Veterinary Medicine - May 2008 - (Page 257) people, uconazole is considered a second-line treatment for histoplasmosis,67 and in mice with experimentally induced Histoplasma species meningitis, uconazole monotherapy was less ef cacious than itraconazole or amphotericin B monotherapy.71 Ketoconazole Successful treatment of feline histoplasmosis with varying dosages of ketoconazole has been reported.18,44,50 However, because of its reduced spectrum of activity against Histoplasma species and increased relative toxicity, ketoconazole TABLE 1 Summary of Samples Yielding a Definitive Diagnosis in Dogs and Cats with Disseminated Histoplasmosis* Dogs Total cases** Rectal scraping Blood smear/buffy coat Bone marrow Miscellaneous cytology Surgical biopsy Necropsy 43 7 12 4 1 19 †† Cats 23 — 3 13 4† 8††† — 5 * Source: References 8, 9, 15, 21, 24-26, 31, 38, 39, 45, 60, 65, and 83. ** Five dogs and five cats had Histoplasma species organisms in more than one site. Fine needle aspirate of lymph node † Fine-needle aspirates of lung (1), liver (1), and lymph node (2). †† Biopsy of intestine (2), mesenteric lymph node (2), popliteal lymph node (1), liver (1), tongue (1), bone (1), skin (2), gingiva (1), and unspecified (1), and cytologic or histologic samples (7). ††† Biopsy of bone (1), skin (2), spleen (1), conjunctiva (1), spinal mass (1), and eye (2). 15 µm 6. A rectal scraping from a dog. A mixture of individualized epithelial cells and macrophages are seen in a moderately heavy background of mixed bacteria. Yeast are seen within macrophages (arrow) and are free in the background (arrowhead) (Diff-Quik, 100X). VETERINARY MEDICINE May 2008 257
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