title: Successful treatment of intracardiac and intraocular blastomycosis in a dog with combination azole therapy.
abstract: A 4 yr old spayed female Labrador retriever with clinical signs of blindness, cutaneous lesions, coughing, inappetence, and lethargy was diagnosed with disseminated blastomycosis based on cytologic (skin and lymph node aspirates) and histopathologic (skin biopsy) examinations of tissue samples. The dog deteriorated clinically during hospitalization and developed sustained ventricular tachycardia. Echocardiography revealed pericardial effusion, a nodule associated with the left ventricular papillary muscle, and a right atrial mural lesion. Therapy for myocardial performance and glaucoma was initiated. A combination of itraconazole and fluconazole successfully treated the dog. The dog regained vision in the left eye (oculus sinister [OS]) and had no residual cardiac disease detectable by either electrocardiography or echocardiography. This report is unique in documenting survival from intracardiac blastomycosis and in the use of combination azole therapy for treating disseminated disease with intraocular involvement.
authors.affiliation: Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA. langlo21@cvm.msu.edu
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Langlois
authors.forename: Augusta
authors.initials: A
authors.lastname: Pelosi
authors.forename: John M
authors.initials: JM
authors.lastname: Kruger
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use; D001759:Blastomycosis / Q000188:drug therapy / Q000662:veterinary*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000662:veterinary*; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004359:Drug Therapy, Combination / Q000662:veterinary*; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000662:veterinary*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D017964:Itraconazole / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D015725:Fluconazole