Successful treatment of cryptococcal pneumonia in a pony mare.
Abstract: A 20-year-old Welsh Mountain Pony (212 kg) mare was initially presented for a chronic cough, fever, weight loss and low grade abdominal pain. She later developed dyspnoea, tachypnoea and exercise intolerance. The presence of multiple masses (up to 17 cm diameter) in the pulmonary parenchyma was established using lateral thoracic radiography and transthoracic ultrasonography. Encapsulated, budding yeasts were observed in smears made from transtracheal washings and needle aspirates of the pulmonary lesions. Cryptococcus gattii (synonym: Cryptococcus neoformans variety gattii; Cryptococcus bacillisporus) was cultured from the transtracheal washings and aspirates of the lung masses. The pony was successfully treated using daily intravenous infusions of amphotericin B (typically 0.5 mg/kg in 1 L 5% dextrose in water over 1 h, following premedication with 50 mg flunixin intravenously) over a 1 month period, until a cumulative dose of 3 g had been administered. Treatment was considered to be successful on the basis of progressive improvement in clinical signs, reduction in the size of pulmonary cryptococcomas, 48 kg weight gain and a reduction in the cryptococcal antigen titre from 4096 to 256, 1 year after cessation of treatment.
Publication Date: 2005-06-28 PubMed ID: 15977613DOI: 10.1111/j.1751-0813.2004.tb12155.xGoogle Scholar: Lookup
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Summary
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This research article recounts the clinical diagnosis and successful treatment of a 20-year-old pony suffering from cryptococcal pneumonia. The pony showed symptoms like chronic cough, fever, weight loss, abdominal pain and eventually, breathing problems. Diagnosed using radiography and ultrasonography, the disease was treated for a month with daily intravenous infusions of amphotericin B, leading to its recovery.
Introduction
- In this study, a case of cryptococcal pneumonia in a 20-year-old Welsh Mountain Pony mare is documented. The initial symptoms included a chronic cough, fever, weight loss, and low-grade abdominal pain. The disease advanced to causing dyspnoea (difficulty breathing), tachypnoea (abnormally rapid breathing), and exercise intolerance.
Diagnosis
- The diagnosis procedure incorporated several steps. Initially, multiple masses of up to 17 cm in diameter were ascertained in the pulmonary parenchyma (functional part of the lung) of the pony using lateral thoracic radiography and transthoracic ultrasonography.
- Further, encapsulated, budding yeasts were observed in the smears obtained from the transtracheal washings (a method used in the clinical investigation of respiratory disease) and needle aspirates from the pulmonary lesions. The yeast turned out to be Cryptococcus gattii, causing the disease.
Treatment and recovery
- The treatment adopted for the pony was daily intravenous infusions of the antifungal drug, amphotericin B. Typically 0.5 mg/kg of the drug was administered in 1 L of 5% dextrose in water over a one-month period, until a cumulative dose of 3g had been administered.
- The treatment was deemed successful based on progressive improvement in clinical signs, reduction in the size of the lung lesions (pulmonary cryptococcomas), and a significant gain in weight.
- The cryptococcal antigen titre, a measurement of antibodies in the blood, was reduced from 4096 to 256 one year post treatment, affirming the success of the treatment applied.
Cite This Article
APA
Begg LM, Hughes KJ, Kessell A, Krockenberger MB, Wigney DI, Malik R.
(2005).
Successful treatment of cryptococcal pneumonia in a pony mare.
Aust Vet J, 82(11), 686-692.
https://doi.org/10.1111/j.1751-0813.2004.tb12155.x Publication
Researcher Affiliations
- Randwick Equine Centre, PO Box 195, Randwick, New South Wales.
MeSH Terms
- Amphotericin B / administration & dosage
- Animals
- Antifungal Agents / administration & dosage
- Cough / etiology
- Cough / veterinary
- Cryptococcosis / complications
- Cryptococcosis / diagnosis
- Cryptococcosis / drug therapy
- Cryptococcosis / veterinary
- Diagnosis, Differential
- Female
- Horse Diseases / diagnosis
- Horse Diseases / diagnostic imaging
- Horse Diseases / drug therapy
- Horse Diseases / pathology
- Horses
- Infusions, Intravenous / veterinary
- Pneumonia / complications
- Pneumonia / diagnosis
- Pneumonia / drug therapy
- Pneumonia / veterinary
- Radiography
- Ultrasonography
Citations
This article has been cited 3 times.- Allano M, Grimes C, Boivin R, Smith G, Dumaresq J, Leclere M. Cryptococcus gattii pneumonia in an adult horse which had travelled in an endemic area. Can Vet J 2019 Dec;60(12):1295-1300.
- Secombe CJ, Lester GD, Krockenberger MB. Equine Pulmonary Cryptococcosis: A Comparative Literature Review and Evaluation of Fluconazole Monotherapy. Mycopathologia 2017 Apr;182(3-4):413-423.
- Byrnes EJ 3rd, Bartlett KH, Perfect JR, Heitman J. Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals. Microbes Infect 2011 Oct;13(11):895-907.
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