Disseminated protothecosis associated with diskospondylitis in a dog

Abstract

A 6 yr old female Labrador retriever was evaluated for an acute onset of difficulty walking and a head tilt. Initial physical examination revealed bilateral retinal detachment, a left-sided head tilt, positional rotary nystagmus, and lumbar hyperpathia. Pertinent preliminary diagnostic findings included systemic hypertension, bony lysis and adjacent sclerosis of the vertebral endplates of the first and second lumbar vertebrae, and positive urine and blood cultures for a yeast identified as Candida spp. Concerned about disseminated candidiasis after subsequent subretinal aspirates confirmed the presence of a yeast-like organism, therapy with voriconazole was initiated. Because of progressive clinical deterioration and the poor prognosis for recovery, the dog was eventually euthanized. Postmortem histological examination of tissues, including the affected vertebral endplates, revealed numerous intralesional algae compatible with Prototheca spp. To the authors' knowledge, this report is the first to document a case of protothecal diskospondylitis with possible concurrent candidiasis in a dog. Although typically associated with signs referable to the gastrointestinal tract, this report underscores the importance of not excluding protothecosis as a differential diagnosis when such signs are absent. Lastly, the use of voriconazole appears ineffective for reversing the clinical course of late-stage disseminated protothecosis.