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Cryptococcus neoformans var. grubii-Induced Arthritis with Encephalitic Dissemination in a Dog and Review of Published Literature

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Abstract

This article describes the clinical, pathological, and immunohistochemical findings associated with Cryptococcus neoformans var. grubii in a 4-year-old female Boxer dog from Uberlândia, Minas Gerais, Southeastern Brazil. Clinically, there was a swelling at the right metatarsal region and the hock joint with enlargement of regional lymph nodes. Radiographical evaluation revealed lysis of the tarsal bone; cytology demonstrated cryptococcal intralesional organisms at the swollen joint. Despite empirical antifungals therapeutic, the animal developed neurological cryptococcosis and died spontaneously. Significant pathological alterations included arthritis, lymphadenitis, and encephalitic cryptococcomas associated with numerous intralesional narrow-necked budding encapsulated yeasts. Immunohistochemistry utilising monoclonal antibodies that label C. neoformans sp. complex capsule, characterised the yeasts as C. neoformans var. grubii. Collectively, the pathological and immunohistochemical findings of this dog indicate that the intralesional organisms observed within the articular surface of the hock joint, lymph nodes, and the brain were C. neoformans var. grubii, confirming the participation of this fungal pathogen in the development of cryptococcal arthritis. In this case, the most likely pathogenesis was percutaneous inoculation with resultant abscess-like lesion, which resulted in the draining sinus, swelling of the right hind limb with progression to the articular disease. Thereafter, the fungal pathogen probably compromised the adjacent lymph nodes with subsequent haematogenous distribution to the brain, terminating with cryptococcal arthritis, lymphadenitis, and encephalitis.

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Acknowledgments

Selwyn A. Headley and João Paulo Elsen Saut are recipients of the National Council for Scientific and Technological Development (CNPq; Brazil) fellowships and grants. The authors thank the owner of this dog for the usage of this animal during this investigation, and sincere appreciation is extended to Dr. Rogério A. Marcasso for the preparation of the histochemical stains. The antibodies utilised for immunohistochemical characterisation of the fungi were kindly provided by Professor Tom Kozel, University of Nevada, Reno. The technical assistance of Ms. Elaine Chew, Mrs. Karen Barnes, and Mr. Huy Tan in the Veterinary Pathology Diagnostic Services, the University of Sydney is gratefully acknowledged.

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Authors and Affiliations

  1. Laboratory of Animal Pathology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, PR 445 Km 380, Campus Universitário, PO Box 10.011, Londrina, Paraná, 86057-970, Brazil

    Selwyn Arlington Headley

  2. Faculty of Veterinary Medicine, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil

    Francisco Claudio D. Mota, Alessandra Aparecida Medeiros & João Paulo Elsen Saut

  3. Department of Veterinary Pathology, Faculty of Veterinary Science, University of Sydney, Sydney, Australia

    Scott Lindsay & Mark Krockenberger

  4. Laboratory of Mycology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Londrina, Paraná, Brazil

    Luiza M. de Oliveira & Lucienne Garcia Pretto-Giordano

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  1. Selwyn Arlington Headley
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  2. Francisco Claudio D. Mota
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  3. Scott Lindsay
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  4. Luiza M. de Oliveira
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Correspondence to Selwyn Arlington Headley.

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Headley, S.A., Mota, F.C.D., Lindsay, S. et al. Cryptococcus neoformans var. grubii-Induced Arthritis with Encephalitic Dissemination in a Dog and Review of Published Literature. Mycopathologia 181, 595–601 (2016). https://doi.org/10.1007/s11046-016-0009-4

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