irregular periosteal proliferation on the left iliac wing. The clinical condition worsened with generalised enlargement of the lymph nodes, azotaemia, and pyelonephritis. The magnetic resonance imaging of the pelvis and a surgical biopsy diagnosed a mycotic myositis and osteomyelitis of the iliac wing and gluteal muscles. Aspergillus terreus was isolated from culture of urine and lymph nodes aspirates. The antifungal susceptibility test showed moderate sensitivity to Itraconazole. After one month of therapy with itraconazole, the dog presented discospondylitis of L1‑L2 and partial ureteral obstruction due to mycotic bezoar that was resolved with medical treatment and itraconazole dose elevation. After twelve months, itraconazole was suspended; a severe osteomyelitis of the left femur developed, and the dog was euthanised. The necropsy confirmed the presence of mycotic osteomyelitis of the iliac wing and femur, discospondylitis, lymphadenitis and severe granulomatous pyelonephritis. Systemic aspergillosis has rarely been reported in the literature, especially in Italy. The pelvic bone involvement is rare both in dogs and humans. Although itraconazole treatment allowed remission of the clinical signs for one year, it was not able to cure the dog.
References
REFERENCES
Biegańska M., Dardzńiska W. & Dworecka-Kaszak B. 2014. Fungal colonization – an additional risk factor for diseased dogs and cats? Ann Parasitol, 60, 139 – 146.
Bruchim Y., Elad D. & Klainbart S. 2006. Disseminated aspergillosis in two dogs in Israel. Mycoses, 49, 130-133.
Corrigan V.K., Legendre A.M., Wheat L.J., Mullis R., Johnson B. & Bemis D.A. 2016. Treatment of disseminated aspergillosis with posaconazole in 10 dogs. J Vet Intern Med, 30, 167-173.
Elad D., Lahav D. & Blum S. 2008. Transuterine transmission of Aspergillus terreus in a case of disseminated canine aspergillosis. Med Mycol, 46, 175–178.
Koehler P., Tacke D. & Cornely O.A. 2013. Aspergillosis of bones and joints – a review from 2002 until today. Mycoses, 57, 323-335.
Kuntz J.A., Berent A.C., Weisse C.W. & Bagley D.H. 2015 Double pigtail ureteral stenting and renal pelvic lavage for renal-sparing treatment of obstructive pyonephrosis in dogs: 13 cases (2008-2012). J Am Vet Med Assoc, 246, 216-225.
Lackner M., Coassin S., Haun M., Binder U., Kronenberg F., Haas H. D., Jank M., Maurer E., Meis J.F. & Lass-Flörl C. 2016. Geographically predominant genotypes of Aspergillus terreus species complex in Austria: s microsatellite typing study. Clin Microbiol Infect, 22, 270-276.
Morabito S., Specchi S., Auriemma E., Ferro S., Kuhnert P. & Zini E. 2020. Computed tomographic and ultrasonographic findings of abdominal arterial pseudoaneurysms caused by systemic mycosis in dogs. J Small Anim Pract, 61, 300-307.
Najafi N., Shokohi T., Basiri A., Parvin M., Yadegarinia D., Taghavi F., Hedayati M.T. & Abdi R. 2013. Aspergillus terreus-related ureteral obstruction in a diabetic patient. Iran J Kidney Dis, 7, 151-155.
Perry J.J., Rech R.R., Camus M.S. & Howerth E.W. 2010. Pathology in practice. J Am Vet Med Assoc, 236, 173-175.
Raper K.B. & Fennell D.I. The Genus Aspergillus. The Williams & Wilkins Company, Baltimore, 1965
Reischies F. & Hoenigl M. 2014. The role of surgical debridement in different clinical manifestations of invasive aspergillosis. Mycoses, 57, 1-14.
Risslegger B., Zoran T., Lackner M., Aigner M., Sánchez-Reus F., Rezusta A., Chowdhary A., Taj-Aldeen S.J., Arendrup M.C., Olivieri S., Kontoyaiannis D.P., Alastruey-Izquierdo A., Lagrou K., Lo Cascio G., Meis J.F., Buzina W., Farina C., Drogari-Apiranthitou M., Grancini A., Tortorano A.M., Willinger B., Hamprecht A., Johnson E., Klingspor L., Arsic-Arsenijevic V., Cornely O.A., Meletiadis J., Prammer W., Tullio V., Vehreschild J.J., Trovato L., Lewis R.E., Segal E., Rath P.M., Hamal P., Rodriguez-Iglesias M., Roilides E., Arikan-Akdagli S., Chakrabarti A., Colombo A.L., Fernández M.S., Martin-Gomez M.T., Badali H., Petrikkos G., Klimko N., Heimann S.M., Houbraken J., Uzun O., Edlinger M., Fuente S. & Lass-Flörl C. P. 2017. A prospective international Aspergillus terreus survey: an EFISG, ISHAM and ECMM joint study. Clin Microbiol Infect, 23, 776-e1-776-e5.
Seyedmousavi S., Guillot J., Arne´ P., de Hoog G.S., Mouton J.W., Melchers W.J.G. & Verweij P.E. 2015. Aspergillus and aspergilloses in wild and domestic animals: a global health concern with parallels to human disease. Med Mycol, 53, 765-797.
Schultz R.M., Johnson E.G, Wisner E.R., Brown N.A., Byrne B.A. & Sykes J.E. 2008. Clinicopathologic and diagnostic imaging characteristics of systemic aspergillosis in 30 dogs. J Vet Intern Med, 22, 851-859.
Starkley R.J. & McLoughlin M.A. 1996. Treatment of renal aspergillosis in a dog using nephrostomy tubes. J Vet Intern Med, 10, 336-338.
Van Wie E., Chen A.V., Thomovsky S.A. & Tucker R.L. 2013. Successful long-term use of itraconazole for the treatment of Aspergillus diskospondylitis in a dog. Case Reports Vet Med, 907276. http://dx.doi.org/10.1155/2013/907276
Yoon Y.K., Kang E.H., In K.H. & Kim M.J. 2010. Unilateral ureteral obstruction caused by Aspergillus, subgenus Nidulantes in a patient on steroid therapy: a case report and review of the literature. Med Mycol, 48, 647-652.
Zoran T., Sartori B., Sappl L., Aigner M., Sánchez-Reus F., Rezusta A., Chowdhary A., Taj-Aldeen S.J., Arendrup M.C., Olivieri S., Kontoyannis D.P., Alastruey-Izquierdo A., Lagrou K., Lo Cascio G., Meis J.F., Buzina W., Farina C., Drogari-Apiranthithou M., Grancini A., Tortorano A.M., Willinger B., Hamprecht A., Johnson E., Klingspor L., Arsic-Arsenijevic V., Cornely O.A., Meletiadis J., Prammer W., Tullio V., Vehreschild J.J., Trovato L., Lewis R.E., Segal E., Rath P.M., Hamal P., Rodriguez-Iglesias M., Roilides E., Arikan-Akdagli S., Chakrabarti A., Colombo A.L., Fernández M.S., Martin-Gomez M.T., Badali H., Petrikkos G., Klimko N., Heimann S.M., Uzun O., Roudbary M., de la Fuente S., Houbraken J., Risslegger B., Sabino R., Lass-Flörl C. & Lackner M. 2019. Corrigendum: Azole-resistance in Aspergillus terreus and related species: an emerging problem or a rare phenomenon? Front Microbiol, 28, 516.