Resp3- Mycotic and Parasitic Resp

  1. Histo, Blasto, and Coccidioides are ________ fungi, which means...
    dimorphic fungi; they are spores in the environment and yeast at body temperature.
  2. Where does Histo like to live?
    high nitrogen environment [pigeon and bat droppings]
  3. How is Histo transmitted?
    inhalation, ingestion (causes intestinal infection)
  4. Histo lives in __________; it has widespread _______________ and causes ____________ inflammatory responses.
    macrophages; hemolymphatic dissemination; granulomatous
  5. The incubation of Histo is __________; infection risk factors are... (4)
    12-16 days; level of exposure, host cell-mediated immunity, young outdoor dog, immunosuppression
  6. Describe subclinical histo infection. (4)
    common, self-limiting, confined to respiratory tract, causes discrete calcified interstitial foci (seen on rads)
  7. Describe acute pulmonary histo infection. (5)
    severe rapidly progressive granulomatous pneumonia; death from hypoxemia in days; diffuse nodular interstitial pulmonary infiltrates; patchy coalescing alveolar density; enlarged tracheobronchial ln
  8. What are clinical signs of acute pulmonary histo infection? (6)
    cough, tachypnea, dyspnea, abnormal lung sounds, fever, malaise
  9. Describe chronic pulmonary histo infection. (3)
    chronic granulomatous pneumonia; marked perihilar tracheobronchial lymphadenopathy; compresses bifurcation of trachea
  10. What are clinical signs of chronic pulmonary histo infection? (5)
    cough for weeks to months, exercise intolerance, dyspnea, weight loss, fever
  11. How is histoplasmosis diagnosed? (4)
    • routine lab work is non-specific [nonregenerative anemia, neutrophilia, monocytosis, thrombocytopenia]
    • thoracic rads suggestive
    • antigen test on serum or urine
    • cytology/ biopsy on BAL, TTW, FNA- visualize organism
  12. What will be seen on histopathology with histoplasmosis? (2)
    granulomatous inflammation, organisms are sparse and don't stain well
  13. What is the treatment for histoplasmosis? (4)
    • itraconazole is txt of choice, 4-6 months
    • amphotericin B IV for very severe cases
    • fluconazole (not as good a itra)- goof for refractory ocular or CNS
    • corticosteroids- tracheobronchial obstruction from lymphadenopathy
  14. How is blasto transmitted? (2)
    inhaled, MAYBE external skin wounds (pretty rare)
  15. What are clinical signs of blasto infection? (8)
    fever, cough, tachypnea, diffuse interstitial pyogranulomatous pneumonia (BAL or TTW), perihilar tracheobronchial lymphadenopathy (rad), alveolar infiltration and consolidation (rad), pleural effusion (rad), solitary mediastinal or lung masses (rad)
  16. What are common locations for lesions associated with disseminated blasto? (6)
    lymph nodes, cutaneous, ocular, bone, CNS, genital (more common in cats)
  17. How is blastomycosis diagnosed? (4)
    • routine lab work is non-specific [nonregenerative anemia, neutrophilia, monocytosis, thrombocytopenia]
    • thoracic rads suggestive
    • antigen test on serum or urine
    • cytology/ biopsy on BAL, TTW, FNA- visualize organism
  18. What will be seen on cytology from an animal with blasto? (4)
    • thick-walled, extracellular yeast bodies with broad-based budding
    • plentiful organisms
    • pyogranulomatous inflammation
  19. What is the treatment of blastomycosis? (6)
    • itraconazole is txt of choice, 4-6 months, at least 2-3 months past resolution
    • Amphotercin B IV if severe
    • fluconazole (not as good as itra)- good choice for refractory ocular, CNS, or prostate
    • Ancillary- topical ophthalamic with uveitis, monitor for glaucoma, castrate if prostatic infection, anti-inflammatories for resp signs
  20. What causes dissemination of Coccidioides?
    burst of precipitation out west causes fungal sporulation; dogs inhale spores
  21. How long is incubation of Coccidioides?
    1-3 weeks
  22. What are clinical syndromes and signs of Coccidioides infections? (3 syndromes)
    • Self-limiting subclinical: most common outcome in healthy animals
    • Pulmonary: acute or chronic; granulomatous pneumonia, perihilar tracheobronchial lymphadenopathy, chronic cough, fever, malaise
    • Extrapulmonary: bone disease in dogs, skin disease in cats
  23. How is coccidioides diagnosed? (5)
    • routine labwork is non-specific
    • thoracic rads are suggestive
    • rads of long bones- osteoproliferative, often lytic
    • ID by cytology/biopsy- spherules, pyogranulomatous inflammation
    • Serology for IgM (early) and IgG (late with severe or disseminated) titers
  24. What is the treatment for coccidioides? (3)
    • itraonazole for 8-12 months
    • if bone ivolvement itraconazole for life
    • fluconazole better for brain or ocular
  25. Cryptococcosis is a(n) __________ that is most common in ________; associated with ___________.
    saprophytic yeast; cats (nose, not really lung); pigeon poop
  26. Describe the pathogenesis of cryptococcus.
    inhale dried yeast--> capsule shield organism from immune system--> usually causes just nasal signs--> can go through cribriform plate and cause CNS signs
  27. Clinical signs of cryptococcus infection. (8)
    anorexia, depression, fever variable, nasal mass, firm swelling on bridge of nose, stertor, inspiratory dyspnea, +/- disseminated to skin/CNS/eyes
  28. How is cryptococcus diagnosed? (5)
    • routine labwork is non-specific
    • serology is presumptive (not necessarily making antibodies b/c shielded from immune system)
    • cytology/ biopsy is definitive
    • capsular antigen test on serum or CSF
    • nasal X-ray/ CT
  29. How is cryptococcus treated? (3)
    • fluconazole is txt of choice, 6-12 months, 2 months beyond resolution
    • itra and amphotericin are effective if need be
    • monitor capsular antigen titer
  30. What is Pneumonyssoides caninum?
    • nasal mite that causes chronic rhintis
    • txt w/ selamectin, milbemycin, ivermectin
  31. What is Eucoleus boehmi?
    • nasal worm
    • txt with milbemycin
  32. What is Oslerus osleri?
    • tracheal worm that is shed in stool, ingested, and migrated from the bowel to the lung
    • young dogs
    • dry cough
    • tracheal nodules seen on scope/ radiograph
  33. How is Oslerus osleri diagnosed and treated?
    • may be seen on Baerman float because they are coughed up and swallowed
    • ivermectin weekly for 2 months, fenbendazole
  34. What are species of lung worms? (4)
    Filaroides hirthi/ milksi, Crenosoma vulpis, Aelurostrongylus abstrusus, Eucoleus aerophila
  35. How are Filaroides transmitted, and what are clinical signs?
    • fecal-oral transmission
    • cough, pulmonary infiltrates
  36. How are Filaroides diagnosed and treated?
    • fecal float or TTW
    • fenbendazole, ivermectin
  37. What are characteristics of Crenosoma vulpis? (4)
    • associated with wild foxes
    • mollusk host
    • fecal exam or TTW for dx
    • fenbendazole, ivermectin, milbemycin
  38. How is aelurostrongylus diagnosed and treated? (2)
    • fecal or TTW
    • ivermectin, fenbendazole, selamectin
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Resp3- Mycotic and Parasitic Resp
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