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魁北克一只 3 个月大的英国塞特犬因吸入孢子(地舌菌病)而引起的过敏性肺炎。

Hypersensitivity pneumonitis associated with inhalation of spores (lycoperdonosis) in a 3-month-old English setter dog in Quebec.

机构信息

Département des sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Québec J2S 2M2 (Lécuyer, Auffret, Martin, Letendre, Finck); Département de pathologie et de microbiologie, Faculté de médecine vétérinaire, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Québec J2S 2M2 (Corrales Mesa, Bédard); Centre Vétérinaire Laval, 4530 A. 440, Laval, Québec H7T 2P7 (Duval).

出版信息

Can Vet J. 2024 Jun;65(6):559-564.

Abstract

A 3-month-old female English setter dog was presented to the Faculty of Veterinary Medicine of the Université de Montréal (Quebec) with acute respiratory distress. The dog had moderately increased C-reactive protein concentrations, and thoracic radiographs revealed a moderate, caudodorsal, nodular-to-miliary alveolo-interstitial pulmonary pattern that was worse in the perihilar region. Initial differential diagnoses included a fungal pneumonia (, blastomycosis or histoplasmosis). Cytology of the bronchoalveolar lavage revealed several round, green structures ~2 μm in diameter, consistent with fungal spores. The dog was hospitalized, but within 24 h the respiratory condition deteriorated and euthanasia was elected. Post-mortem panfungal PCR and sequencing tests identified the spores as sp. Retrospectively, the owners recalled that the dog had played in a wood pile with mushrooms and had sneezed in a cloud of spores, implying inhalation of spores. This is the first report of a confirmed case of canine lycoperdonosis in eastern Canada (Quebec), and the radiographic features in this case differed slightly from previous reports. Diagnosis before bronchoalveolar lavage analysis was challenging, as spore inhalation was not initially reported. Although the disease is infrequently reported in dogs, this case report reminds veterinarians to consider lycoperdonosis as a differential diagnosis when addressing animals presented with acute dyspnea with similar radiographic lesions, and highlights the importance of history and cytology in diagnosing this condition. Key clinical message: Hypersensitivity pneumonitis secondary to inhalation of spores must be included in differential diagnoses for a dog with acute onset of respiratory signs and a nodular-to-miliary interstitial pulmonary pattern coalescing in patchy perihilar alveolar pulmonary lesions, and should prompt clinicians to question owners regarding inhalation of mushroom spores.Although cytological examination of a bronchoalveolar lavage reveals the presence of fungal spores, panfungal PCR and sequencing tests are needed to pinpoint the species involved.

摘要

一只 3 月龄雌性英国塞特犬因急性呼吸窘迫症被送到蒙特利尔大学(魁北克省)兽医学院。该犬的 C 反应蛋白浓度中度升高,胸部放射影像显示出一种中度的、背侧尾端、结节至粟粒状的肺泡间质性肺模式,在肺门周围区域更严重。最初的鉴别诊断包括真菌性肺炎(例如,芽生菌病或组织胞浆菌病)。支气管肺泡灌洗液的细胞学检查显示出几个直径约 2 微米的圆形、绿色结构,与真菌孢子一致。该犬被住院治疗,但在 24 小时内呼吸状况恶化,选择了安乐死。死后全真菌 PCR 和测序测试鉴定这些孢子为 sp. 回顾性地,主人回忆说,这只狗在一堆蘑菇中玩耍,并在一团孢子中打喷嚏,暗示吸入了 spores。这是在加拿大东部(魁北克)首次确诊的犬块菌病病例,并且该病例的放射学特征与以前的报告略有不同。在支气管肺泡灌洗分析之前进行诊断具有挑战性,因为最初未报告孢子吸入。尽管这种疾病在狗中很少报道,但该病例报告提醒兽医在处理具有类似放射学病变的急性呼吸困难的动物时,将块菌病考虑为鉴别诊断,并强调了病史和细胞学在诊断这种疾病中的重要性。主要临床信息:由于吸入 spores 引起的过敏性肺炎必须包括在具有急性发作性呼吸道症状和结节至粟粒状间质性肺模式的犬的鉴别诊断中,这些模式在斑片状肺门周围肺泡病变中融合,并应促使临床医生询问主人是否吸入蘑菇孢子。虽然支气管肺泡灌洗的细胞学检查显示存在真菌孢子,但需要进行全真菌 PCR 和测序测试来确定涉及的物种。

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本文引用的文献

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Hypersensitivity pneumonitis: new concepts and classifications.过敏性肺炎:新概念与分类
Mod Pathol. 2022 Jan;35(Suppl 1):15-27. doi: 10.1038/s41379-021-00866-y. Epub 2021 Sep 16.
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Pathogenic Fungal Infection in the Lung.肺部病原真菌感染。
Front Immunol. 2019 Jul 3;10:1524. doi: 10.3389/fimmu.2019.01524. eCollection 2019.
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Hypersensitivity pneumonitis: a complex lung disease.过敏性肺炎:一种复杂的肺部疾病。
Clin Mol Allergy. 2017 Mar 7;15:6. doi: 10.1186/s12948-017-0062-7. eCollection 2017.
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Immunopathology, diagnosis, and management of hypersensitivity pneumonitis.过敏性肺炎的免疫病理学、诊断和治疗。
Semin Respir Crit Care Med. 2012 Oct;33(5):543-54. doi: 10.1055/s-0032-1325163. Epub 2012 Sep 21.
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Hypersensitivity pneumonitis: insights in diagnosis and pathobiology.过敏性肺炎:诊断与病理生物学的新认识。
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