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Fungal Pneumonia in Dogs and Cats with Pulmonary Clinical Signs in Southern Brazil1 Mariana Pavelski2*, Sandra V

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Fungal Pneumonia in Dogs and Cats with Pulmonary Clinical Signs in Southern Brazil1 Mariana Pavelski2*, Sandra V Pesq. Vet. Bras. 38(4):696-702, abril 2018 DOI: 10.1590/1678-5150-PVB-5066 Vet 2615 pvb-5066 SA Fungal pneumonia in dogs and cats with pulmonary clinical signs in southern Brazil1 Mariana Pavelski2*, Sandra V. Seixas3, José Francisco G. Warth4, Cybelle de Souza4, Rosangela L. Dittrich4 and Tilde R. Froes4 ABSTRACT.- Pavelski M., Seixas S.V., Warth J.F.G., Souza C., Dittrich R.L. & Froes T.R. 2018. Fungal pneumonia in dogs and cats with pulmonary clinical signs in southern Brazil. Pesquisa Veterinária Brasileira 38(4):696-702. Departamento de Medicina Veterinária, Universidade Federal do Paraná, Rua dos Funcionários 1540, Curitiba, PR 80035-050, Brazil. E-mail: [email protected] Fungal pneumonia has been a differential diagnosis in dogs and cats with pulmonary clinical signs, posting also a public health risk to respective owners. Since a common-source environmental exposure may result in infection, dogs and cats may also act as sentinels for both animal and human disease. Accordingly, the present study has aimed to evaluate the occurrence of fungal pneumonia in dogs and cats with pulmonary clinical signs from May 2013 to February 2015 in southern Brazil. Thoracic radiographs, blood work and non-bronchoscopic Bronchoalveolar Lavage (BAL), followed by cytology and microbiologic pathogenic fungus (Cryptococcus neoformans) and another dog to an opportunistic fungus analysis(Candida were parapsilosis) performed. Both in dogsall animals. have presented One dog coughwas positive as the prior in the clinical BAL fluid sign culture and showed for a thoracic radiographic changes. In conclusion, the occurrence of fungal pneumonia in southern allow diagnosis of fungal pneumonia caused by opportunistic or pathogenic fungi and this Brazildiagnosis in dogs should and be cats a concern through in of dogs this andstudy cats was with relatively pulmonary low. clinicalThe BAL signs. fluid culture may INDEX TERMS: Fungal pneumonia, dogs, cats, southern Brazil, bronchoalveolar lavage, public health, mycoses. RESUMO.- [Pneumonia fúngica em cães e gatos do sul do Brasil com sinais clínicos pulmonares.] Pneumonia do LBA para um fungo patogênico (Cryptococcus neoformans) fúngica tem sido um diagnóstico diferencial em cães e gatos eme outro todos cão os para animais. um fungo Um cão oportunista foi positivo (Candida na cultura parapsilosis). do fluido com sinais clínicos pulmonares, sendo também um risco de Ambos os cães apresentaram tosse como sinal clínico principal saúde pública para seus respectivos proprietários. Uma vez que e alterações radiológicas torácicas. Em conclusão, a ocorrência uma fonte comum de exposição ambiental pode resultar em de pneumonia fúngica no sul do Brasil em cães e gatos por infecção, cães e gatos podem agir como sentinelas da doença meio deste estudo foi relativamente baixa. A cultura do LBA para ambos, pessoas e animais. Assim, o presente estudo teve pode possibilitar o diagnóstico de pneumonia fúngica causada como objetivo avaliar a ocorrência de pneumonia fúngica em por fungos oportunistas ou patogênicos e este diagnóstico cães e gatos com sinais clínicos pulmonares, de maio de 2013 a diferencial deve ser uma preocupação em cães e gatos com sinais clínicos pulmonares. de sangue e lavado broncoalveolar (LBA) não broncoscópico fevereiroseguido de 2015 análise no sulcitológica do Brasil. e microbiológica Radiografias torácicas,foram realizados exame TERMOS DE INDEXAÇÃO: Pneumonia fúngica, cães, gatos, sul do Brasil, lavado broncoalveolar, saúde pública, micoses. 1 Received on May 3, 2017. Accepted for publication on May 16, 2017. 2 Doctoral student, Departamento de Medicina Veterinária, Universidade Federal do Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, PR 80035- INTRODUCTION 050, Brazil. *Corresponding author: [email protected] The most common type of pneumonia detected in dogs 3 Veterinary Hospital Internship, Departamento de Medicina Veterinária, and cats is caused by bacteria, however, fungal, parasitic Universidade Federal do Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, PR 80035-050, Brazil. and viral pneumonia require a differential diagnosis in 4 Professor, Departamento de Medicina Veterinária, Universidade Federal patients with respiratory distress (Cohn 2009). Mycotic do Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, PR 80035-050. pneumonia can be caused by Histoplasma capsulatum, 696 Fungal pneumonia in dogs and cats with pulmonary clinical signs in southern Brazil 697 Blastomyces dermatitidis, Coccidioides immitis, Cryptococcus are no published studies showing the occurrence of fungal neoformans and Aspergillus fumigatus. The respiratory tract pneumonia in dogs and cats in southern Brazil. This study is a portal of entrance for these organisms and the infection aimed to evaluate the occurrence of fungal pneumonia in can involve the lungs alone or spread systemically to various dogs and cats attending in a university hospital in Parana target organs (Norris 2004, Hawkins 2014). state, Brazil and describe the clinical signs, blood work, Fungal pneumonia is also a concern in humans, an increasing number of affected people with high morbidity and mortality positive patients for this disease. have been described (Richardson 2005, Limper 2010, Silva 2010, radiographic findings, and BAL cytology and culture of the Wilson et al. 2002, Brown et al. 2012, Garnacho-Montero et al. MATERIALS AND METHODS 2013, Mandanas & Byrd 2014). A common-source environmental Client-owned dogs and cats of any breed or age admitted to the exposure may result in disease of both animals and humans. veterinary hospital from May 2013 to February 2015 with clinical signs The presence of infection in dogs and cats acts as a sentinel of lower respiratory diseases such as cough, dyspnea or tachypnea for human exposure and potential infection (Greene & Bromel were selected for the study. Animals with respiratory clinical signs 2012, Sylkes & Malik 2012). but without abnormalities on thoracic radiographs were excluded, also animals that presented masses on thoracic radiographs or fungal diseases. Histoplasmosis in humans and animals has increased global heart associated to pulmonary edema or venous a higherDefined incidence geographic in midwestern locations have and been the related Atlantic to certainUnited congestions suggesting primary heart disease. States and may be found in all regions in Brazil; however, in The selected dogs and cats involved in the study underwent humans, the state of Rio de Janeiro is responsible for most a physical examination, complete blood count (CBC), thoracic of the microepidemics described (Aidé 2009, Brown et al. radiography and subsequently non-guided bronchoalveolar lavage. 2012, Greene & Bromel 2012). In dogs and cats the disease Also, a detailed survey history with environmental characteristics is also found in all regions in Brazil (Silva-Ribeiro et al. 1987, was searched. The study was approved by the local Ethics Committee Carneiro et al. 2005, Cordeiro et al. 2011, Brilhante et al. 2012, CEUA 067/2013. Souza et al. 2015). Blastomycosis is endemic in humans and For the radiographic exam, three incidences (ventrodorsal, animals in the central and the southeastern United States, right and left lateral recumbency) were made following the including Ohio and Mississippi Valleys, and in parts of Canada, recommended technique, alignment and overlays (Rudorf et al. 2008). Africa and India (Bromel & Sykes 2005, Brown et al. 2012). Expiration radiographs were also accepted in this study due to the The incidence of this fungal disease in Brazil is not known. respiratory restriction of some patients during the examination. Coccidioidomycosis is found mainly in the southwestern The x-rays (500mA) for thorax radiography examination were United States, north Mexico and in other dry regions, such as generated by the Neo-Diagnomax ZB-1 (Medicor Budapest, Hungary) northeastern Brazil (Wanke et al. 1999, Johnson et al. 2003, and the images (DICOM format) then digitally processed (Agfa CR Togashi et al. 2009). Cryptococcus and Aspergillus are spread 30-X, Healthcare, Belgium) and interpreted using K-PACS software worldwide, affecting animals and humans (O’Brien et al. (IMAGE Information Systems Ltd, United Kingdom). 2004, Marcasso et al. 2005, Richardson 2005, Ferreira 2008, Radiographic examinations were interpreted immediately after Queiroz et al. 2008, Brown et al. 2012, Pereira et al. 2013). their acquisition and radiologists were not aware of the laboratory There are limited studies regarding the incidence of fungal tests or the BAL results. Thorough and careful interpretation of pneumonia in dogs and cats in Brazil. Only two epidemiology the pulmonary radiographic appearance was performed to detect studies in dogs were found in the literature, both conducted at a university hospital in Porto Alegre, Rio Grande do Sul lung pattern nomenclature. (30o2’4.73”S; 51o13’3.57”W). One study concerned the occurrence alteredThe BALradiopacity was performed and the within changes a maximum were classified 3 days of according the thoracic to of cryptococcosis, addressing 53 dogs with respiratory clinical radiograph capture. Animals did not receive any medication during signs (Oliveira et al. 2005). Another study concerned the this period. Prior to the BAL, the animals were fast for 8 hours. occurrence of pulmonary aspergillosis, addressing 46 dogs Then, each animal was sedated with meperidine (5mg/kg) followed with respiratory disorders (Teixeira 2012). No published by anesthesia with propofol
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