Feline Aspergillosis
Abstract
Fungal rhinosinusitis (FRS), the most common form of aspergillosis in immunocompetent cats, comprises two anatomic forms: sinonasal aspergillosis (SNA) and sino-orbital aspergillosis (SOA). SNA is confined to the sinonasal cavity, while SOA also involves paranasal structures including the orbit. Although Aspergillus fumigatus sensu stricto is the most common cause of SNA, cryptic species in sections Fumigati and Nigri can also cause disease. SOA is an increasingly recognised invasive mycosis that is most frequently caused by the recently discovered opportunist A. felis and by A. udagawae, two cryptic species in section Fumigati. Serological detection of Aspergillus-specific IgG has high diagnostic utility for feline FRS, but galactomannan assays are only positive in a quarter of cases. Fungal pathogens causing FRS can be cultured from sinonasal fungal plaques or tissue biopsies for identification. Comparative sequence analysis of the rDNA internal transcribed spacer region and partial calmodulin gene enables differentiation of cryptic species from A. fumigatus s. str. Accurate species identification is required to guide therapy since minimum inhibitory concentrations of most antifungal drugs are higher for cryptic species than for A. fumigatus s. str. and azole cross-resistance can occur. Current treatment recommendations for SNA include endosurgical debridement of sinonasal plaques and topical intranasal azole infusion. The prognosis for SOA is poor overall. Individual cases have been successfully treated with itraconazole or posaconazole monotherapy or combined with amphotericin B and/or terbinafine.
Keywords
Aspergillosis Sinonasal aspergillosis Sino-orbital aspergillosis Aspergillus felis Fungal rhinosinusitis FelineReferences
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