ISSN 2398-2969      

Nasal aspergillosis/penicillosis

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Introduction

  • CauseAspergillus spp (most commonly Aspergillus fumigatus Aspergillus fumigatus ) and Penicillium spp, infection by spores (usually inhaled). Occasionally associated with inhalation of foreign bodies such as grass awns.
  • Signs: rhinitis Rhinitis and sinusitis.
  • Diagnosis: diagnostic imaging (radiographs, CT or MRI), cytology, histopathology, microbiology, serology.
  • Treatment: debridement, topical clotrimazole Clotrimazole or enilconazole Enilconazole. Occasionally surgical intervention or oral antifungal agents are preferred.
  • Prognosis: fair to good.
Print off the owner factsheet on Fungal nasal disease Fungal nasal disease to give to your client.

Pathogenesis

Etiology

  • Aspergillus fumigatus Aspergillus fumigatus.
  • Occasionally A. nidulans, A. niger, A. flavus.
  • Penicillium spp (less common than aspergillosis).
  • Rarely other fungal types have been reported.

Predisposing factors

General

  • Access to saprophytic fungi in soil and decaying vegetation.
  • Meso- and dolichocephalic breeds.

Specific

  • Previous cranial trauma/surgery.
  • Unlike disseminated aspergillosis Aspergillosis: disseminated , affected dogs are usually immunocompetent.

Pathophysiology

  • Inhalation of fungal spores → infection starts unilaterally within the nasal turbinates and can extend to become bilateral → mucopurulent discharge (+/- epistaxis), and destruction of turbinates and potential extension to become bilateral , or involve the paranasal sinuses → chronic mucopurulent nasal discharge, sometimes with epistaxis → pain and facial distortion.
  • May cause loss of bone and extend into the orbit and calvarium → exopthalmus, altered mentation, seizures.

Timecourse

  • Some cases: rapid progression over 2-3 weeks.
  • Other cases: more gradual (chronic nasal discharge of several months' duration).

Epidemiology

  • Worldwide, ubiquitous saprophytic fungi → inhalation of fungal spores.
  • A. fumigatus: from decaying vegetation, compost, mouldy hay, etc.
  • Most dogs eliminate spores rapidly from upper respiratory tract, but some dogs become infected.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Sharman M J & Mansfield C S (2012) Sinonasal aspergillosis in dogs: A review. JSAP 53 (8), 434-444 PubMed.
  • Billen F, Guieu L, Bernaerts F et al (2010) Efficacy of intrasinusal administration of bifonazole cream alone or in combination with enilconazole irrigation in canine sinonasal aspergillosis: 17 cases. Can Vet J 51 (2), 164-168 PubMed.
  • Sharman M J, Paul A E H, Davies D et al (2010) Multi-centre assessment of mycotic rhinosinusitis in dogs: A retrospective study of initial treatment success (1998-2008). JSAP 51 (8), 423-7 PubMed.
  • Schuller S & Clercx C (2007) Long term outcomes in dogs wth sinonasal aspergillosis treated with intranasal infusions of enilconazole. JAAHA 43 (1), 33-38 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 (6), 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 techniquesJSAP 47 (6), 316-319 PubMed.
  • 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 (5), 738-742 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 aspergillosisJSAP 47 (6), 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 PubMed.
  • Saunders J, Clercx C, Snaps F et al (2003) Use of computed tomography to predict the outcome of a non-invasive intranasal infustion in dogs with nasal aspergillosis. Can Vet J 44 (4), 305-11 PubMed.
  • Friend E G, Williams J M, White R A (2002) Invasive treatment of canine nasal aspergillosis with topical clotrimazole. Vet Rec 151 (10), 298-299 PubMed.
  • Zonderland J L, Störk 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 (10), 1421-1425 PubMed.
  • Willis A M, Martin C L, Stiles J (1999) Sino-orbital aspergillosis in a dog. J Am Vet Med Assoc 214 (11), 1644-1647 PubMed.
  • Mathews K G, Davidson A P, Koblik P D et al (1998) Comparison of topical administration of clotrimazole through surgically placed versus nonsurgically placed catheters for treatment of nasal aspergillosis in dogs: 60 cases (1990-1996).​ J Am Vet Med Assoc 213 (4), 501-506 PubMed.
  • Sharp N, Sullivan M, Harvey C et al (1993) Treatment of canine nasal aspergillosis with enilconazole. JVIM 7 (1), 40-43 PubMed.
  • 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 13 (1), 41-47 VetMedResource.
  • Sharp N & Sullivan M (1986) Treatment of canine nasal aspergillosis with systemic ketoconazole and topical enilconazole. Vet Rec 118 (20), 560-1 PubMed.

Other sources of information

  • Day M J, Peeters I R & Clercx C (2012) Aspergillosis and Penicillosis. In: Greene C E Infectious Diseases of the Dog and Cat. 4th edn. W B Saunders, Philadelphia. Chapter 2, pp 651.
  • Sharp N J K (1998) Canine nasal aspergillosis-penicilliosis. In: Greene C E Infectious Diseases of the Dog and Cat. 2nd edn. W B Saunders, Philadelphia, pp 404-409.
  • 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.

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