A Case of Concurrent Disseminated Coccidioidomycosis and Embryonal Carcinoma When Lice and Fleas Coexist.

Coccidioidomycosis (CM) is a fungal infection endemic to the southwestern United States with a wide range of clinical presentations depending on the infected organ systems. Most infections are asymptomatic. Coccidioidomycosis causes a primary pulmonary infection and when symptoms occur, they most often resemble community-acquired pneumonia. One percent of cases disseminate, typically via hematogenous or lymphatic spread. It is in these cases that more severe symptoms may present and potentially overlap with those characteristics of other systemic illnesses. This is a case of CM disseminated to lymph nodes in a 24-year-old man with concomitant metastatic embryonal carcinoma. It is difficult to identify the primary etiology for many components of this patient's presentation, including diffuse lymphadenopathy and multiple pulmonary nodules. Furthermore, the relationship between these 2 concurrent disease processes is not entirely clear. Factors that may contribute include the well-known phenomenon of locus minoris resistentiae (LMR) or potentially a shared immune failure between infectious organisms and malignant cells.

Feline demodicosis in Santa Catarina state, Brazil / Demodicose felina em Santa Catarina, Brasil

Feline demodicosis is considered a rare dermatopathy and can be caused by Demodex cati, Demodex gatoi and a third species not yet named. An adult male feline was attended with severe pruritus for 9 months and a history of treatment with cephalexin and prednisolone, with progressive worsening. On physical examination, there was alopecia, hyperkeratosis, abrasions and erythema on the head, neck, lumbosacral region, tail and pelvic limbs, in addition to the presence of fleas. For pulicosis, selamectin spot on was prescribed every 30 days and use of amitraz in the environment every seven days. In order to control secondary infection, weekly baths with chlorhexidine were recommended. Deep skin scraping and hair plucking were performed for trichogram and parasitological skin examination, respectively, with diagnoses of demodicosis by Demodex cati, and mycotic dermatitis associated with secondary bacterial infection. The treatment was modified to use selamectin every 2 weeks, but the tutor did not return and reported, after several months, that he had done therapy with selamectin only every 30 days and discontinued baths. For this feline, it was not possible to associate demodicosis with other comorbidities. It is believed that the generalized presentation of the disease occurred due to the pruritus caused by pulicosis.

A demodicose felina é considerada uma dermatopatia rara e pode ser causada pelos ácaros Demodex cati,Demodex gatoi e uma terceira espécie ainda não nomeada. Foi atendido um felino adulto apresentando prurido intenso há 9 meses e histórico de tratamento com cefalexina e prednisolona, com piora progressiva. Ao exame físico, havia alopecia, hiperqueratose, escoriações e eritema em cabeça, pescoço, região lombossacra, cauda e membros pélvicos, além da presença de pulgas. Para puliciose, foram prescritos selamectina spot on a cada 30 dias e uso de amitraz no ambiente a cada sete dias e, para controle da infecção secundária pelas escoriações, foram recomendados banhos semanais com clorexidine. Realizaram-se raspado de pele profundo e arrancamento de pelos para tricograma e exame parasitológico de pele, respectivamente, com diagnósticos de demodicose por Demodex cati, e dermatite micótica associada a infecção bacteriana secundária. O tratamento foi modificado para uso de selamectina a cada 2 semanas, mas tutor não retornou e informou, após vários meses, ter feito terapia com selamectina apenas a cada 30 dias e descontinuidade dos banhos. Não foi possível associar a demodicose, para este felino, a outras comorbidades e acredita-se que a apresentação generalizada da doença tenha se dado pelo prurido causado pela puliciose.

Preventive efficacy of Frontline® Combo and Certifect® against Dipylidium caninum infestation of cats and dogs using a natural flea (Ctenocephalides felis) infestation model.

Two studies were performed to evaluate the effectiveness of two monthly topical anti-flea products for the prevention of Dipylidium caninum infestations in cats and dogs. A single treatment with Frontline(®) Combo spot-on for cats (fipronil-(S)-methoprene) and two successive monthly treatments of Certifect(®) for dogs (fipronil-amitraz-(S)-methoprene) were assessed for the prevention of D. caninum infestations following weekly challenges of treated cats or dogs with metacestode naturally-infected fleas. The rate of infestations using the model in cats versus dogs explains the choice of a 1-month trial in cats and a 2-month trial in dogs. The experimental flea-infection model resulted in a range of 22-53% of the fleas being infected by Dipylidium cysticercoids. The arithmetic mean flea counts recorded for the untreated cats ranged from 51.2 to 68. The geometric mean flea counts recorded for the Frontline Combo treated cats differed significantly (p < 0.05) from those of the untreated control cats on all assessment days. The arithmetic mean flea counts recorded for the untreated dogs ranged from 166.6 to 238.6. The geometric mean flea counts recorded for the Certifect treated dogs differed significantly (p < 0.001) from those of the untreated group on all assessment days. Frontline Combo treatment on cats provided ≥99.8% persistent anti-flea efficacy throughout the 30-day treatment period. In the dog study, the two Certifect treatments provided ≥97% persistent efficacy throughout the 60-day study. Based on the collection of expelled D. caninum proglottids by cats, 100% (6/6) of the control cats and 0% (0/6) of Frontline Combo treated cats were infested with D. caninum. Frontline Combo spot-on for cats was therefore 100% effective in preventing infection with D. caninum. In dogs, 7 out of the 8 control group dogs (87.5%) produced proglottids following infestation of infected fleas, whereas 0 out of 8 dogs (0%) in the treated group were infected. The infection rates of the two groups were significantly different. The percent effectiveness for the Certifect treatment group for the prevention of D. caninum infection was 100% during this 2-month trial. No treatment-related adverse events were observed in either cats or dogs during these studies.