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Diagnosis and treatment of blastomycosis affecting the nose and nasopharynx of a dog

Astrid Wehner DVM1, Sonia Crochik DVM, MS2, Elizabeth W. Howerth DVM, PhD, DACVP3, and Amie Koenig DVM, DACVIM, DACVECC4
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  • 1 Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.
  • | 2 Department of Anatomy and Radiology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.
  • | 3 Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.
  • | 4 Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

Abstract

Case Description—A 2-year-old 38.9-kg (85.58-lb) sexually intact male German Shepherd Dog was examined because of a 4-month history of severe nasal swelling and nasal mucosa congestion. The signs were slowly progressive.

Clinical Findings—Physical examination revealed that the dorsal aspect of the dog's nose was swollen and hard. Mucous membranes in both nostrils were hyperemic and edematous. Diagnostic investigation revealed severe nasal osteolysis and pyogranulomatous rhinitis and nasopharyngitis attributable to blastomycosis.

Treatment and Outcome—Oral administration of itraconazole was initiated (5 mg/kg [2.27 mg/lb], q 12 h for 5 days and then q 24 h). After a treatment period of 3 months, the nose had regained its normal appearance. After 5 months of treatment, the Blastomyces infection was eliminated as confirmed by results of rhinoscopy and biopsy specimen examination. No relapse was evident within 1 year after discontinuation of treatment.

Clinical Relevance—In dogs, nasal and nasopharyngeal blastomycosis can result in severe osteolysis of the nasal bone. Resolution of disease can be achieved with oral administration of itraconazole for a period of at least 5 months.

Abstract

Case Description—A 2-year-old 38.9-kg (85.58-lb) sexually intact male German Shepherd Dog was examined because of a 4-month history of severe nasal swelling and nasal mucosa congestion. The signs were slowly progressive.

Clinical Findings—Physical examination revealed that the dorsal aspect of the dog's nose was swollen and hard. Mucous membranes in both nostrils were hyperemic and edematous. Diagnostic investigation revealed severe nasal osteolysis and pyogranulomatous rhinitis and nasopharyngitis attributable to blastomycosis.

Treatment and Outcome—Oral administration of itraconazole was initiated (5 mg/kg [2.27 mg/lb], q 12 h for 5 days and then q 24 h). After a treatment period of 3 months, the nose had regained its normal appearance. After 5 months of treatment, the Blastomyces infection was eliminated as confirmed by results of rhinoscopy and biopsy specimen examination. No relapse was evident within 1 year after discontinuation of treatment.

Clinical Relevance—In dogs, nasal and nasopharyngeal blastomycosis can result in severe osteolysis of the nasal bone. Resolution of disease can be achieved with oral administration of itraconazole for a period of at least 5 months.

Contributor Notes

Dr. Wehner's present address is the Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.

Address correspondence to Dr. Wehner.