Aspergillosis

Aspergillosis is caused by several Aspergillus spp, especially A fumigatus and A terreus. A niger,
A nidulans, A viridinutans, A flavus, and A felis are being recognized more commonly with
increasing use of molecular techniques for identification. Aspergillus infection is found
worldwide and in almost all domestic animals and birds as well as in many wild species. It is
primarily a respiratory infection that may become generalized; however, tissue predilection
varies among species. The most common forms are pulmonary infections in poultry and other
birds; mycotic abortion in cattle; guttural pouch mycosis in horses; infections of the nasal and
paranasal tissues, intervertebral sites, and kidneys of dogs; and sinonasal, sino-orbital, and
pulmonary infection in domestic cats.

Clinical Findings and Lesions:

In birds, aspergillosis (brooder pneumonia) is primarily bronchopulmonary, with dyspnea,

gasping, anorexia, and emaciation. Torticollis and disturbances of equilibrium are seen when
infection disseminates to the brain. Yellow nodules of varying size and consistency or plaque
lesions are found in the respiratory passages, lungs, air sacs, or membranes of body cavities. Fur-
like growth of fungus may be found on the thickened walls of air sacs.

A: Bird showing signs of Brooder pneumonia. B: Necropsy photo of aspergillosis lesions in the
coelomic cavity (liver, air sacs, heart lesions).
In ruminants, aspergillosis may be asymptomatic, appear in a bronchopulmonary form, cause
mastitis, or cause placentitis and abortion (mycotic abortion). Mycotic pneumonia may be
rapidly fatal. Signs include pyrexia; rapid, shallow, stertorous respiration; nasal discharge; and a
moist cough. The lungs are firm, heavy, and mottled and do not collapse. In subacute to chronic
mycotic pneumonia, the lungs contain multiple discrete granulomas, and the disease grossly
resembles tuberculosis.

In horses, aspergillus cause (Guttural Pouch Mycosis) epistaxis and dysphagia are common
complications of gutturomycosis. Guttural pouch is characterized by a necrotizing inflammation
and is thickened, hemorrhagic, and covered by a friable pseudomembrane. Mycotic rhinitis
characterized by dyspnea and nasal discharge has also been described. Aspergillosis can be a
rapidly fatal disease associated with diffuse pulmonary invasion. Locomotor and visual
disturbances, including blindness, may occur when the infection spreads to the brain and optic
nerve.
Aspergillosis in horses (Gutteral poucj Mycosis)

In dogs, aspergillosis is typically localized to the nasal cavity or paranasal sinuses and is usually
caused by infection with A fumigatus. The clinical signs of aspergillosis may include lethargy,
lameness, anorexia, weight loss, muscle wasting, pyrexia, hematuria, urinary incontinence,
generalized lymphadenopathy, and neurologic deficits. Lesions are frequently found in the
abdominal and thoracic lymph nodes, kidneys, spleen, and vertebrae. Discospondylitis is
common.
Diagnosis:

Radiographs in dogs with nasal aspergillosis may show generalized radiolucence of the nasal
cavity secondary to turbinate tissue destruction. A diagnosis based on culture results alone is not
appropriate, because aspergilli are ubiquitous and can be isolated from the nasal cavities of
healthy dogs. Positive culture results should be supported by demonstration of narrow, hyaline,
septate, branching hyphae within lesions or by serological tests

Treatment:

In dogs, topical treatment is considered the treatment of choice for nasal and paranasal
aspergillosis. Several surgical techniques and drug regimens have been used with varying
success. Clotrimazole formulated in a polyethylene glycol base is generally considered the first-
line treatment. Enilconazole, ketoconazole, itraconazole, fluconazole, voriconazole, and
posaconazole are effective.

In horses, surgical exposure and curettage have been used to treat gutturomycosis. Topical
natamycin and oral potassium iodide have been reported effective in cases of Aspergillus
infection. Itraconazole (3 mg/kg, bid for 84–120 days) has been reported effective in Aspergillus
rhinitis in horses.

Bovine mastitis has been treated successfully with combined intra-arterial and intramammary
injection with miconazole.