title: MAGNETIC RESONANCE IMAGING FEATURES AND OUTCOME FOR SOLITARY CENTRAL NERVOUS SYSTEM COCCIDIOIDES GRANULOMAS IN 11 DOGS AND CATS.
abstract: Little published information is available to guide therapy for canine and feline patients with Coccidioides infections involving the central nervous system (CNS). The purpose of this cross-sectional retrospective study was to describe magnetic resonance imaging (MRI) features and outcome for a group of dogs and cats with solitary CNS Coccidiodes granulomas. Nine canine and two feline cases met inclusion criteria; four diagnosed and treated with surgery and fluconazole and seven diagnosed by serology or cytology and treated medically. Three cases had left Coccidioides endemic areas long before developing neurological disease. The MRI lesions shared many features with neoplastic masses. The extra-axial granulomas often had a lack of a distinct border between the mass and neural parenchyma. Four cases were extra-axial and seven were intra-axial, but distinguishing between extra-axial and intra-axial locations was sometimes challenging. The surgical cases had good outcomes and histology allowed definitive diagnosis. Medically managed patients also had generally good outcomes, with resolution of clinical signs in most cases. Findings indicated that distinction between neoplasia and focal Coccidioides granulomas based on MRI features is likely to be imprecise. Demonstration of the organism by cytology or histology is required for definitive diagnosis. The role of surgery for improving the outcome of brain or spinal coccidioidomycosis granulomas warrants further study.
authors: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47907.
authors: R Timothy
authors: RT
authors: Bentley
authors: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47907.
authors: Hock Gan
authors: HG
authors: Heng
authors: Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47907.
authors: Craig
authors: C
authors: Thompson
authors: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47907.
authors: Chun-Sheng
authors: CS
authors: Lee
authors: VCA Northwest Veterinary Specialists, Clackamas, OR, 97015.
authors: Robert A
authors: RA
authors: Kroll
authors: Veterinary Specialty Center of Tucson, Tucson, AZ, 85704.
authors: Michael E
authors: ME
authors: Roy
authors: Veterinary Neurological Center, Phoenix, AZ, 85040.
authors: Lauren
authors: L
authors: Marini
authors: VCA All-Care Animal Referral Center, Fountain Valley, CA, 92708.
authors: Jin
authors: J
authors: Heo
authors: Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47907.
authors: William L
authors: WL
authors: Wigle
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D002415:Cats; D002494:Central Nervous System Infections / Q000382:microbiology / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D003045:Coccidioides / Q000502:physiology; D003047:Coccidioidomycosis / Q000382:microbiology / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D003430:Cross-Sectional Studies; D004283:Dog Diseases / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D004285:Dogs; D005260:Female; D006099:Granuloma / Q000382:microbiology / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D008279:Magnetic Resonance Imaging / Q000662:veterinary*; D008297:Male; D012189:Retrospective Studies
keywords: abscess; canine; feline; fungal; neurosurgery