title: Protozoal nodular dermatitis and panniculitis in a Rottweiler puppy caused by Caryospora bigenetica.
abstract: BACKGROUND
  Caryospora bigenetica is an intracellular protozoan parasite in snakes and raptors (primary hosts) and rodents (secondary host). Experimental infection has been documented in mice, pigs and goats; natural infection in dogs is rare.
  
  
  OBJECTIVE
  To describe the clinical presentation, histological features, treatment and outcome of a case of protozoal nodular dermatitis and panniculitis in a Rottweiler puppy caused by C. bigenetica.
  
  
  RESULTS
  The puppy presented with generalized subcutaneous nodules measuring up to 2 cm in diameter. Histopathology revealed marked suppurative to pyogranulomatous dermatitis and panniculitis with intralesional protozoal organism. PCR and DNA sequencing confirmed infection with C. bigenetica. Treatment with a combination of oral trimethoprim-sulfamethoxazole (TMS), pyrimethamine and high-dose clindamycin (20 mg/kg twice daily) resulted in resolution of lesions in 6 weeks. Discontinuation of the treatment 2 weeks later was followed by a rapid relapse of skin lesions. Clindamycin and TMS were restarted and all lesions resolved within 2 weeks; TMS was discontinued 4 weeks later due to adverse effects. The lesions remained in remission for 2 months while the puppy received clindamycin monotherapy before a second relapse of skin lesions occurred.
  
  
  CONCLUSIONS
  To the best of the authors' knowledge, this is the first documentation of the treatment and outcome of C. bigenetica cutaneous infection in a dog. Although remission of clinical signs can be achieved with combination therapy of clindamycin and TMS, long-term management is challenging and relapses should be anticipated.
authors.affiliation: Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Heng L
authors.initials: HL
authors.lastname: Tham
authors.affiliation: Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, 1052 William Moore Drive, Raleigh, NC, 27607, USA.|Center for Comparative Medicine and Translational Research, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Keith E
authors.initials: KE
authors.lastname: Linder
authors.affiliation: Rollins Animal Disease Diagnostic Laboratory, 2101 Blue Ridge Rd., Raleigh, NC, 27607, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Tucker
authors.affiliation: Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Maggi
authors.affiliation: Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1052 William Moore Drive, Raleigh, NC, 27607, USA.|Center for Comparative Medicine and Translational Research, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Petra
authors.initials: P
authors.lastname: Bizikova
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D004283:Dog Diseases / Q000188:drug therapy / Q000469:parasitology*; D004285:Dogs; D021743:Eimeriidae / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D011529:Protozoan Infections, Animal / Q000469:parasitology* / Q000473:pathology; D012876:Skin Diseases, Parasitic / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology / Q000662:veterinary*
chemical_list: D000890:Anti-Infective Agents