Davidson Autumn P, Shubitz Lisa F, Alcott Cody J, Sykes Jane E
School of Veterinary Medicine, University of California-Davis, Davis, California, USA.
Valley Fever Center for Excellence, The University of Arizona, Tucson, Arizona, USA.
Med Mycol. 2019 Feb 1;57(Supplement_1):S67-S75. doi: 10.1093/mmy/myy113.
Canine coccidioidomycosis, a systemic fungal infection endemic to arid and semiarid regions of North, Central, and South America, is commonly diagnosed in dogs living in or traveling through lower Sonoran life zones in the states of California and Arizona. Canine and human cases have geographic overlap. Similarities between clinical coccidioidomycosis in dogs and humans include asymptomatic infection, primary respiratory disease and disseminated disease. Differences include a high rate of dissemination in dogs, differences in predilection of dissemination sites, and a granulomatous or diffuse meningoencephalopathic form in the canine central nervous system (CNS) without the obstructive component seen in humans. Dogs presenting with CNS coccidioidomycosis most commonly experience seizures. Prior disease history and serology are unreliable indicators of CNS coccidioidomycosis. Magnetic resonance imaging (MRI) is advantageous for diagnosis of CNS coccidioidomycosis in dogs. Long-term administration of antifungal medication is promoted for treatment of both primary and disseminated coccidioidomycosis in dogs. Supportive treatment addressing pain, fever, inappetance, coughing, and other clinical signs improves patient care. Glucocorticoids and or anticonvulsants are also recommended for canine disseminated CNS disease. Protracted treatment times, lack of owner compliance, failure of the disease to respond to the first antifungal drug selected, and high cost are challenges of successfully treating dogs.
犬球孢子菌病是一种系统性真菌感染，在北美洲、中美洲和南美洲的干旱和半干旱地区流行，常见于生活在加利福尼亚州和亚利桑那州索诺兰低地生活带或途经此地的犬只。犬类和人类病例存在地域重叠。犬类和人类临床球孢子菌病的相似之处包括无症状感染、原发性呼吸道疾病和播散性疾病。不同之处包括犬类的播散率高、播散部位的偏好差异，以及犬类中枢神经系统（CNS）出现肉芽肿性或弥漫性脑膜脑病变形式，而人类没有梗阻成分。患有中枢神经系统球孢子菌病的犬只最常出现癫痫发作。既往疾病史和血清学检查对于中枢神经系统球孢子菌病来说是不可靠的指标。磁共振成像（MRI）有利于诊断犬类中枢神经系统球孢子菌病。对于犬类原发性和播散性球孢子菌病的治疗，提倡长期使用抗真菌药物。针对疼痛、发热、食欲不振、咳嗽和其他临床症状的支持性治疗可改善患者护理。对于犬类播散性中枢神经系统疾病，也推荐使用糖皮质激素和/或抗惊厥药。治疗时间长、主人依从性差、疾病对所选的第一种抗真菌药物无反应以及成本高，都是成功治疗犬只面临的挑战。
