title: Retroperitoneal pyogranulomatous and fibrosing inflammation secondary to fungal infections in two dogs.
abstract: METHODS
  A 4-year-old spayed female Golden Retriever (dog 1) was examined because of acute edema and erythema in the left hind limb and an inguinal mass, and a 5-year-old female Jack Russell Terrier (dog 2) was examined because of a recurring retro-peritoneal mass.
  
  
  RESULTS
  Dog 1 had an edematous, hyperemic left hind limb with a fixed inguinal mass. Monocytic neutrophilic leukocytosis and hypoalbuminemia were detected. Diagnostic imaging revealed abnormal tissue surrounding the larger vessels and ureters and complete occlusion of the left limb veins. Surgery resulted in incomplete removal of the mass. Histologic examination revealed fibrosing pyogranulomatous inflammation. Results of a Histoplasma antigen test were positive, and reanalysis of the tissues revealed yeast cells indicative of Histoplasma capsulatum. Dog 2 had incomplete removal of a retroperitoneal mass. Histologic examination revealed fibrosing pyogranulomatous inflammation. The mass recurred 8 months later in dog 2; exploratory abdominal surgery at that time resulted in substantial hemorrhage from the adhered caudal aorta. Histologic examination of tissue sections from the second surgery revealed yeast cells consistent with Blastomyces dermatitidis.
  
  
  RESULTS
  Both dogs had temporary improvement after surgery. Full clinical resolution required treatment for fungal disease. Dog 1 was treated with itraconazole, then fluconazole (total treatment time, 23 weeks). Dog 2 was treated with fluconazole for 36 weeks.
  
  
  CONCLUSIONS
  Retroperitoneal pyogranulomatous fibrosis caused by fungal infections has not been reported in veterinary medicine. There was substantial morbidity, but the prognosis can be good when this abnormality is recognized and antifungal medications are administered.
authors.affiliation: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA. drclemans@slvetspecialists.com
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Clemans
authors.forename: Krysta L
authors.initials: KL
authors.lastname: Deitz
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Riedesel
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Yaeger
authors.forename: Alfred M
authors.initials: AM
authors.lastname: Legendre
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001758:Blastomyces / Q000302:isolation & purification*; D001759:Blastomycosis / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D004283:Dog Diseases / Q000473:pathology*; D004285:Dogs; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006099:Granuloma / Q000382:microbiology / Q000662:veterinary; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D017964:Itraconazole / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D017964:Itraconazole; D015725:Fluconazole; D004318:Doxycycline