Nasal aspergillosis/Penicillosis

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Age predisposition, Sex predisposition, Breed predisposition, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Epidemiology (population dynamics), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Standard treatment, Monitoring, Subsequent management, Prevention, Control, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Prof. Richard Ford DVM DipACVIM
Dr Rhea Morgan DVM DACVIM DACVO
Dr Lynelle Johnson DVM PhD DipACVIM

Introduction

  • Cause : Aspergillusspp (most commonly Aspergillus fumigatus Aspergillus fumigatus ) and Penicillium spp, infection by spores (usually inhaled).
  • Signs : rhinitis Rhinitis and sinusitis.
  • Diagnosis : serology, cytology, histopathology, microbiology.
  • Treatment : topical clotrimazole Clotrimazole or enilconazole Enilconazole.
  • Prognosis : fair to good.

Diagnosis

Clinical signs

  • Mucopurulent (initially serous), unilater or bilateral nasal discharge.
  • Ulceration or depigmentation of the nares.
  • Sneezing.
  • Facial pain.
  • Epistaxis.
  • Stertorous breathing.

Diagnosis

Differential diagnosis

  • Nasal neoplasia Nasal cavity: neoplasia.
  • Bacterial rhinitis: Bordetella bronchiseptica Bordetella bronchiseptica , Pasteurella multocida Pasteurella multocida.
  • Mixed bacterial/viral rhinitis.
  • Cryptococcosis Cryptococcosis.
  • Dental disease Periodontal disease.
  • Palatine defects Cleft lip and palate.
  • Prior trauma.
  • Allergic rhinitis.
  • Canine distemper.
  • Rhinosporidiosis.

Sequelae

Prognosis

  • Good in mnay cases.
  • Fair is complicated by primary or secondary bacterial rhinitis.
  • Poor to guarded with extension into the orbit or brain.

Expected response to treatment

  • Resolution of nasal discharge/epistaxis within 7-14 days of completion of topical treatment.
  • Improvement in clinical signs within 4 weeks of systemic treatment.
  • Absence of fungal plaques on rhinoscopy.
  • Negative histopathology on follow-up biopsy.

Reasons for treatment failure

  • Infection in frontal sinus not adequately treated during topical therapy.
  • Extension into the orbit or brain.
  • Resistance to one or more antifungal drugs.
  • Inappropriate treatment dosages or duration.

Sources

Publications

Refereed papers

  • Johnson L R, Drazenovich T L, Herrera M A & Wisner E R (2006) Results of rhinoscopy alone or in conjunction with sinuscopy in dogs with aspergillosis: 46 cases (2001-2004). JAVMA 228 , 738-742 PubMed.
  • Claeys S, Lefebvre J-B, Schuller S, Hamaide A & Clercx C (2006) Surgical treatment of canine nasal aspergillosis by rhinotomy combined with enilconazole infusion and oral itraconazole. JSAP 47 , 320-324 PubMed.
  • De Lorenzi D, Bonfanti U, Masserdotti C, Caldin M & Furlanello T (2006) Diagnosis of canine nasal aspergillosis by cytological examination: a comparison of four different collection techniques. JSAP 47 , 316-319 PubMed.
  • Sissener T R, Bacon N J, Friend E, Anderson D M & White R A S (2006) Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosis. JSAP 47 , 312-315 PubMed.
  • Saunders J H, Clercx C, Snaps F R, Sullivan M, Duchateau L, van Bree H J & Dondelinger R F (2004) Radiographic, magnetic resonance imaging, computed tomographic, and rhinoscopic features of nasal aspergillosis in dogs. JAVMA 225 (11), 1703-1712 PMID.
  • Friend E G, Williams J M, White R A (2002) Invasive treatment of canine nasal aspergillosis with topical clotrimazole. Vet Rec 151, 298-299.
  • Zonderland J L, Stork C K, Saunders J H et al(2002) Intranasal infusion of enliconazole for treatment of sinonasal aspergillosis in dogs. J Am Vet Med Assoc 221, 1421-1425.
  • Willis A M, Martin C L, Stiles J (1999) Sino-orbital aspergillosis in a dog. J Am Vet Med Assoc 214, 1644-1647.
  • Matthews K G, Davidson A P, Koblik P D et al(1998) Topical clotrimazole therapy in dogs with nasal aspergillosis. J Am Vet Med Assoc 213 (4), 501-506.
  • Davison A, Komtebedde J, Pappagianis D et al(1992) Treatment of nasal aspergillosis with topical clotrimazole. J Vet Intern Med 6, 124.
  • Sharp N J K, Harvery C E, Sullivan M (1991) Canine nasal aspergillosis and penicilliosis. Compend Contin Educ Pract Vet 12, 41-48.

Other sources of information

  • Davidson A P & Pappagianis D (1995) Treatment of nasal aspergillosis with clotrimazole. In: Bonagura J D & Kirk R W (eds) Current Veterinary Therapy XII. Philadelphia: W B Saunders. pp 899.
  • Sharp N J K (1998) Canine nasal aspergillosis-penicilliosis. In Greene CE: Infectious Diseases of the Dog and Cat. 2nd Edn. W B Saunders, Philadelphia, pp 404-409.

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