Veterinary Medicine - May 2008 - (Page 252) Histoplasmosis PEER-REVIEWED seminated histoplasmosis.8,15 The hypoalbuminemia may result from intestinal blood loss, decreased synthesis associated with in ammation, liver dysfunction, or proteinlosing enteropathy.8-11,15 Hyperglobulinemia secondary to in ammation is reported in dogs and cats.8,10,15,33,38 Hepatic involvement can result in increased serum alanine aminotransferase (ALT) activity, alkaline phosphatase activity, and total bilirubin concentration.8,9,11,38 Hypercalcemia has been reported in cats with histoplasmosis.38 Urinalysis While proteinuria has been reported,8,38 urinalysis results in dogs and cats with histoplasmosis are usually within reference ranges.10,50 Thoracic radiography Dogs. Common thoracic radiographic abnormalities in canine pulmonary histoplasmosis include hilar lymphadenopathy and a bronchial-interstitial or interstitial pattern (Figures 1A & 1B).10,51 Mineralization of lymph nodes and pulmonary in ltrates is occasionally observed and may indicate inactive disease.7,10,11,17,20 Pleural effusion and sternal lymph node enlargement are infrequently observed.17,23,35 Additional unusual ndings include a focal alveolar opacity affecting one lung lobe and a fungal granuloma in the thoracic cavity cranial to the heart.35,52 1A Cats. Unspeci ed thoracic radiographic abnormalities were present in 27 of 31 (87.1%) cats with disseminated histoplasmosis.1 An interstitial miliary pattern was the most common radiographic abnormality in a study of 12 cats.15 Radiographic patterns in cats with pulmonary histoplasmosis include a ne, diffuse or linear interstitial in ltrate; nodular interstitial in ltrate; or, rarely, alveolar pattern.16,53,54 Enlarged or mineralized tracheobronchial lymph nodes were not a feature of feline pulmonary histoplasmosis.16 Areas of pulmonary consolidation were reported in one cat.54 Abdominal radiography and ultrasonography Abdominal radiographs in dogs and cats may show hepatomegaly or splenomegaly; ascites was reported in one dog.9,10,15,35,55 On abdominal ultrasonographic examination, the affected liver may have a hyperechoic appearance, as well as nodular lesions.10,36,55 Lymphadenomegaly may also be observed.9 1B 1A & 1B. Lateral and ventrodorsal thoracic radiographs of a 7-year-old American cocker spaniel with pulmonary histoplasmosis. A heavy unstructured interstitial-to-coalescing nodular interstitial pattern is seen throughout all lung fields in both views, partially obscuring the pulmonary vessels. Skeletal radiography Dogs. Bony lesions of histoplasmosis are rarely reported in dogs; affected sites 252 May 2008 VETERINARY MEDICINE
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