Fielder Susan E, Meinkoth James H, Rizzi Theresa E, Hanzlicek Andrew S, Hallman Ruth Mackenzie
Veterinary Pathobiology, Oklahoma State University Center for Veterinary Sciences, Stillwater, OK, USA.
Veterinary Clinical Sciences, Oklahoma State University Center for Veterinary Sciences, Stillwater, OK, USA.
J Feline Med Surg. 2019 Oct;21(10):887-892. doi: 10.1177/1098612X18806706. Epub 2018 Nov 8.
The aim of this study was to describe clinical and diagnostic findings in cats with bone and joint disease associated with histoplasmosis.
Medical records from between 2011 and 2017 were reviewed. Inclusion criteria required: (1) diagnosis of histoplasmosis by cytology, histology, urine or serum antigen testing, or culture; and (2) lameness or joint effusion as a presenting complaint or physical examination finding.
Twenty-five cases met the inclusion criteria. Four had incomplete records, but available data were included when applicable. Lameness was a presenting complaint in 17/21 cats and was the only complaint in 9/21 cats. Initial diagnosis was made by cytology in 22/25 cats and by culture, urine antigen and necropsy in one case each. Diagnostic cytology samples included synovial fluid (n = 13), lymph node (n = 5), skin (n = 2), lung (n = 1) and bone (n = 1). Two additional cases had synovial fluid examined but no organisms present. Inflammation was present in all synovial fluid samples examined. Biopsy was obtained in two cats and histologic diagnoses included osteomyelitis with no infectious organisms identified and severe lymphoplasmacytic synovitis suggestive of feline periosteal proliferative polyarthritis. Histoplasma urine antigen test was positive in 7/12 cats.
Inflammatory arthritis is common in cats with histoplasmosis, with lameness a common presenting complaint. Organisms are found in synovial fluid cytology in most cases. If not, appropriate additional diagnostics must be pursued.
本研究旨在描述患有与组织胞浆菌病相关的骨和关节疾病的猫的临床及诊断结果。
回顾了2011年至2017年期间的病历。纳入标准要求：（1）通过细胞学、组织学、尿液或血清抗原检测或培养诊断为组织胞浆菌病；（2）以跛行或关节积液作为就诊主诉或体格检查发现。
25例符合纳入标准。4例记录不完整，但适用时纳入了可用数据。17/21只猫以跛行为就诊主诉，其中9/21只猫仅以此为唯一主诉。22/25只猫通过细胞学进行初步诊断，1例分别通过培养、尿液抗原检测和尸检进行诊断。诊断性细胞学样本包括滑液（n = 13）、淋巴结（n = 5）、皮肤（n = 2）、肺（n = 1）和骨（n = 1）。另外2例检查了滑液，但未发现病原体。所有检查的滑液样本均有炎症。对2只猫进行了活检，组织学诊断包括未发现感染病原体的骨髓炎和提示猫骨膜增生性多关节炎的严重淋巴浆细胞性滑膜炎。7/12只猫的组织胞浆菌尿液抗原检测呈阳性。
炎症性关节炎在患有组织胞浆菌病的猫中很常见，跛行是常见主诉。大多数情况下，在滑液细胞学检查中可发现病原体。如果未发现，则必须进行适当的其他诊断。
