Histoplasmosis in domestic cats: new minimally invasive diagnostic techniques.

OBJECTIVES: The aim of the present study was to evaluate minimally invasive diagnostic techniques, such as the semi-quantitative indirect IgG antibody enzyme immunoassay (EIA) using blood serum and the urinary lateral flow assay (LFA), for the detection of Histoplasma capsulatum in cats with histoplasmosis. METHODS: Eight client-owned domestic cats diagnosed with histoplasmosis were selected based on cytological, histopathological, mycological, molecular or antigenic techniques. The blood serum of these animals was tested in a semi-quantitative indirect IgG antibody EIA for the detection of H capsulatum. Urine samples were tested for H capsulatum antigen using LFA. RESULTS: Five cats were seropositive on IgG EIA (5/8, with diagnostic sensitivity equal to 62.5%; 95% confidence interval [CI] 24.5-91.5) and five cats were positive on H capsulatum antigen LFA (5/7, with diagnostic sensitivity equal to 71.4%; 95% CI 29.0-96.3). The combined diagnostic sensitivity when interpreted in parallel was 87.5% (7/8, 95% CI 47.3-99.7). The specificity for the anti-Histoplasma IgG EIA was 100% (95% CI 71.5-100) and for the H capsulatum antigen LFA it was also 100% (95% CI 71.5-100). CONCLUSIONS AND RELEVANCE: The semi-quantitative indirect IgG antibody EIA for the detection of H capsulatum in blood serum and the urinary LFA for the detection of the same agent emerge as new minimally invasive diagnostic techniques that can assist in the approach to disseminated and pulmonary feline histoplasmosis, especially when both techniques are considered together.

Molecular detection of Histoplasma capsulatum in organ samples from bats randomly captured in urban areas of Araraquara, São Paulo state, Brazil.

The mycosis histoplasmosis is also considered a zoonosis that affects humans and other mammalian species worldwide. Among the wild mammals predisposed to be infected with the etiologic agent of histoplasmosis, bats are relevant because they are reservoir of Histoplasma species, and they play a fundamental role in maintaining and spreading fungal propagules in the environments since the infective mycelial phase of Histoplasma grows in their accumulated guano. In this study, we detected the fungal presence in organ samples of bats randomly captured in urban areas of Araraquara City, São Paulo, Brazil. Fungal detection was performed using a nested polymerase chain reaction to amplify a molecular marker (Hcp100) unique to H. capsulatum, which revealed the pathogen presence in organ samples from 15 out of 37 captured bats, indicating 40.5% of infection. Out of 22 Hcp100-amplicons generated, 41% corresponded to lung and trachea samples and 59% to spleen, liver, and kidney samples. Data from these last three organs suggest that bats develop disseminated infections. Considering that infected bats create environments with a high risk of infection, it is important to register the percentage of infected bats living in urban areas to avoid risks of infection to humans, domestic animals, and wildlife.

Histoplasma antigens as novel players for the development of new enzyme immunoassays for the serodiagnosis of histoplasmosis: A comparative study of their analytical performance.

Definitive diagnosis of histoplasmosis relies on culture and/or cytology/histopathology; however, these procedures have limited sensitivity and cultures are time-consuming. Antibodies detection by immunodiffusion has low sensitivity in immunocompromised individuals and uses histoplasmin (HMN), a crude antigenic extract, as reagent. Novel protein antigen candidates have been recently identified and produced by DNA-recombinant techniques to obtain standardized and specific reagents for diagnosing histoplasmosis. To compare the analytical performance of novel enzyme-linked immunosorbent assays (ELISAs) for antibodies testing for diagnosing histoplasmosis using different Histoplasma capsulatum antigens as reagents. The H. capsulatum 100 kDa protein (Hcp100), the M antigen and its immunoreactive fragment F1 were produced by DNA-recombinant techniques. Galactomannan was purified from both the yeast and mycelial cell walls (yGM and mGM, respectively). The analytical performance of the ELISA tests for the serological detection of antibodies against these antigens was evaluated and compared with those obtained using HMN as reagent. Antibodies detection by the Hcp100 ELISA demonstrated 90.0% sensitivity and 92.0% specificity, versus 43.3% sensitivity and 95.0% specificity of the M ELISA, 33.3% sensitivity and 84.0% specificity of the F1 ELISA, 96.7% sensitivity and 94.0% specificity of the yGM ELISA, 83.3% sensitivity and 88.0% specificity of the mGM ELISA, and 70.0% sensitivity and 86.0% specificity for the HMN ELISA. In summary, Hcp100 is proposed as the most promising candidate for the serodiagnosis of histoplasmosis. The primary immunoreactive element in HMN proved to be GM rather than the M antigen. Nevertheless, a higher incidence of cross-reactions was noted with GM compared to M.

Hcp100 is a promising serodiagnostic candidate for histoplasmosis, boasting high sensitivity and specificity. Notably, GM, rather than M antigen, emerged as the primary immunoreactive element in HMN, despite a higher incidence of cross-reactions with GM compared to M.

Evidence of anti-Hcp100 antibodies in COVID-19 critically ill patients with detectable anti-histoplasmin antibodies in a highly endemic area for histoplasmosis.

Patients with severe COVID-19 are at increased risk for invasive fungal infections, which are underestimated. Histoplasmosis reactivation in endemic areas should not be overlooked in this population. In a previous study, seroconversion to anti-histoplasmin antibodies by ELISA was detected in 6/39 (15.4%) patients with severe COVID-19. In this work, samples were further investigated to detect seroconversion to antibodies against the Histoplasma capsulatum 100-kDa antigen (Hcp100) by ELISA. Seroconversion to anti-Hcp100 antibodies was detected in 7/39 patients, of whom 6 also seroconverted anti-histoplasmin antibodies. These results reinforce previous findings that show histoplasmosis as an underdiagnosed fungal entity complicating COVID-19.

This study verifies that patients with severe COVID-19 at intensive care units are at risk for histoplasmosis reactivation in endemic areas. Accurate diagnosis of this deadly fungal disease among critically ill patients with COVID-19 living in endemic areas for histoplasmosis is needed.

Fungal diseases in dogs and cats in Northeastern Brazil / Doenças fúngicas em cães e gatos no Nordeste do Brasil

In this retrospective study, the clinical and anatomopathological findings of fungal diseases in dogs and cats in Northeastern Brazil are described. During the study period, 6,827 histopathological examinations (4,090 necropsies and 2,737 biopsies) of companion animals were reviewed, and fungal infections were diagnosed in 54 cases. Of these, 32 cases were diagnosed in cats and 22 in dogs. Sporotrichosis was the most prevalent mycosis (19/54), followed by dermatophytosis (9/54), cryptococcosis (8/54), candidiasis (7/54), and phaeohyphomycosis (4/54). Other diseases had two cases each, including aspergillosis, mucormycosis, and histoplasmosis, whereas coccidioidomycosis occurred once. Mycoses were diagnosed through microscopic lesions associated with the histomorphological characteristics of the agent, as evidenced by routine and special histochemical stains. They were occasionally confirmed by immunohistochemistry and microbiological cultivation. This retrospective study showed that despite being uncommon, fungal diseases are important causes of death in dogs and cats in the region, with cats being the most affected species and sporotrichosis being the most prevalent mycosis. Clinical signs were correlated with the portal of entry of the infection associated with localized or disseminated superficial and deep skin lesions or affecting parenchymal organs, especially in systemic infections. Microscopic lesions were mainly characterized by pyogranulomatous inflammation associated with fungal structures. In dogs, mycoses occurred mainly owing to an immunological impairment secondary to canine distemper virus co-infection.

Neste estudo retrospectivo, são descritos os achados clínicos e anatomopatológicos das doenças fúngicas em cães e gatos no Nordeste do Brasil. Durante o período de estudo, foram revisados 6.827 exames histopatológicos (4.090 necropsias e 2.737 biópsias) de animais de companhia e diagnosticados 54 casos de infecções fúngicas. Destes, 32 casos foram diagnosticados em gatos e 22 em cães. A esporotricose foi a micose mais prevalente (19/54), seguida pela dermatofitose (9/54), criptococose (8/54), candidíase (7/54) e feo-hifomicose (4/54). Outras doenças tiveram dois casos cada, incluindo aspergilose, mucormicose e histoplasmose, enquanto a coccidioidomicose ocorreu uma vez. As micoses foram diagnosticadas por meio das lesões microscópicas associadas às características histomorfológicas do agente, evidenciadas pelas colorações de rotina e histoquímicas especiais, e ocasionalmente confirmadas pela imuno-histoquímica e cultivo microbiológico. Esse estudo retrospectivo demonstrou que apesar de incomuns, as doenças fúngicas são importantes causas de morte em cães e gatos da região, sendo os gatos a espécie mais afetada e a esporotricose, a micose mais prevalente. Os sinais clínicos estavam correlacionados com a porta de entrada da infecção, associados a lesões cutâneas localizadas ou disseminadas superficiais e profundas ou afetando órgãos parenquimatosos, especialmente em infecções sistêmicas. As lesões microscópicas eram caracterizadas principalmente por inflamação piogranulomatosa associada a estruturas fúngicas. Nos cães, as micoses ocorreram principalmente devido ao comprometimento imunológico secundária a coinfecção pelo vírus da cinomose canina.

Histoplasmose felina / Feline histoplasmosis

A histoplasmose é uma doença zoonótica, causada por um fungo oportunista, chamado Histoplasma capsulatum. O fungo é endêmico de regiões subtropicais e temperadas, sendo sua presença relatada principalmente nas Américas, na Índia e no Sudoeste Asiático.Acredita-se que os casos de histoplasmose em gatos ainda sejam subestimados. No Brasil, a maioria dos casos relatados foram provenientes do estado do Ceará. A histoplasmose é considerada a segunda causa mais comum de afecção micótica sistêmica em gatos. Desta forma, o objetivo do presente trabalho foi relatar a ocorrência de um caso com resolução satisfatória em Fortaleza/Ceará. O animal apresentou histórico de espirros crônicos, secreção nasal e um aumento de volume na região nasal, além de um nódulo ulcerado no flanco direito. Foram solicitadas citologia e cultura da lesão, onde foram evidenciadas leveduras sugestivas de Histoplasma capsulatum. O tratamento escolhido foi itraconazol na dose de 100mg/gato, sendo administrada por via oral uma cápsula ao dia. Após 30 dias, o animal retornou ao consultório, apresentando uma melhora considerável, sem aumento de plano nasal, processo obstrutivo nasal e lesões de pele.

Histoplasmosis is a zoonotic disease caused by an opportunistic fungus called Histoplasma capsulatum. The fungus is endemic to subtropical and temperate regions, with its presence being reported mainly in the Americas, India, and Southeast Asia. It is believed that the cases of histoplasmosis in cats are still underestimated. In Brazil, most reported cases were from the state of Ceará. Histoplasmosis is considered the second most common cause of systemic mycotic disease in cats. Thus, the present study aimed to report the occurrence of a case with satisfactory resolution in Fortaleza/Ceará. The animal showed a history of chronic sneezing, nasal secretion, and an increase in volume in the nasal region, in addition to an ulcerated nodule on the right flank. Cytology and culture of the lesion were requested, where yeasts suggestive of Histoplasma capsulatum were evidenced. The chosen treatment was itraconazole at a dose of 100mg/cat, being administered orally one capsule a day. After 30 days, the animal returned to the clinic showing considerable improvement, without an increase in the nasal plane, nasal obstructive process, and skin lesions.

Considerations about the Geographic Distribution of Histoplasma Species.

Histoplasmosis is a mycotic infection principally affecting pulmonary tissue; sometimes, histoplasmosis can progress into a systemic disease. This infection involves immunocompetent and immunosuppressed human and other mammalian hosts, depending on particular circumstances. Histoplasmosis infection has been documented worldwide. The infection is acquired by inhaling infective mycelial propagules of the dimorphic fungus Histoplasma capsulatum. New reports of clinical cases of histoplasmosis in extreme latitudes could be related to human social adaptations and climate changes in the world, which are creating new favorable environments for this fungus and for bats, its major natural reservoirs and dispersers. Histoplasma has been isolated from most continents, and it is considered a complex of cryptic species, consisting of various groups of isolates that differ genetically and correlate with a particular geographic distribution. Based on updated studies, Histoplasma taxonomy is adjusting to new genetic data. Here, we have suggested that Histoplasma has at least 14 phylogenetic species distributed worldwide and new genotypes that could be under deliberation. Histoplasma's geographic radiation began in South America millions of years ago when the continents were joined and the climate was favorable. For fungal spreading, the role of bats and some birds is crucial, although other natural factors could also participate.

Aspectos gerais da histoplasmose em pequenos animais e importância clínica / General aspects of histoplasmosis in small animals and the clinical importance / Aspectos generales de la histoplasmosis en pequeños animales e importancia clínica

Histoplasma capsulatum é o agente causador da histoplasmose, uma das principais doenças que acomete o sistema respiratório inferior de cães e gatos. Este patógeno é frequentemente isolado de fezes de aves e morcegos. A infecção ocorre por inalação dos esporos fúngicos em solos contaminados com as fezes. As manifestações clínicas da doença são divididas em infecção pulmonar, gastrointestinal, subclínica e disseminada. Esta revisão descreve como a doença ocorre em cães e felinos domésticos, seus achados clínicos, diagnóstico, tratamento e prevenção, evidenciando sua importância na clínica médica de pequenos animais.(AU)

Histoplasma capsulatum is the causative agent of histoplasmosis, one of the main diseases that affects the lower respiratory system of dogs and cats. This pathogen is often isolated from bird and bat droppings. Infection occurs by inhaling fungal spores in soil contaminated with faeces. The clinical manifestations of the disease are divided into pulmonary, gastrointestinal, subclinical and disseminated infection. This review describes how the disease occurs in dogs and domestic cats, their clinical findings, diagnosis, treatment and prevention, highlighting its importance in the medical clinic of small animals.(AU)

Histoplasma capsulatum es el agente causante de la histoplasmosis, una de las principales enfermedades que afecta al sistema respiratorio inferior de perros y gatos. Este patógeno a menudo se aísla de los excrementos de pájaros y murciélagos. La infección se produce al inhalar esporas de hongos en suelo contaminado con heces. Las manifestaciones clínicas de la enfermedad se dividen en infección pulmonar, gastrointestinal, subclínica y diseminada. Esta revisión describe cómo se presenta la enfermedad en perros y gatos domésticos, sus hallazgos clínicos, diagnóstico, tratamiento y prevención, destacando su importancia en la clínica médica de pequeños animales.(AU)

Aspectos gerais da histoplasmose em pequenos animais e importância clínica / General aspects of histoplasmosis in small animals and the clinical importance / Aspectos generales de la histoplasmosis en pequeños animales e importancia clínica

Histoplasma capsulatum é o agente causador da histoplasmose, uma das principais doenças que acomete o sistema respiratório inferior de cães e gatos. Este patógeno é frequentemente isolado de fezes de aves e morcegos. A infecção ocorre por inalação dos esporos fúngicos em solos contaminados com as fezes. As manifestações clínicas da doença são divididas em infecção pulmonar, gastrointestinal, subclínica e disseminada. Esta revisão descreve como a doença ocorre em cães e felinos domésticos, seus achados clínicos, diagnóstico, tratamento e prevenção, evidenciando sua importância na clínica médica de pequenos animais.

Histoplasma capsulatum is the causative agent of histoplasmosis, one of the main diseases that affects the lower respiratory system of dogs and cats. This pathogen is often isolated from bird and bat droppings. Infection occurs by inhaling fungal spores in soil contaminated with faeces. The clinical manifestations of the disease are divided into pulmonary, gastrointestinal, subclinical and disseminated infection. This review describes how the disease occurs in dogs and domestic cats, their clinical findings, diagnosis, treatment and prevention, highlighting its importance in the medical clinic of small animals.

Histoplasma capsulatum es el agente causante de la histoplasmosis, una de las principales enfermedades que afecta al sistema respiratorio inferior de perros y gatos. Este patógeno a menudo se aísla de los excrementos de pájaros y murciélagos. La infección se produce al inhalar esporas de hongos en suelo contaminado con heces. Las manifestaciones clínicas de la enfermedad se dividen en infección pulmonar, gastrointestinal, subclínica y diseminada. Esta revisión describe cómo se presenta la enfermedad en perros y gatos domésticos, sus hallazgos clínicos, diagnóstico, tratamiento y prevención, destacando su importancia en la clínica médica de pequeños animales.

Molecular detection of Histoplasma capsulatum in bats of the Amazon biome in Pará state, Brazil.

Histoplasma capsulatum, the fungus causing histoplasmosis, has a strong impact on public health. Histoplasmosis is one of the most prevalent systemic mycoses in the Americas and occurs in several mammalian species. Bats are important in the epidemiological cycle of histoplasmosis because they disseminate the fungus throughout the environment. The aim of the present study was to investigate natural H. capsulatum infection in bats located in forested areas, which have undergone anthropogenic perturbations, as well as in the urban areas of the state of Pará. Twenty-two species of bats were captured in 18 municipalities of Pará; the samples obtained from these animals were subjected to nested PCR for amplification of H. capsulatum DNA. The HCI/HCII and HCIII/HCIV primers were used, and the final 210-pb fragment was amplified. Of the 100 bats analysed, two were confirmed to be positive for H. capsulatum. Samples amplified by nested PCR were sequenced and found to share identity and have 100% match with H. capsulatum DNA. H. capsulatum was detected in the area of study: the state of Pará has a wide diversity of bat species, and the region under investigation is situated in the north of the state, which suffers the most severe environmental and climatic changes. Therefore, it is essential to elucidate the distribution of H. capsulatum hosts in this region to facilitate the implementation of effective disease surveillance.

Histoplasmosis Outbreaks in Brazil: Lessons to Learn About Preventing Exposure.

Histoplasmosis is considered the most common invasive opportunistic fungal disease in the Americas, with outbreaks and micro-epidemics reported for over 80 years. In Brazil, this disease has been described since 1946, reaching a remarkable incidence in the population, especially during the HIV-AIDS pandemic. In this study, published and unpublished outbreaks and micro-epidemics of histoplasmosis in Brazil were revisited by accessing different database sources and evaluating epidemiological and clinical features. We have found reports spanning 1946-2017, across 10 Brazilian states and with involvement of 370 humans and 2 dogs, and 13 disseminated cases and 3 deaths were reported. Rio de Janeiro had the largest number of outbreaks (n = 20/40; 50%) reported in this study. The majority of outbreaks and micro-epidemics was reported in caves (n = 21/40; 52.5%), followed by reports in abandoned/deactivated sites (n = 6/40; 15%), mines (n = 5/40; 12.5%), chicken coops (n = 4/40; 10%). Histoplasmosis is a serious health issue in Brazil considering the attractive and growing market of ecotourism throughout more than 7000 caves, and all levels of poultry farming activity are important to raise awareness about how dangerous this neglected disease can be and establish ways to decrease exposure to contaminated environmental sources through adequate preventive measures.

Rabies virus and Histoplasma suramericanum coinfection in a bat from southeastern Brazil.

Bats are essential to the global ecosystem, but their ability to harbour a range of pathogens has been widely discussed, as well as their role in the emergence and re-emergence of infectious diseases. This paper describes the first report of coinfection by two zoonotic agents, rabies virus (RABV) and the fungus Histoplasma suramericanum in a bat. The bat was from the Molossus molossus species, and it was found during the daytime in the hallway of a public psychiatric hospital in a municipality in São Paulo State, southeastern Brazil. RABV infection was diagnosed by the direct fluorescent antibody test and mouse inoculation test. The fungus was isolated by in vitro culture. Both diagnoses were confirmed by molecular techniques. Phylogenetic analysis showed that the fungus isolate had proximity to H. suramericanum in the Lam B clade, while the RABV isolate was characterized in the Lasiurus cinereus lineage. Since the M. molossus bat was found in a peri-urban transition area (urban/peri-urban), the possibility of cross-species transmission of this RABV lineage becomes more plausible, considering that this scenario may provide shelter for both M. molossus and L. cinereus. These are relevant findings since there has been an increase in bat populations in urban and peri-urban areas, particularly due to environmental modifications and anthropogenic impacts on their habitat. Thus, the detection of two zoonotic agents in a bat found in a public hospital should raise awareness regarding the importance of systematic surveillance actions directed towards bats in urban areas.

Adenocarcinoma renal em faisão-de-coleira (Phasianus colchicus) / Renal adenocarcinoma in collared pheasant (Phasianus colchicus)

O faisão-de-coleira (Phasianus colchicus) pertence à família Phasianidae, sendo originário da Ásia, ocupando áreas naturais das regiões da Rússia, China, Nepal e Japão. Há uma relação direta entre longevidade e neoformações em animais selvagens. Neoplasias renais são raramente observadas em aves selvagens de vida livre e ocasionalmente ocorrem em animais domésticos, porém com relatos escassos na literatura científica em relação a aves selvagens mantidas sob cuidados humanos. O presente artigo relata o diagnóstico histopatológico de adenocarcinoma associado à coinfecção por Histoplasma sp em um exemplar de faisão-de-coleira mantido sob cuidados humanos em uma coleção de animais selvagens.(AU)

The collared pheasant (Phasianus colchicus) is an exotic bird, belong to order Galliformes, family Phasianidae, being originally from Asia, occupying natural areas in the regions of Russia, China, Nepal and Japan. There is a direct relationship between longevity and neoformations in wild animals. Renal neoplasms are rarely observed in wild freeliving birds and occasionally occur in domestic animals, but with scarce reports in the scientific literature related wild birds kept under human care. The present article reports the histopathological diagnosis of adenocarcinoma associated with co-infection with Histoplasma sp in a specimen of collared pheasant kept under human care in a wild animal collection.(AU)

Adenocarcinoma renal em faisão-de-coleira (Phasianus colchicus) / Renal adenocarcinoma in collared pheasant (Phasianus colchicus)

O faisão-de-coleira (Phasianus colchicus) pertence à família Phasianidae, sendo originário da Ásia, ocupando áreas naturais das regiões da Rússia, China, Nepal e Japão. Há uma relação direta entre longevidade e neoformações em animais selvagens. Neoplasias renais são raramente observadas em aves selvagens de vida livre e ocasionalmente ocorrem em animais domésticos, porém com relatos escassos na literatura científica em relação a aves selvagens mantidas sob cuidados humanos. O presente artigo relata o diagnóstico histopatológico de adenocarcinoma associado à coinfecção por Histoplasma sp em um exemplar de faisão-de-coleira mantido sob cuidados humanos em uma coleção de animais selvagens.

The collared pheasant (Phasianus colchicus) is an exotic bird, belong to order Galliformes, family Phasianidae, being originally from Asia, occupying natural areas in the regions of Russia, China, Nepal and Japan. There is a direct relationship between longevity and neoformations in wild animals. Renal neoplasms are rarely observed in wild freeliving birds and occasionally occur in domestic animals, but with scarce reports in the scientific literature related wild birds kept under human care. The present article reports the histopathological diagnosis of adenocarcinoma associated with co-infection with Histoplasma sp in a specimen of collared pheasant kept under human care in a wild animal collection.

Infection by Histoplasma capsulatum, Cryptococcus spp. and Paracoccidioides brasiliensis in bats collected in urban areas.

Epidemiological studies on endemic mycosis can be improved using molecular biology techniques to elucidate the role of bats as reservoirs and vectors of pathogenic fungi for infection of other animals and humans. The objective of this study was to explore the presence of Histoplasma capsulatum, Cryptococcus spp. and Paracoccidioides brasiliensis in insectivorous, frugivorous and nectarivorous bats collected in urban areas. We analysed 172 bats collected by the Epidemiological Surveillance Agency in 12 municipalities of the Midwest region of the state of São Paulo, Brazil. Spleen, liver, intestine and lung samples were subjected to microbiological culture and nested PCR analyses. Prevalence of H. capsulatum infection was 8.1% (14/172), with one bat found to be positive by fungal culturing, 12 positive by nested PCR and one positive by both methods. Two insectivorous bats were found positive by nested PCR for Cryptococcus spp., one in the spleen and the other in the spleen and lung. Two insectivorous bats showed natural infection by P. brasiliensis, in the spleen of one bat and the spleen and liver of the other. Our results reinforce the importance of bats as fungal dispersers in urban environments and the importance of constant epidemiologic surveillance because these synanthropic animals are in close contact with humans and animals.

Molecular detection of Histoplasma capsulatum in insectivorous and frugivorous bats in Southeastern Brazil.

Bats are considered to play a significant role in the epidemiology of histoplasmosis, worldwide. We investigated the occurrence of H. capsulatum in lung samples from 89 bats, from urban areas in Southeastern Brazil, using nested PCR based on ribosomal DNA. Fungal DNA was detected in 31/89 samples (34.8%), of which 13/31 were Molossids (41.9%), 4/31 Eumops spp. (12.9%), 2/31 Artibeus lituratus (6.5%), and 12/31 others (38.7%). This is the first report of natural infection by H. capsulatum in A. lituratus in Southeastern Brazil, which reinforces the importance of these synanthropic animals in the epidemiology of histoplasmosis in urban areas.

Histoplasmose pulmonar grave em um gato doméstico: tratamento com Anfotericina B e Itraconazol / acute pulmonary histoplasmosis in a domestic cat treated with Amphotericin B and Itraconazole

Background: Histoplasmosis is a systemic mycosis whose etiologic agent is the fungus Histoplasma capsulatum. This fungal infection, which is the second most frequent systemic mycotic fungal disease in felines in the United States, has rarely been found in cats in Brazil. This paper reports on a case of acute pulmonary histoplasmosis in a domestic cat treated with oral itraconazole associated with amphotericin B administered subcutaneously. This treatment resulted in clinical remission of the patients symptoms, as evidenced by radiographic follow-ups.Case: A domestic cat suffering from acute dyspnea was taken to a veterinary clinic. The animal was subjected to emergency oxygen therapy, and kept at rest through sedation with midazolam. A physical examination revealed normally colored mucosa, 8% dehydration, bristly fur, body condition score 2/9, tachypnea with respiratory rate of 100 breaths per minute and expiratory dyspnea. The radiographic examination showed marked opacification of all the pulmonary fields, with a mixed pattern (interstitial and alveolar) of heterogeneous appearance and diffuse distribution, which are changes consistent with an inflammatory infectious process (pneumonia). A cytological analysis of the pleural fluid revealed round to oval-shaped intracytoplasmic structures, varying in size from 2 to 4 μm, inside foamy macrophages, consistent with Histoplasma capsulatum. Based on the diagnosis of pulmonary histoplasmosis, and in view of the patients acute respiratory distress, it was decided to treat the cat using itraconazole associated with amphotericin B. Itraconazole was administered orally at a dose of 100 mg/cat every 24 h, while amphotericin B was administered subcutaneously at a dose of 0.5 mg/kg, combined with 100 mL of sodium chloride 0.9% and 100 mL of 5% glycated serum, with monitoring of serum concentrations of symmetric dimethylarginine (SDMA).[...](AU)

Histoplasmose pulmonar grave em um gato doméstico: tratamento com Anfotericina B e Itraconazol / acute pulmonary histoplasmosis in a domestic cat treated with Amphotericin B and Itraconazole

Background: Histoplasmosis is a systemic mycosis whose etiologic agent is the fungus Histoplasma capsulatum. This fungal infection, which is the second most frequent systemic mycotic fungal disease in felines in the United States, has rarely been found in cats in Brazil. This paper reports on a case of acute pulmonary histoplasmosis in a domestic cat treated with oral itraconazole associated with amphotericin B administered subcutaneously. This treatment resulted in clinical remission of the patient’s symptoms, as evidenced by radiographic follow-ups.Case: A domestic cat suffering from acute dyspnea was taken to a veterinary clinic. The animal was subjected to emergency oxygen therapy, and kept at rest through sedation with midazolam. A physical examination revealed normally colored mucosa, 8% dehydration, bristly fur, body condition score 2/9, tachypnea with respiratory rate of 100 breaths per minute and expiratory dyspnea. The radiographic examination showed marked opacification of all the pulmonary fields, with a mixed pattern (interstitial and alveolar) of heterogeneous appearance and diffuse distribution, which are changes consistent with an inflammatory infectious process (pneumonia). A cytological analysis of the pleural fluid revealed round to oval-shaped intracytoplasmic structures, varying in size from 2 to 4 μm, inside foamy macrophages, consistent with Histoplasma capsulatum. Based on the diagnosis of pulmonary histoplasmosis, and in view of the patient’s acute respiratory distress, it was decided to treat the cat using itraconazole associated with amphotericin B. Itraconazole was administered orally at a dose of 100 mg/cat every 24 h, while amphotericin B was administered subcutaneously at a dose of 0.5 mg/kg, combined with 100 mL of sodium chloride 0.9% and 100 mL of 5% glycated serum, with monitoring of serum concentrations of symmetric dimethylarginine (SDMA).[...]

Histoplasmose nasocutânea em gato / Nasocutaneous histoplasmosis in cat

Histoplasmosis is a systemic fungal disease of an opportunistic nature that affects humans and animals. The objective of this work were to report a clinical case of histoplasmosis in a cat. In the Veterinary Hospital Professor Sylvio Barbosa Cardoso (HVSBC) a cat, no defined breed, female, of four years of age. No cytopathological examination was obtained through histoplasma spp. without cytoplasm of macrophages. Itraconazole in suspension (40 mg / mL / SID) was prescribed for the patient. On the return of the animal, after 21 days of treatment, it was not printed on a readiness scale, then the same drug was prescribed with dose adjustment (50 mg / capsule / SID for 90 days) and pharmaceutical form, and after 38 days was remission of the nasal region.(AU)

Histoplasmose nasocutânea em gato / Nasocutaneous histoplasmosis in cat

Histoplasmosis is a systemic fungal disease of an opportunistic nature that affects humans and animals. The objective of this work were to report a clinical case of histoplasmosis in a cat. In the Veterinary Hospital Professor Sylvio Barbosa Cardoso (HVSBC) a cat, no defined breed, female, of four years of age. No cytopathological examination was obtained through histoplasma spp. without cytoplasm of macrophages. Itraconazole in suspension (40 mg / mL / SID) was prescribed for the patient. On the return of the animal, after 21 days of treatment, it was not printed on a readiness scale, then the same drug was prescribed with dose adjustment (50 mg / capsule / SID for 90 days) and pharmaceutical form, and after 38 days was remission of the nasal region.