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Fungal infection in dogs

Fungal infection in dogs


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Fungal infection in dogs is common and is most commonly associated with a variety of dermatological conditions, such as demodectic mange and pyoderma. Less common but important, however, are the opportunistic systemic fungal infections that are associated with neutrophilia and/or eosinophilia in the peripheral circulation. In humans, the most common of these is invasive aspergillosis, and more than one-third of immunosuppressed patients develop this opportunistic infection. Systemic fungal infection is a potentially fatal disease, especially in humans and dogs, although the majority of cases can be successfully treated with antifungal therapy.

The aim of this article is to review the diagnosis, epidemiology, and treatment of systemic fungal infections of dogs and to discuss the prognosis in individual cases.

Epidemiology {#s0002}

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Invasive systemic fungal infections in dogs can occur in any patient at any age but are most common in those older than 6 months.

A variety of species are responsible for causing systemic fungal infections in dogs. Most infections result from fungi that are capable of colonizing the skin and mucous membranes of healthy dogs. These opportunistic pathogens include *Trichophyton, Microsporum*, and *Candida.*

Other fungi, however, are pathogenic in dogs and cause serious disease. Among these are the ubiquitous *Cryptococcus, Blastomyces,* and *Histoplasma* species. Invasive disease is more common in animals with suppressed immune function.

*Candida* species are opportunistic fungal pathogens of dogs and humans. Fungal pneumonia is the most common cause of fungal pneumonia in dogs (O'Brien et al. [@CIT0048]). In one study, *Candida* spp. was cultured from 24% of cases and was the most frequently cultured organism in cases of fungal pneumonia (Kilpatrick et al. [@CIT0031]). *Candida albicans* was the most common isolate (65.6%), followed by *C. parapsilosis* (17.5%) and *C. glabrata* (12.3%). In addition, a study investigating *C. albicans* in dogs with ocular keratitis found that 40% of infected dogs were also infected with *C. parapsilosis* (Alvarez-Tobar et al. [@CIT0002]).

Systemic candidiasis is common in humans, especially those with hematologic malignancy and patients with advanced human immunodeficiency virus. Systemic fungal infections are not as common in humans, but recent changes in management and prevention of *Candida* spp. infection in humans have resulted in an increase in the incidence of candidiasis. In one study, fungal infections were the second most common infection type in immunosuppressed patients (20.2%), following respiratory tract infections (19.1%, Rehm et al. [@CIT0052]).

In dogs, systemic *Candida* infection occurs in dogs with primary immunodeficiency and those receiving corticosteroids (Mendelson et al. [@CIT0041]). In addition, systemic *Candida* infection may develop in dogs with secondary immunodeficiency, particularly those with systemic lupus erythematosus (SLE) or with concurrent thrombocytopenia (Petersen et al. [@CIT0051]).

Many cases of systemic fungal infections in dogs are diagnosed clinically as dermatitis or pyoderma. One study found that nearly two-thirds of dogs with systemic fungal infection were also diagnosed with dermatological disease (Bak and Tarr [@CIT0004]). However, a more recent study found that *Cryptococcus* spp. and *Histoplasma* spp. were most commonly isolated in cases of histiocytic meningoencephalitis (Johannesen et al. [@CIT0030]).

Clinical Presentation {#s0003}

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Systemic fungal infections may present as a localized skin condition (dermatitis) or an invasive, hematogenous infection of the respiratory, gastrointestinal, or urinary tract. The clinical presentation of systemic fungal infections may be similar to that of systemic bacterial infections, with fever, anorexia, and lethargy. In addition, vomiting and diarrhea are common, particularly in animals with primary immunodeficiency. The severity of clinical signs can vary depending on the affected organs, and therefore, clinical diagnosis can be challenging. The more serious clinical signs can include severe, life-threatening hemorrhage and acute kidney injury, and death may be a result of disseminated intravascular coagulation.

Dermatological disease is more common than systemic fungal infection in dogs. Infections are most often seen in dogs with concurrent dermatological disease, with dermatitis being the most common type of dermatological disease. Dermatological disease is also a common complication of corticosteroid administration (Petersen et al. [@CIT0051]).

Primary immunodeficiency disorders, such as severe combined immunodeficiency, immune dysregulation polyendocrinopathy syndrome, and agammaglobulinemia, are more common in the dog and may predispose the animal to both local and systemic fungal infections. In addition, some of the most common systemic fungal infections in dogs have been associated with primary immunodeficiency disorders. These disorders include *Cryptococcus* spp. infection (Wright et al. [@CIT0067]), histoplasmosis (Bak et al. [@CIT0005]), and systemic *Candida* infection (Mendelson et al. [@CIT0041]).

Pyoderma is common in many breeds of dog, especially breeds with a short muzzle, such as the Pekingese and Pug (Petersen et al. [@CIT0051]).

The most common sites of fungal infections in dogs are



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