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病例报告:犬临床真菌性心内膜炎作为疑似系统性曲霉病感染的一部分

Case report: Clinical fungal endocarditis as a component of presumptive systemic aspergillosis infection in a dog.

作者信息

Drake L Kay

机构信息

Veterinary Specialty Hospital - North County, Internal Medicine, Ethos Veterinary Health, San Marcos, CA, United States.

出版信息

Front Vet Sci. 2025 Mar 4;12:1471231. doi: 10.3389/fvets.2025.1471231. eCollection 2025.

Abstract

A 2-year-old 26-kilogram female spayed mixed breed dog presented for acute azotemia, a new heart murmur, anorexia, and lethargy. Further workup revealed marked azotemia with bilateral renal changes on abdominal ultrasound. An echocardiogram detected vegetative lesion on the mitral valve, consistent with infective endocarditis. The patient tested positive for the galactomannan antigen (Aspergillus EIA Galactomannan Test by MiraVista) leading to a presumptive diagnosis of systemic aspergillosis. Despite aggressive treatment, the patient continued to deteriorate and developed signs of dyspnea which temporarily improved with furosemide therapy (VetOne; Boise, ID). After humane euthanasia, postmortem evaluation confirmed fungal endocarditis. This is the first published case of clinical endocarditis in a dog suspected to be from aspergillosis based on both antemortem diagnostics and postmortem pathology. Thus, this case serves to further our understanding of systemic aspergillosis manifestations which in turn can aid in prompt diagnosis and treatment of the condition.

摘要

一只2岁、体重26公斤的已绝育雌性混种犬因急性氮质血症、新出现的心杂音、厌食和嗜睡前来就诊。进一步检查发现严重氮质血症,腹部超声显示双侧肾脏有变化。超声心动图检测到二尖瓣上有赘生物病变,符合感染性心内膜炎。该患者半乳甘露聚糖抗原检测呈阳性(通过MiraVista的曲霉酶免疫分析半乳甘露聚糖检测),从而初步诊断为系统性曲霉病。尽管进行了积极治疗,但患者病情仍持续恶化,并出现呼吸困难症状,使用速尿治疗(VetOne;爱达荷州博伊西)后症状暂时改善。实施安乐死后,尸检评估证实为真菌性心内膜炎。这是首例基于生前诊断和死后病理学怀疑由曲霉病引起的犬临床心内膜炎病例。因此,该病例有助于加深我们对系统性曲霉病表现的理解,进而有助于对该病进行及时诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e46/11913859/6ef9df77eccc/fvets-12-1471231-g001.jpg

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