Arbona Nichole, Butkiewicz Christine D, Keyes Minta, Shubitz Lisa F
College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA.
Valley Fever Center for Excellence, University of Arizona, Tucson, AZ, USA.
J Feline Med Surg. 2020 Feb;22(2):129-137. doi: 10.1177/1098612X19829910. Epub 2019 Feb 20.
The goal of this study was to describe the clinical presentation, diagnosis and treatment of coccidioidomycosis in cats residing in a region endemic for species.
A retrospective review of records was performed at both primary and tertiary care veterinary practices in Tucson and Phoenix, Arizona, USA. Data collected included signalment, clinical signs, physical examination findings, diagnostic test results, treatment and outcome.
Fifty-one feline cases were identified from six veterinary hospitals. Cats presented with clinical signs and laboratory abnormalities similar to what has been seen in dogs, including respiratory illness (n = 20/51), neutrophilia (n = 24/31), monocytosis (n = 17/31) and hyperglobulinemia (n = 16/30). However, cats at diagnosis were typically significantly ill, with 31/51 having disseminated infection, most commonly to the skin (n = 22). Additionally, 43/44 cats that had serum antibody tests performed were positive, and median titer at diagnosis was 1:32 (range 1:4 to ⩾1:256). Serum antibody titers were significantly reduced ( ⩽0.001) in cats that responded to treatment compared with cats that did not clinically improve. Forty of 46 cats that were treated with oral fluconazole responded and did not require additional therapy. Fourteen cats developed recurrent disease and all but one had antifungal therapy successfully reinstituted.
Coccidioidomycosis is a disease of concern for cats residing in the regions endemic for species. Disease is most often disseminated at the time of diagnosis, possibly due to delays in presentation for care and recognition of the infection. Suspicion of disease, serum chemistries, blood cell counts, presence of antibody and imaging aid in the diagnosis of coccidioidomycosis in cats. Serum antibody reduction during treatment frequently correlated with an adequate response to medication. Consideration of coccidioidomycosis as a cause of illness will lead to earlier diagnosis and potentially better treatment outcomes in cats.
本研究的目的是描述居住在该菌种地方流行区的猫球孢子菌病的临床表现、诊断和治疗。
在美国亚利桑那州图森市和凤凰城的一级和三级兽医诊所对记录进行回顾性研究。收集的数据包括特征、临床症状、体格检查结果、诊断测试结果、治疗和预后。
从六家兽医医院确定了51例猫病例。猫表现出与犬相似的临床症状和实验室异常，包括呼吸道疾病（n = 20/51）、中性粒细胞增多（n = 24/31）、单核细胞增多（n = 17/31）和球蛋白血症（n = 16/30）。然而，确诊时的猫通常病情严重，31/51有播散性感染，最常见于皮肤（n = 22）。此外，进行血清抗体检测的44只猫中有43只为阳性，诊断时的中位滴度为1:32（范围1:4至⩾1:256）。与临床未改善的猫相比，对治疗有反应的猫血清抗体滴度显著降低（⩽0.001）。46只接受口服氟康唑治疗的猫中有40只产生反应，无需额外治疗。14只猫出现复发性疾病，除1只外所有猫再次成功接受抗真菌治疗。
球孢子菌病是居住在该菌种地方流行区的猫所关注的疾病。疾病在诊断时最常已播散，可能是由于就诊延迟和感染识别延迟。对疾病的怀疑、血清化学检查、血细胞计数、抗体存在情况和影像学检查有助于猫球孢子菌病的诊断。治疗期间血清抗体降低通常与对药物的充分反应相关。将球孢子菌病视为疾病病因会使猫得到更早诊断并可能获得更好的治疗结果。
