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Feline disseminated cutaneous phaeohyphomycosis due to Exophiala spinifera.

ABSTRACT: A six-year-old domestic shorthair cat was presented for a subcutaneous digital nodular lesion on the right forelimb. On physical examination a similar lesion was identified on the right hindlimb. Disseminated cutaneous phaeohyphomycosis was diagnosed from histopathological changes in representative tissue biopsies and fungal culture. The isolate was identified by sequencing of ITS rDNA as Exophiala spinifera. This is the first report of disseminated cutaneous disease caused by E. spinifera in the cat.

SUBMITTER: Daly JA

PROVIDER: S-EPMC6938812 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Feline disseminated cutaneous phaeohyphomycosis due to Exophiala spinifera.

Daly Julie-Anne JA Hubka Vit V Kubátová Alena A Gimeno Marina M Barrs Vanessa R VR

Medical mycology case reports 20191224

A six-year-old domestic shorthair cat was presented for a subcutaneous digital nodular lesion on the right forelimb. On physical examination a similar lesion was identified on the right hindlimb. Disseminated cutaneous phaeohyphomycosis was diagnosed from histopathological changes in representative tissue biopsies and fungal culture. The isolate was identified by sequencing of ITS rDNA as Exophiala spinifera. This is the first report of disseminated cutaneous disease caused by E. spini ...[more]

PMID: 31908910

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Feline disseminated cutaneous phaeohyphomycosis due to Exophiala spinifera

Project description:Feline disseminated cutaneous phaeohyphomycosis due to Exophiala spinifera

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Project description:Exophiala spinifera has been reported as an agent of cutaneous disease 18 times in the literature. Clinical presentations of cutaneous lesions vary widely, including erythematous papules, verrucous plaques, and deep subcutaneous abscesses. The clinical distribution and course of disease are also variable, depending on the age and immune competency of the patient. Histologic appearance occurs in one of two patterns--phaeohyphomycosis or chromoblastomycosis. While E. spinifera appears to be susceptible to multiple antimicrobial agents in vitro, clinical experience with treatment modalities has been variable. Prior to the availability of sequencing methods, species identification was based on the histopathologic presentation in tissue and morphologic features of the fungus in culture. It is likely that E. spinifera cutaneous infections have been underreported due to its incorrect identification based on earlier methods. We report an additional case of E. spinifera phaeohyphomycosis, the first to be definitively identified by sequencing. In addition, we summarize the variable clinical, histopathologic, and morphologic features, as well as treatment responses described in previously reported cutaneous infections caused by E. spinifera.

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Project description:Case summaryA 3-year-old neutered domestic shorthair cat with a long history of idiopathic immune-mediated haemolytic anaemia and thrombocytopenia treated with ciclosporin and prednisolone was referred 2 months after the appearance of nodular dermatitis. A single pigmented nodule was present in the lateral carpal region of the right foreleg. The lesion was 7 mm in diameter, non-exudative and cutaneous to subcutaneous. Fine-needle aspiration of the mass revealed the presence of pigmented fungal elements. Excisional surgery was planned; in the meantime, a plaque-like lesion developed in the interorbital region. Histopathological examination confirmed the presumptive diagnosis of phaeohyphomycosis, and Exophiala spinifera was identified as the aetiological agent. Itraconazole, given orally at a dose of 10 mg/kg for 8 weeks following surgery, enabled clinical resolution despite continued use of immunosuppressants. The follow-up was carried out over 14 weeks.Relevance and novel informationThis case report provides the first evidence of multifocal cutaneous phaeohyphomycosis caused by E spinifera with clinical resolution after combined surgical and itraconazole treatment in an immunocompromised cat.

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Project description:A 7-year-old female-spayed, domestic short-haired cat was presented to her veterinarian with a mass on the hind paw. Histopathologic examination of a tissue biopsy revealed nodular pyogranulomatous panniculitis with intralesional pigmented fungal hyphae. A dematiaceous fungal isolate was isolated with a micromorphological phenotype consistent with the anamorphic genus Exophiala: budding cells, torulose mycelium and annellidic conidiogenesis from simple conidiophores consisting of terminal and lateral cells that tapered to a short beak at the apex. Sequence homology of the internal transcribed spacer region of the rDNA gene confirmed the identification of the isolate as Exophiala attenuata. Reported here is the first confirmed case of feline phaeohyphomycosis caused by E. attenuata in North America. Similar to historical cases of feline phaeohyphomycosis caused by Exophiala spp., there was no history or postmortem evidence to suggest the patient was in an immunocompromised state (e.g., suffering from FeLV or FIV). Although aggressive surgical excision of local lesions is recommended prior to drug treatment when dealing with subcutaneous phaeohyphomycosis, surgery followed by itraconazole treatment did not resolve the E. attenuata infection in this cat.

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Project description:NBRP: Genome sequencing of Exophiala spinifera JCM 15939

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