• 1.

    Carpenter J. Exotic animal formulary. 3rd ed. St Louis: Elsevier Saunders, 2005;464465.

  • 2.

    Katsu M, Kidd S, Ando A, et al. The internal transcribed spacers and 5.8S rRNA gene show extensive diversity among isolates of the Cryptococcus neoformans species complex. FEMS Yeast Res 2004;4:377388.

    • Search Google Scholar
    • Export Citation
  • 3.

    Thompson JD, Higgins DG, Gibson TJ. ClustalW: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position-specific gap penalties and weight matrix choice. Nucleic Acids Res 1994;22:46734680.

    • Search Google Scholar
    • Export Citation
  • 4.

    Malik R, Krockenberger M, O'Brien CR, et al. Cryptococcosis. In: Greene CE, ed. Infectious disease of the dog and cat. 3rd ed. St Louis: Saunders Elsevier, 2006;584598.

    • Search Google Scholar
    • Export Citation
  • 5.

    Franzot SP, Salkin IF, Casadevall A. Cryptococcus neoformans var. grubii: separate varietal status for Cryptococcus neoformans serotype A isolates. J Clin Microbiol 1999;37:838840.

    • Search Google Scholar
    • Export Citation
  • 6.

    Bovers M, Hagen F, Boekhout T. Diversity of the Cryptococcus neoformans-Cryptococcus gattii species complex. Rev Iberoam Micol 2008;25:S4S12.

    • Search Google Scholar
    • Export Citation
  • 7.

    Nielsen K, De Obaldia AL, Heitman J. Cryptococcus neoformans mates on pigeon guano: implications for the realized ecological niche and globalization? Eukaryot Cell 2007;6:949959.

    • Search Google Scholar
    • Export Citation
  • 8.

    Lazéra MS, Pires FDA, Camillo-Coura L, et al. Natural habitat of Cryptococcus neoformans var. neoformans in decaying wood forming hollows in living trees. J Med Vet Mycol 1996;34:127131.

    • Search Google Scholar
    • Export Citation
  • 9.

    Stephen C, Lester SJ, Black W, et al. Multispecies outbreak of cryptococcosis on southern Vancouver Island, British Columbia. Can Vet J 2002;43:792794.

    • Search Google Scholar
    • Export Citation
  • 10.

    Lester SJ, Kowalewich NJ, Bartlett KH, et al. Clinicopathologic features of an unusual outbreak of cryptococcosis in dogs, cats, ferrets, and a bird: 38 cases (January to July 2003). J Am Vet Med Assoc 2004;225:17161722.

    • Search Google Scholar
    • Export Citation
  • 11.

    Duncan C, Schwantje H, Stephen C, et al. Cryptococcus gattii in wildlife of Vancouver Island, British Columbia, Canada. J Wildl Dis 2006;42:175178.

    • Search Google Scholar
    • Export Citation
  • 12.

    Bartlett KH, Kidd SE, Kronstad JW. The emergence of Cryptococcus gattii in British Columbia and the Pacific Northwest. Curr Infect Dis Rep 2008;10:5865.

    • Search Google Scholar
    • Export Citation
  • 13.

    Kidd SE, Bach PJ, Hingston AO, et al. Cryptococcus gattii dispersal mechanisms, British Columbia, Canada. Emerg Infect Dis 2007;13:5157.

  • 14.

    O'Toole TE, Sato AF, Rozanski EA. Cryptococcosis of the central nervous system in a dog. J Am Vet Med Assoc 2003;222:17221725.

  • 15.

    Kidd SE. A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada). Proc Natl Acad Sci U S A 2004;101:1725817263.

    • Search Google Scholar
    • Export Citation
  • 16.

    Malik R, McPetrie R, Wigney DI, et al. Use of the cryptococcal latex agglutination antigen test for diagnosis and monitoring of therapy in veterinary patients with cryptococcosis. Aust Vet J 1996;74:358364.

    • Search Google Scholar
    • Export Citation
  • 17.

    Malik R, Alderton B, Finlaison D, et al. Cryptococcosis in ferrets: a diverse spectrum of clinical disease. Aust Vet J 2002;80:749755.

  • 18.

    Krockenberger MB, Canfield PJ, Kozel TR, et al. An immunohistochemical method that differentiates Cryptococcus neoformans varieties and serotypes in formalin-fixed paraffin-embedded tissues. Med Mycol 2001;39:523533.

    • Search Google Scholar
    • Export Citation
  • 19.

    Ellis D, Marriott D, Hajjeh RA, et al. Epidemiology: surveillance of fungal infections. Med Mycol 2000;38:173182.

  • 20.

    Meyer W, Marszewska K, Amirmostofian M, et al. Molecular typing of global isolates of Cryptococcus neoformans var. neoformans by polymerase chain reaction-fingerprinting and randomly amplied polymorphic DNA-a. A pilot study to standardize techniques on which to base a detailed epidemiological survey. Electrophoresis 1999;20:17901799.

    • Search Google Scholar
    • Export Citation
  • 21.

    Chen S. Pancreatic endocrinopathies in ferrets. Vet Clin North Am Exot Anim Pract 2008;11:107123.

  • 22.

    Lewington JH. Disease of the ferret eyes, ears and nose. In: Lewington JH, ed. Ferret husbandry, medicine and surgery. 2nd ed. St Louis: Saunders-Elsevier, 2007;308317.

    • Search Google Scholar
    • Export Citation
  • 23.

    Lewington JH. Isolation of Cryptococcus neoformans from a ferret. Aust Vet J 1982;58:124.

  • 24.

    Malik R, Martin P, McGill J, et al. Successful treatment of invasive nasal cryptococcosis in a ferret. Aust Vet J 2000;78:158159.

  • 25.

    Greenlee PG, Stephens E. Meningeal cryptococcosis and congestive cardiomyopathy in a ferret. J Am Vet Med Assoc 1984;184:840841.

  • 26.

    Erdman SE, Moore FM, Rose R, et al. Malignant lymphoma in ferrets: clinical and pathological findings in 19 cases. J Comp Pathol 1992;106:3747.

    • Search Google Scholar
    • Export Citation
  • 27.

    Hanley CS, MacWilliams P, Giles S, et al. Diagnosis and successful treatment of Cryptococcus neoformans variety grubii in a domestic ferret. Can Vet J 2006;47:10151017.

    • Search Google Scholar
    • Export Citation
  • 28.

    Fox JG. Mycotic diseases. In: Fox JG, ed. Biology and diseases of the ferret. Philadelphia: Lea & Febiger, 1988;248254.

  • 29.

    Skulski G, Symmers WSC. Actinomycosis and torulosis in the ferret (Mustela furo L). J Comp Pathol 1954;64:306311.

  • 30.

    Rosenthal KL. Respiratory disease in ferrets. In: Quesenberry KE, Carpenter J, eds. Ferrets, rabbits, and rodents: clinical medicine and surgery. 2nd ed. St Louis: Elsevier, 2004;7278.

    • Search Google Scholar
    • Export Citation
  • 31.

    Malik R, Craig AJ, Wigney DI, et al. Combination chemotherapy of canine and feline cryptococcosis using subcutaneously administered amphotericin B. Aust Vet J 1996;73:124128.

    • Search Google Scholar
    • Export Citation

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Disseminated, histologically confirmed Cryptococcus spp infection in a domestic ferret

David Eshar DVM1, Jörg Mayer Dr med vet, MSC, DABVP2, Nicola M. Parry MSC, BVSc, DACVP3, Misty J. Williams-Fritze DVM, MS4, and Daniel S. Bradway BS5
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  • 1 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 2 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 3 Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 4 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 5 Molecular Diagnostics Section, Washington Animal Disease Diagnostic Laboratory, Washington State University, Pullman, WA 99164.

Abstract

Case Description—A 4-year-old castrated male domestic ferret from central Massachusetts was evaluated for weight loss over a 1.5-month period and for 2 days of retching, diarrhea, and signs of lethargy. It had been housed indoors, with 2 other ferrets, 2 cats, and humans that lacked signs or symptoms of disease.

Clinical Findings—Physical examination revealed a thin body condition, tachypnea, an increase in respiratory effort, and retching. Splenomegaly was detected during abdominal palpation. Clinicopathologic analysis revealed lymphopenia, lactic acidosis, hypoglycemia, hypocalcemia, hypoalbuminemia, and hyperglobulinemia. A pulmonary bronchointerstitial pattern was evident on radiographs, and abdominal ultrasonography revealed a suspected pancreatic mass and mesenteric lymphadenopathy.

Treatment and Outcome—After 2 weeks of medical treatment and once clinical signs resolved, an exploratory laparotomy was performed and a lymph node biopsy specimen was collected. Histologic evaluation of the specimen revealed Cryptococcus-like organisms. Antifungal treatment was initiated with itraconazole (PO) and amphotericin B (IV). The ferret died after 2 days of treatment. A full necropsy was performed, revealing multicentric cryptococcosis affecting the lungs, brain, spleen, and multiple lymph nodes. Paraffin-embedded, formalin-fixed lung tissue was submitted for DNA extraction, and the organism was identified as Cryptococcus neoformans var grubii.

Clinical Relevance—To the authors' knowledge, this is the first report of disseminated cryptococcosis in a North American ferret. This case is unique in that the ferret lived indoors, in a geographic region in which reports of cryptococcosis are rare. The genotyping technique used to identify the Cryptococcus strain can aid in better understanding the epidemiology of cryptococcosis.

Abstract

Case Description—A 4-year-old castrated male domestic ferret from central Massachusetts was evaluated for weight loss over a 1.5-month period and for 2 days of retching, diarrhea, and signs of lethargy. It had been housed indoors, with 2 other ferrets, 2 cats, and humans that lacked signs or symptoms of disease.

Clinical Findings—Physical examination revealed a thin body condition, tachypnea, an increase in respiratory effort, and retching. Splenomegaly was detected during abdominal palpation. Clinicopathologic analysis revealed lymphopenia, lactic acidosis, hypoglycemia, hypocalcemia, hypoalbuminemia, and hyperglobulinemia. A pulmonary bronchointerstitial pattern was evident on radiographs, and abdominal ultrasonography revealed a suspected pancreatic mass and mesenteric lymphadenopathy.

Treatment and Outcome—After 2 weeks of medical treatment and once clinical signs resolved, an exploratory laparotomy was performed and a lymph node biopsy specimen was collected. Histologic evaluation of the specimen revealed Cryptococcus-like organisms. Antifungal treatment was initiated with itraconazole (PO) and amphotericin B (IV). The ferret died after 2 days of treatment. A full necropsy was performed, revealing multicentric cryptococcosis affecting the lungs, brain, spleen, and multiple lymph nodes. Paraffin-embedded, formalin-fixed lung tissue was submitted for DNA extraction, and the organism was identified as Cryptococcus neoformans var grubii.

Clinical Relevance—To the authors' knowledge, this is the first report of disseminated cryptococcosis in a North American ferret. This case is unique in that the ferret lived indoors, in a geographic region in which reports of cryptococcosis are rare. The genotyping technique used to identify the Cryptococcus strain can aid in better understanding the epidemiology of cryptococcosis.

Contributor Notes

Dr. Eshar's present address is Moriah Veterinary Clinic, 70 Moriah Ave, Haifa, 34613, Israel.

Dr. Parry's present address is Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA 02139.

Dr. Williams-Fritze's present address is Department of Comparative Medicine, School of Medicine, Yale University, New Haven, CT 06511.

Supported in part by the “Bandit-Mouse” ferret fund.

Address correspondence to Dr. Eshar (dreshard@gmail.com).