Atypical cutaneous cryptococcosis in four cats in the USA.

Authors:
Alexandra Myers
Alexandra Myers
College of Veterinary Medicine & Biomedical Science
Fort Collins | United States
Joanne Mansell
Joanne Mansell
College Station
United States
Mark Krockenberger
Mark Krockenberger
University of Sydney
Australia
Harold Ross Payne
Harold Ross Payne
College of Veterinary Medicine & Biomedical Sciences
Aline Rodrigues Hoffmann
Aline Rodrigues Hoffmann
College Station
United States

Vet Dermatol 2017 Aug 29;28(4):405-e97. Epub 2017 Jan 29.

Dermatopathology Specialty Service, College of Veterinary Medicine & Biomedical Science, Texas A&M University, College Station, TX, 77843, USA.

Background: Cryptococcosis is an uncommon fungal infection in humans and mammals. Occasionally, cryptococcosis manifests as cutaneous lesions, either as an extension of nasal disease or as stand alone lesions unassociated with the nose. Histologically, these lesions are typically characterized by abundant organisms with mild granulomatous dermatitis. Herein, four feline cases of atypical cutaneous cryptococcal infections are described.

Methods: Skin punch biopsies from four client owned cats were submitted for histological evaluation between 2006 and 2015. Histological examination, including histochemical stains, was performed in all cases. Immunohistochemical stains and PCR were performed in three of four cases. Fungal culture was performed in two cases and transmission electron microscopy was performed in one case.

Results: Grossly, the cutaneous lesions were papular to nodular with occasional ulceration and were located predominantly on the trunk. Histological examination revealed severe granulomatous to pyogranulomatous and eosinophilic dermatitis with rare, capsule-deficient yeasts. Immunohistochemistry, PCR and fungal culture confirmed Cryptococcus spp. to be the aetiological agent in these cases.

Conclusions And Clinical Importance: In cutaneous lesions, capsule-deficient strains of Cryptococcus spp. may induce a severe inflammatory response with rare intralesional organisms that may not be readily identified on routine haematoxylin and eosin stained slides. Special stains with careful examination and ancillary tests (PCR, immunohistochemistry, fungal culture or antigen testing) should be performed when pyogranulomatous and eosinophilic dermatitis is encountered without an identifiable cause.

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August 2017
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Virulence in Cryptococcus species
Ma et al.
Adv Appl Microbiol 2009

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2005
Panfungal PCR for identification of fungal pathogens in formalin-fixed animal tissues
Smith et al.
Vet Pathol
Capsule size of Cryptococcus neoformans: control and relationship to virulence
Dykstra et al.
Infect Immun 1977

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