Blastomycosis

by: Dr. Josie Arkush from Animal Care Center

Princess* is a seven year-old west highland terrier who was presented to the Animal Care Center in mid-April. Her owners noticed that she had a cough for about two weeks and had also developed two small, oozing lesions on her back (see image below for skin lesion). Though the owners did not think her appetite was decreased, it was noted that Princess had lost three pounds since her last grooming appointment a few weeks prior.

On physical exam, she was bright and alert. Two oozing lesions on her back were easily seen. She had a fever of 104.3°F (normal temperature for a dog is around 101.5°F). Her lymph nodes were of normal size. She was breathing faster than normal and a significant wheeze was heard when listening to her chest with a stethoscope.

Chest radiographs (x-rays) were performed, and an abnormal lung pattern (that looked like sponge painting) could be seen throughout her entire chest. (See images below for a "normal" lung x-ray vs. Princess' x-ray)

Impression smears were performed using fluid from the lesions on her back. When observed under a microscope, several broad-based budding organisms were seen (see picture).

It was determined that Princess had blastomycosis.

Blastomycosis is an infection that is caused by the fungal organism, Blastomyces dermatitidis, which can be found in soil in many parts of the midwest. Animals and people are at risk for developing blastomycosis - especially those who are exposed to soil such as farmers, hunting dogs, campers, dogs who dig in the yard, etc. When left untreated, blastomycosis can infect many parts of the body, including the eyes, lymph nodes, skin, lungs, and can sometimes cross into the brain. The infection can cause fevers, decreased appetite, a bad cough, blindness, seizures and death.

A urine antigen titer was submitted. This gave a measurement of the severity of infection in Princess' body. She was placed on oral antifungal medication. Treatment for blastomycosis can take up to 4-6 months in some cases. It will be important to monitor the "blasto" levels in Princess by doing routine urine tests in the upcoming months. Since antifungal medication can be a little tough for the liver to metabolize, we will also perform routine checks of her liver values.

So far, Princess is doing well. She has no side effects from her antifungal medication. Her skin lesions have cleared up and her owners report that her cough is getting better as well.

We anticipate that, with proper treatment on the owners' part, Princess will make a full recovery.

*Name changed to protect privacy

_______Skin Lesions______________Normal Lungs____________Princess's Lungs____________Blastomycosis______