title: A case in Europe of feline histoplasmosis apparently limited to the skin.
abstract: BACKGROUND
  Histoplasma capsulatum has a worldwide distribution, but reports in Europe remain rare. We present the second report of histoplasmosis in a cat in Europe and, to the best of our knowledge, the first case of feline histoplasmosis infection apparently limited to the skin.
  
  
  METHODS
  A 6-year-old male castrated outdoor cat was presented to the dermatology service with a history of skin lesions evolving over 1 month and consisting of multiple papules and nodules on the head and neck. General examination was unremarkable. Cytological examination of the ulcerated nodules revealed a pyogranulomatous infiltrate, with numerous macrophages containing oval yeast-like cells, 2-5 μm in size, with a central, lightly basophilic core surrounded by a clear halo. A tentative diagnosis of fungal infection was made, and skin biopsy specimens were taken. Histological examination confirmed the cytology findings, and Grocott staining showed numerous organisms suggestive of Histoplasma within macrophages. Thoracic radiographs, abdominal ultrasound and routine laboratory testing were unremarkable. Fungal culture of a nodule was negative. PCR of total DNA extracted from the infected tissue and subsequent sequencing confirmed the diagnosis of H. capsulatum var. capsulatum. Surgical excision of the other nodules was performed, and the cat was treated with oral itraconazole 5 mg/kg once daily; 12 weeks after initial consultation, no lesions were visible. No recurrence was observed during an 8 month follow-up period.
  
  
  CONCLUSIONS
  Histoplasmosis should be included in the differential diagnosis of nodular diseases of cats worldwide.
authors.affiliation: Department of Dermatology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
authors.forename: Nina M
authors.initials: NM
authors.lastname: Fischer
authors.forename: Claude
authors.initials: C
authors.lastname: Favrot
authors.forename: Michel
authors.initials: M
authors.lastname: Monod
authors.forename: Paula
authors.initials: P
authors.lastname: Grest
authors.forename: Katia
authors.initials: K
authors.lastname: Rech
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wilhelm
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use; D002371:Cat Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology* / Q000601:surgery; D002415:Cats; D005060:Europe / Q000453:epidemiology; D006660:Histoplasmosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole