Eshar David, Mayer Jörg, Parry Nicola M, Williams-Fritze Misty J, Bradway Daniel S
Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA.
J Am Vet Med Assoc. 2010 Apr 1;236(7):770-4. doi: 10.2460/javma.236.7.770.
A 4-year-old castrated male domestic ferret from central Massachusetts was evaluated for weight loss over a 1.5-month period and for 2 days of retching, diarrhea, and signs of lethargy. It had been housed indoors, with 2 other ferrets, 2 cats, and humans that lacked signs or symptoms of disease.
Physical examination revealed a thin body condition, tachypnea, an increase in respiratory effort, and retching. Splenomegaly was detected during abdominal palpation. Clinicopathologic analysis revealed lymphopenia, lactic acidosis, hypoglycemia, hypocalcemia, hypoalbuminemia, and hyperglobulinemia. A pulmonary bronchointerstitial pattern was evident on radiographs, and abdominal ultrasonography revealed a suspected pancreatic mass and mesenteric lymphadenopathy.
After 2 weeks of medical treatment and once clinical signs resolved, an exploratory laparotomy was performed and a lymph node biopsy specimen was collected. Histologic evaluation of the specimen revealed Cryptococcus-like organisms. Antifungal treatment was initiated with itraconazole (PO) and amphotericin B (IV). The ferret died after 2 days of treatment. A full necropsy was performed, revealing multicentric cryptococcosis affecting the lungs, brain, spleen, and multiple lymph nodes. Paraffin-embedded, formalin-fixed lung tissue was submitted for DNA extraction, and the organism was identified as Cryptococcus neoformans var grubii.
To the authors' knowledge, this is the first report of disseminated cryptococcosis in a North American ferret. This case is unique in that the ferret lived indoors, in a geographic region in which reports of cryptococcosis are rare. The genotyping technique used to identify the Cryptococcus strain can aid in better understanding the epidemiology of cryptococcosis.
一只来自马萨诸塞州中部的4岁去势雄性家养雪貂,因在1.5个月内体重减轻以及出现2天的干呕、腹泻和嗜睡症状而接受评估。它一直饲养在室内,与另外2只雪貂、2只猫以及无疾病体征或症状的人类共同生活。
体格检查显示身体状况消瘦、呼吸急促、呼吸费力增加以及干呕。腹部触诊时发现脾肿大。临床病理分析显示淋巴细胞减少、乳酸酸中毒、低血糖、低钙血症、低白蛋白血症和球蛋白血症。X线片上可见肺部支气管间质模式,腹部超声检查发现疑似胰腺肿块和肠系膜淋巴结病。
经过2周的药物治疗且临床症状缓解后,进行了剖腹探查术并采集了淋巴结活检标本。对标本的组织学评估显示有隐球菌样生物体。开始使用伊曲康唑(口服)和两性霉素B(静脉注射)进行抗真菌治疗。雪貂在治疗2天后死亡。进行了全面尸检,发现多中心性隐球菌病累及肺部、脑部、脾脏和多个淋巴结。将石蜡包埋、福尔马林固定的肺组织送去进行DNA提取,鉴定该生物体为新型隐球菌格鲁比变种。
据作者所知,这是北美雪貂播散性隐球菌病的首例报告。该病例的独特之处在于这只雪貂生活在室内,而该地理区域隐球菌病报告罕见。用于鉴定隐球菌菌株的基因分型技术有助于更好地了解隐球菌病的流行病学。