First report on the diagnosis and treatment of encephalic and urinary paracoccidioidomycosis in a cat

Abstract

A male Persian cat was presented with persistent fever, anorexia, weakness, hypopyon, nystagmus, and intention tremors. The hemogram showed severe neutropenia and laboratory analysis on cerebrospinal fluid (CSF) smears revealed abundant yeast cells compatible with Paracoccidioides brasiliensis. Urinalysis demonstrated persistent funguria and an increased urine protein-to-creatinine ratio (UPC) in addition to mild azotemia. Long-term therapy with oral fluconazole was effective in controlling the nervous system signs. Funguria was resolved with subcutaneous administration of diluted amphotericin B in a large volume of saline solution for a period of 12 weeks during the second year after initial diagnosis. Throughout 5 years of treatment, no adverse effects were observed and tolerance to the drugs was normal. Due to development of progressive uremic syndrome the animal was euthanased. To the best of our knowledge, this report is the first clinical case described of a nervous and urinary system infection caused by the P brasiliensis in a cat.

Fig 1

(A and B) Cerebrospinal fluid of the cat stained with Giemsa. Abundant yeast cells of different sizes and budding daughter cells in the form of the spokes of a ship's steering wheel or ‘Mickey Mouse’ ears can be observed. Note the presence of thin hyphae. 40× and 100× magnification.

Fig 2

Cerebrospinal fluid of the same cat showing thick-walled yeast cells with narrow-based budding. 100× magnification.