Successful treatment of intracardiac and intraocular blastomycosis in a dog with combination azole therapy

J Am Anim Hosp Assoc. 2013 Jul-Aug;49(4):273-80. doi: 10.5326/JAAHA-MS-5874. Epub 2013 May 20.

Abstract

A 4 yr old spayed female Labrador retriever with clinical signs of blindness, cutaneous lesions, coughing, inappetence, and lethargy was diagnosed with disseminated blastomycosis based on cytologic (skin and lymph node aspirates) and histopathologic (skin biopsy) examinations of tissue samples. The dog deteriorated clinically during hospitalization and developed sustained ventricular tachycardia. Echocardiography revealed pericardial effusion, a nodule associated with the left ventricular papillary muscle, and a right atrial mural lesion. Therapy for myocardial performance and glaucoma was initiated. A combination of itraconazole and fluconazole successfully treated the dog. The dog regained vision in the left eye (oculus sinister [OS]) and had no residual cardiac disease detectable by either electrocardiography or echocardiography. This report is unique in documenting survival from intracardiac blastomycosis and in the use of combination azole therapy for treating disseminated disease with intraocular involvement.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Antifungal Agents / therapeutic use
  • Blastomycosis / drug therapy
  • Blastomycosis / veterinary*
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / veterinary*
  • Dog Diseases / drug therapy*
  • Dogs
  • Drug Therapy, Combination / veterinary*
  • Eye Infections, Fungal / drug therapy
  • Eye Infections, Fungal / veterinary*
  • Female
  • Fluconazole / therapeutic use*
  • Itraconazole / therapeutic use*
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Itraconazole
  • Fluconazole