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Histoplasmosis PDF Print E-mail
Definition
Histoplasmosis is a systemic fungal infection. It is primary respiratory disease with dissemination to liver, spleen, intestine, lymph node, CNS dan bone.

Etiology
Histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum. Infective conidia are either inhaled or ingested.

Pathophysiology
Dissemination can be to any organ, resulting in a granulomatous inflamatory respone. Typically, spread occurs to organs such as the lungs, GI tract, liver, bone marrow and eyes. The choroid appears to be a target region in the eye.

Clinical presentation/signs
Ocular signs in dogs and cats include granulomatous choriorenitis, optic neuritis and retinal detachment, with some sign of anterior uveitis.

Differential Diagnosis
Cats
  • Dyspnea from fungal pneumonia, differentiate from heart failure, feline asthma, lymphosarcoma, pneumonia, pyothorax, and other fungal pneumonias.
  • Lameness, differentiate from trauma.
  • Ocular changes, differentiate from lymphosarcoma, toxoplasmosis , and feline infectious peritonitis .
Dogs
  • Severe chronic diarrhea and weight loss, consider lymphocytic plasmacytic enteritis, eosinophilic enteritis, lymphosarcoma, chronic parasitism, and pancreatic exocrine insufficiency.
  • Diarrhea and anemia, consider severe hookworm infection.
  • Hepatosplenomegaly and peripheral lymphadenopathy, consistent with lymphosarcoma
  • Respiratory signs: distemper, bacterial pneumonia, and heart disease

Diagnosis
The organism is found in endemic areas. Normocytic, normochromic, nonregenerative anemia is the most common hematologic abnormality. The organism may occasionally be seen in circulating mononuclear cells and eosinophils. The definitive diagnosis is based on identification of the organisms, usually by cytology, biosopsy and culture. Serologic test are available.

Treatment
Ketoconazole or Itraconazole
  • Drug of choice if adequate intestinal function for drug absorption exists.
  • Dogs and cats—5mg/kg PO q12h; give with a high-fat meal.
  • Minimum treatment is 90 days.
  • Combinated treatment with amphotericin B and ketoconazole or intraconazole is preferred in patients with severe or fulminating disease.
Fluconazole
  • Use for dogs that cannot be given amphotericin B.
  • Usual dose (intravenous form), 5 mg/kg IV q12h until intestinal absorption allows oral itraconazole treatment

Tags:  Article Pets Animals Histoplasmosis
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