title: Fungal pericarditis and endocarditis secondary to porcupine quill migration in a dog.
abstract: A dog evaluated for acute onset of neurologic clinical signs was discovered to have a porcupine quill traversing the left atrium with fungal endocarditis. The dog had been quilled by a porcupine one month prior to presentation and had had several quills removed from the thoracic inlet and left dorsal shoulder areas. A new murmur was identified during the initial examination. Echocardiographic changes consistent with mitral valve endocarditis were identified, in addition to a linear, hyperechoic structure in the left atrium. A thoracic CT identified a possible mediastinal migrating foreign body tract. The foreign body was surgically removed and confirmed as a porcupine quill. Routine aerobic cultures of blood and pericardial samples resulted in growth of presumptive candidal organisms. PCR amplification and sequencing of samples from pericardial cultures identified the presence of a fungal organism, Lodderomyces elongisporus. The neurologic signs were attributed to a left-sided central vestibular lesion presumed secondary to an embolic event from infective endocarditis. After 3 months of antimicrobial and antifungal therapy the valvular changes had markedly improved and the clinical signs resolved. To the authors' knowledge, this is the first description of fungal endocarditis secondary to an intracardiac foreign body in a dog.
authors.affiliation: Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, P.O. Box 647060, Pullman, WA 99164-7060, USA. Electronic address: apcosta@vetmed.wsu.edu.
authors.forename: Ana
authors.initials: A
authors.lastname: Costa
authors.affiliation: Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, P.O. Box 647060, Pullman, WA 99164-7060, USA.
authors.forename: Sunshine
authors.initials: S
authors.lastname: Lahmers
authors.affiliation: Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, P.O. Box 647060, Pullman, WA 99164-7060, USA.
authors.forename: Sabrina L
authors.initials: SL
authors.lastname: Barry
authors.affiliation: Department of Veterinary Microbiology and Pathology, Washington State University, College of Veterinary Medicine, P.O. Box 647060, Pullman, WA 99164-7060, USA.
authors.forename: James
authors.initials: J
authors.lastname: Stanton
authors.affiliation: Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, P.O. Box 647060, Pullman, WA 99164-7060, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Stern
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use; D004283:Dog Diseases / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D004285:Dogs; D004696:Endocarditis / Q000209:etiology / Q000382:microbiology / Q000628:therapy / Q000662:veterinary*; D015725:Fluconazole / Q000627:therapeutic use*; D005547:Foreign Bodies / Q000150:complications / Q000628:therapy / Q000662:veterinary*; D008297:Male; D009181:Mycoses / Q000209:etiology / Q000382:microbiology / Q000662:veterinary*; D010493:Pericarditis / Q000628:therapy / Q000662:veterinary*
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole
keywords: Foreign body; Infective endocarditis; Intracardiac; Lodderomyces elongisporus; Mitral valve