Comparison of histologic lesions of endophthalmitis induced by Blastomyces dermatitidis in untreated and treated dogs: 36 cases (1986–2001)

Diane V. H. Hendrix Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996-4544.

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 DVM, DACVO
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Barton W. Rohrbach Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996-4544.

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 VMD, MPH, DACVPM
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Philip N. Bochsler Department of Pathology, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996-4544.
Present address is Wisconsin Veterinary Diagnostic Laboratory, 6101 Mineral Point Rd, Madison, WI 53705-4494.

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Robert V. English Animal Eye Care Associates, 220 High House Rd, Cary, NC 27513.
Immunology Program, North Carolina State University, 4700 Hillsborough St, Raleigh, NC 27609.

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 DVM, PhD, DACVO

Abstract

Objective—To compare prevalence of organisms and histologic changes in eyes from dogs with blastomycosis that were either untreated or undergoing treatment with itraconazole.

Design—Retrospective study.

Animals—36 dogs with endophthalmitis associated with blastomycosis.

Procedure—Signalment, results of ophthalmic examination, and duration of treatment with itraconazole were extracted from medical records. Histologic sections from eyes were examined for prevalence and viability (ie, budding) of fungal organisms. A scoring system was devised to assess the degree of inflammation.

Results—Clinically, all eyes were blind and had signs of severe endophthalmitis. Histologically, the type and degree of inflammation and prevalence of Blastomyces dermatitidis were not significantly different between dogs treated with itraconazole and untreated dogs or among groups of dogs treated for different time periods (4 to 14, 15 to 28, or 29 to 72 days). Replication of the organisms in vascular tissues as well as avascular spaces in the eyes was similar in treated and untreated dogs. Lens rupture was seen in 12 of 29 (41%) eyes.

Conclusions and Clinical Relevance—Persistence of inflammation in eyes of dogs with naturally occurring blastomycosis is likely attributable to the continued presence of B dermatitidis, regardless of the duration of treatment with itraconazole. Lens capsule rupture, a common and previously unreported histologic finding, may contribute to cataract formation and continued inflammation. (J Am Vet Med Assoc 2004; 224:1317–1322)

Abstract

Objective—To compare prevalence of organisms and histologic changes in eyes from dogs with blastomycosis that were either untreated or undergoing treatment with itraconazole.

Design—Retrospective study.

Animals—36 dogs with endophthalmitis associated with blastomycosis.

Procedure—Signalment, results of ophthalmic examination, and duration of treatment with itraconazole were extracted from medical records. Histologic sections from eyes were examined for prevalence and viability (ie, budding) of fungal organisms. A scoring system was devised to assess the degree of inflammation.

Results—Clinically, all eyes were blind and had signs of severe endophthalmitis. Histologically, the type and degree of inflammation and prevalence of Blastomyces dermatitidis were not significantly different between dogs treated with itraconazole and untreated dogs or among groups of dogs treated for different time periods (4 to 14, 15 to 28, or 29 to 72 days). Replication of the organisms in vascular tissues as well as avascular spaces in the eyes was similar in treated and untreated dogs. Lens rupture was seen in 12 of 29 (41%) eyes.

Conclusions and Clinical Relevance—Persistence of inflammation in eyes of dogs with naturally occurring blastomycosis is likely attributable to the continued presence of B dermatitidis, regardless of the duration of treatment with itraconazole. Lens capsule rupture, a common and previously unreported histologic finding, may contribute to cataract formation and continued inflammation. (J Am Vet Med Assoc 2004; 224:1317–1322)

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