Gender: FEMALE, SPAYED
Patient is a 9- year- old female spayed Poodle that presented to her veterinarian in Ohio for fever, multiple skin lesions (most ulcerated), mild generalized lymphadenopathy and lameness (swollen right carpus). On CBC she had an inflammatory leukogram. On urinalysis she has 1.012 specific gravity with trace proteins. Her total protein and globulins were elevated at 8.3g/dl and 5.6g/dl respectively. Her remaining blood work was normal.
The submitted slides are a combination of impression smears from the skin ulcerations and FNAs of a SQ swelling on her thorax.
Click here for the IDEXX Pathology Report on this case.
The slides are abundantly cellular consisting of a heterogenious population of inflammatory cells. The cells are comprised primarily of mildly degenerate neutrophils with lesser numbers of macrophages and lymphocytes. Occasional plasma cells are seen.
Rare turquoise to green staining oval shaped structures (on image 2) that are approximately the size of a neutrophil or slightly larger, (15-30 microns in size) are noted. These structures reveal a thin visible double walled capsule around the circumference of the structure and exhibit broad-based budding (often described as resembling a snowman).
Blastomycoses dermatitidis is usually acquired via inhalation, or less often, traumatic inoculation of microconidia from the mold/hyphal form of the organism. (Not the yeast form as depicted above.) Blastomycoses is a dimorphic fungus, therefore it exists as a yeast form in the patient (due to the high body temperature), but in a mold/hyphal form in the environment. This fungus is endemic in certain geographic areas of North America with large river beds such as the Ohio and Mississippi rivers. There are generally considered three manifestations of disease including respiratory, cutaneous or disseminated but most dogs have pulmonary involvement. Dogs are more prone to infection then cats, in which infection is rare. Dogs will often be febrile, lethargic, have weight loss, skin sores and frequently have lymphadenopathy.