Temporal tracheobronchial lymphadenopathy resolution is affected by initial severity and poorly correlated to serologic antibody testing in dogs with pulmonary coccidioidomycosis

Rebecca Urion Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Jared A. Jaffey Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ

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Eric T. Hostnik Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Andrew S. Hanzlicek MiraVista Diagnostics, Indianapolis, IN

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George E. Moore Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN

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DOI:
https://doi.org/10.2460/javma.23.04.0220
Volume/Issue:
Volume 261: Issue 11
Online Publication Date:
21 Jul 2023
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Abstract

OBJECTIVE

To determine associations between antibody serologic tests and tracheobronchial lymphadenopathy (TBL) in dogs with pulmonary coccidioidomycosis and identify variables associated with time to resolution of TBL.

ANIMALS

32 client owned dogs with newly diagnosed pulmonary coccidioidomycosis from October 2020 to February 2021.

METHODS

Prospective cohort study. Thoracic radiographs and anti–Coccidioides spp antibody serology were performed at baseline and once every 3 months until remission or for a maximum of 12 months. Radiographic tracheobronchial lymph node height, length, and area were measured and recorded as ratios via comparison with the length of the T4 vertebral body (LT4) and length of the manubrium. Severity of TBL was also subjectively categorized as mild, moderate, or severe.

RESULTS

Tracheobronchial lymphadenopathy was identified in 81% (26/32; 95% CI, 64% to 93%) of dogs. There was no relevant association between TBL presence or severity and antibody serology results. Tracheobronchial lymphadenopathy resolved in 72% (n = 18) of dogs at the 3-month evaluation. The median time to resolution of TBL after initiation of fluconazole was 96 days (range, 72 to 386 days). Univariate analysis identified increasing TBL severity (hazard ratio, 0.40; 95% CI, 0.19 to 0.84; P = .02) and length:LT4 ratio (hazard ratio, 0.41; 95% CI, 0.20 to 0.82; P = .01) as variables associated with reduced probability of resolution of TBL.

CLINICAL RELEVANCE

Antibody serologic test results are not clinically useful to predict TBL presence or severity in dogs with pulmonary coccidioidomycosis, and larger tracheobronchial lymph nodes are more likely to take longer to resolve. Resolution of TBL occurs in most dogs within 3 to 6 months after fluconazole administration.

Abstract

OBJECTIVE

To determine associations between antibody serologic tests and tracheobronchial lymphadenopathy (TBL) in dogs with pulmonary coccidioidomycosis and identify variables associated with time to resolution of TBL.

ANIMALS

32 client owned dogs with newly diagnosed pulmonary coccidioidomycosis from October 2020 to February 2021.

METHODS

Prospective cohort study. Thoracic radiographs and anti–Coccidioides spp antibody serology were performed at baseline and once every 3 months until remission or for a maximum of 12 months. Radiographic tracheobronchial lymph node height, length, and area were measured and recorded as ratios via comparison with the length of the T4 vertebral body (LT4) and length of the manubrium. Severity of TBL was also subjectively categorized as mild, moderate, or severe.

RESULTS

Tracheobronchial lymphadenopathy was identified in 81% (26/32; 95% CI, 64% to 93%) of dogs. There was no relevant association between TBL presence or severity and antibody serology results. Tracheobronchial lymphadenopathy resolved in 72% (n = 18) of dogs at the 3-month evaluation. The median time to resolution of TBL after initiation of fluconazole was 96 days (range, 72 to 386 days). Univariate analysis identified increasing TBL severity (hazard ratio, 0.40; 95% CI, 0.19 to 0.84; P = .02) and length:LT4 ratio (hazard ratio, 0.41; 95% CI, 0.20 to 0.82; P = .01) as variables associated with reduced probability of resolution of TBL.

CLINICAL RELEVANCE

Antibody serologic test results are not clinically useful to predict TBL presence or severity in dogs with pulmonary coccidioidomycosis, and larger tracheobronchial lymph nodes are more likely to take longer to resolve. Resolution of TBL occurs in most dogs within 3 to 6 months after fluconazole administration.

Supplementary Materials

    • Supplementary Table S1 (PDF 119 KB)

Contributor Notes

Corresponding author: Dr. Jaffey (jjaffe@midwestern.edu)
Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
Publication Date:
01 Nov 2023
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