Adiaspiromycosis
Adiaspiromycosis is a pulmonary disease of small mammals and occasionally humans, and is caused by dimorphic fungi belonging to the genus Emmonsia. E. crescens (renamed Chrysosporium parvum var.
crescens) is widespread in Europe, and Emmonsia parva (renamed Chrys- osporium parvum var. p arva) is found in the Americas, Central Asia and Africa. These fungi are ubiquitous in the environment, grow on soil and produce 2 to 4 μm conidia in the saprophytic form and thick-walled spherules, designated as adiaconidia, in the infective form. Emmonsia crescens produces multinucleate adiaconidia that reach diameters in excess of 500 μm, whereas E. parva produces mononucleate adiaconidia of 20—40 μm in diameter.I nfection is widespread, especially among the families Cricetidae, Muridae and Mustelidae(2). The infection occurs when dust- borne adiaconidia are inhaled by the host and reach the alveoli. Adiaconidia thereafter increase their size and form thick-walled, non-replicating adiaco- nidia that elicit extensive granulomatous reactions, which may bear a resemblance to those of mycobacterial granulomas. Clinical signs of adiaspiromycosis include coughing, progressive dyspnoea and lung failure.
The diagnosis of adiaspiromycosis is based on the observation of adiaconidia on histopathological examination using periodic acid-Schiff (PAS), Gomori’s methenamine silver (GMS), and mucicarmine stains. The large (up to 300 μm) fungal spherules are composed of fine granular eosinophilic material and are surrounded by a thick trilamellar wall capsule, PAS- and GMS-positive but mucicarmine-negative.
Infectious Diseases of Wild Mammals and Birds in Europe, First Edition. Edited by Dolores Gavier-Widen, J. Paul Duff, and Anna Meredith. © 2012 Blackwell Publishing Ltd. Published 2012 by Blackwell Publishing Ltd.
TABLE 40.1 Antifungal agents of use in animal health.
| Chemical class | Drugsa | Target | Indication | Dosageb and note |
| Polyenes | GrisefUlvin (o) | Inhibits microtubule | Microsporum, Trichophyton | 50mg∕kg once daily or 25 mg/kg twice daily; |
| sliding | should be administered with a fatty meal | |||
| Amphotericin | Membrane barrier | Aspergillus, Candida, | Sometimes amphotericin B is used in conjunction | |
| B (iv, t, o) | function | Histoplasma, | with an azole antifungal. The drug requires | |
| Coccidioides, Sporothrix, | intensive patient monitoring because of the risk | |||
| Mucorales, E. crescens, | for adverse effects (nephrotoxicity). | |||
| Blastomyces, Coccidioides | ||||
| Natamycin (t) | Trichophyton, Microsporum | Topical 100ppm suspension; two times, with | ||
| interval of pimaricin 4 days or spray suspension on the horse; repeat after 4—5 days, and 14 days later | ||||
| Nystatin (t, o) | Candida, Microsporum, | 100,000-300,000IU∕kg, every 12 hours, 7-10 | ||
| Trichophyton | days with antibiotic therapy in Candida infections in birds | |||
| Azole | Clotrimazole | Ergosterol | Microsporum, Trichophyton, | Intranasal infusion of clotrimazole is an effective |
| Imidazoles | (t) | biosynthesis | Pneumocystis | treatment for canine nasal aspergillosis; |
| Aspergillus | association of trimethoprim and sulfamethoxazole in P neumocystis pneumonia | |||
| Econazole (t) | Microsporum, Trichophyton | |||
| Enilconazole | Microsporum, Trichophyton, | 2% solution, whole-body applications with 3- to | ||
| (t) | Malassezia, Aspergillus | 4-day intervals; intranasal infusion of enilconazole is an effective treatment for canine nasal aspergillosis | ||
| Ketoconazole | Microsporum, Trichophyton, | 10 mg/kg per day for 3-4 weeks; tablets should be | ||
| (t, o) | Malassezia, Coccidioides | given with a meal | ||
| Miconazole (t) | Microsporum Trichophyton | Shampoo containing 2% miconazole + 2% | ||
| Malassezia | chlorhexidine or other topical human formulations | |||
| Triazoles | Fluconazole | Aspergillus, | 2.5-5 mg/kg daily | |
| (o, iv) | Cryptococcus Blastomyces | |||
| Itraconazole | Microsporum, Trichophyton, | 5-20 mg/kg daily or with 48-hour intervals | ||
| (o, iv) | Malassezia, Sporothrix, | |||
| E. crescens, | ||||
| Blastomyces, Coccidioides, Histoplasma capsulatum, Mucorales | ||||
| Allylamines | Terbinafine (t, | Squalene epoxidase | Microsporum, Trichophyton, | 8M0 mg/kg once daily |
| o) | Mucorales | |||
| Benzimidazoles | Thiabendazole | Microtubule | Trichophyton, Microsporum | 4% solution |
| (o, t) | assembly | |||
| Pyrimidine | Flucytosine | DNA and RNA | Aspergillus, | Oral 75-120mg/kg, every 6 hours; 50mg/kg, |
| (o, iv) | synthesis | Candida | every 12 hours for 2-4 weeks (mainly in birds) | |
| Iodine | Saturated | Enhances the | Sporothrix, | 20-40 mg/kg once daily intravenously or |
| compounds | solution of | halide-perioxidase | Entomophtorales | parenterally |
| potassium | killing system of | |||
| iodide (SSKI) | phagocytic cells |
ao — oral; t — topical; iv — intravenous bDosage varies, depending on the animal species