Clinical Signs, Imaging Features, Neuropathology, and Outcome in Cats and Dogs with Central Nervous System Cryptococcosis from California

Jane E Sykes, Beverly Sturges, M. S. Cannon, B. Gericota, Robert Higgins, S. R. Trivedi, Peter J Dickinson, Karen Vernau, W. Meyer, Erik R Wisner

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Cryptococcus spp. is a fungal pathogen with a predilection for the central nervous system (CNS).Objectives: To compare the clinical, advanced imaging, and neuropathologic findings in dogs and cats with CNS cryptococcosis, and to evaluate outcome of treatment in these animals.Animals: Twenty-six cats and 21 dogs with CNS cryptococcosis.Methods: Medical records were reviewed for clinical findings and results of CNS imaging. Archived cerebrospinal fluid and CNS tissue specimens were reviewed for pathology. Findings in cats were compared with those in dogs and the effects of variables on survival were determined by survival curve analysis.Results: When present, pain was localized to the cervical region in dogs and was generalized or localized to the thoracolumbar spine or pelvic limbs in cats. Magnetic resonance imaging (MRI) findings were variable but correlated with CNS histopathological findings of meningitis, meningitis with gelatinous pseudocyst formation, and granulomatous mass lesions. Peripherally enhancing brain lesions were seen only in cats. Histopathologically, the inflammatory response was milder in cats compared with dogs. Remissions of ≥1 year occurred in 32% of treated animals. Altered mentation was associated with negative outcome. Glucocorticoid use after diagnosis was associated with improved survival in the first 10 days.Conclusions and Clinical Importance: Lesions seen on MRI reflected neuropathological findings and were similar to those reported in human patients. The immune response to infection may differ between cats and dogs, or relate to the infecting cryptococcal species. Long-term (>6 month median survival time) survival may be possible in animals surviving ≥4 days after diagnosis.

Original languageEnglish (US)
Pages (from-to)1427-1438
Number of pages12
JournalJournal of Veterinary Internal Medicine
Volume24
Issue number6
DOIs
StatePublished - Nov 2010

Fingerprint

neuropathology
Cryptococcosis
central nervous system
Cats
Central Nervous System
image analysis
Dogs
cats
dogs
lesions (animal)
Survival
meningitis
Meningitis
magnetic resonance imaging
animals
Magnetic Resonance Imaging
Cryptococcus
Nerve Tissue
remission
spine (bones)

Keywords

  • Brain
  • Cryptococcal antigen latex agglutination serology
  • Cryptococcus
  • Fungal
  • Magnetic resonance imaging
  • Mycoses

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Clinical Signs, Imaging Features, Neuropathology, and Outcome in Cats and Dogs with Central Nervous System Cryptococcosis from California. / Sykes, Jane E; Sturges, Beverly; Cannon, M. S.; Gericota, B.; Higgins, Robert; Trivedi, S. R.; Dickinson, Peter J; Vernau, Karen; Meyer, W.; Wisner, Erik R.

In: Journal of Veterinary Internal Medicine, Vol. 24, No. 6, 11.2010, p. 1427-1438.

Research output: Contribution to journalArticle

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abstract = "Background: Cryptococcus spp. is a fungal pathogen with a predilection for the central nervous system (CNS).Objectives: To compare the clinical, advanced imaging, and neuropathologic findings in dogs and cats with CNS cryptococcosis, and to evaluate outcome of treatment in these animals.Animals: Twenty-six cats and 21 dogs with CNS cryptococcosis.Methods: Medical records were reviewed for clinical findings and results of CNS imaging. Archived cerebrospinal fluid and CNS tissue specimens were reviewed for pathology. Findings in cats were compared with those in dogs and the effects of variables on survival were determined by survival curve analysis.Results: When present, pain was localized to the cervical region in dogs and was generalized or localized to the thoracolumbar spine or pelvic limbs in cats. Magnetic resonance imaging (MRI) findings were variable but correlated with CNS histopathological findings of meningitis, meningitis with gelatinous pseudocyst formation, and granulomatous mass lesions. Peripherally enhancing brain lesions were seen only in cats. Histopathologically, the inflammatory response was milder in cats compared with dogs. Remissions of ≥1 year occurred in 32{\%} of treated animals. Altered mentation was associated with negative outcome. Glucocorticoid use after diagnosis was associated with improved survival in the first 10 days.Conclusions and Clinical Importance: Lesions seen on MRI reflected neuropathological findings and were similar to those reported in human patients. The immune response to infection may differ between cats and dogs, or relate to the infecting cryptococcal species. Long-term (>6 month median survival time) survival may be possible in animals surviving ≥4 days after diagnosis.",
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