Veterinary Medicine - December 2007 - (Page 771)

Clinical Exposures illuminating images from patient files OP E E R - R E V I E W E D Canine dermatophyte infection Maria Vandis, DVM, and Joyce S. Knoll, VMD, PhD, DACVP 1A 1B 1C 1A, 1B, & 1C. Cytologic examination of a fine-needle aspirate from the nodular lesion on the puppy’s thigh revealed hyphae with a nonstaining cell wall. Note the branch of the hyphal element (B) and the variable sizes and shapes of the fungal organisms (C). A few neutrophils are adjacent to these organisms (C) (Wright’s-Giemsa stain; 1,000X; bar = 10 µm). A 3-month-old intact male boxer was presented for a preadoption evaluation at the Foster Hospital for Small Animals at Tufts University after being rescued in North Carolina. The physical examination results were unremarkable except for mild, patchy alopecia on the frontal aspect of the head and a 3-x-2-cm dermal, nodular lesion on the left lateral thigh. These skin lesions were nonpruritic and nonulcerated. CYTOLOGIC EXAMINATION FINDINGS Demodex and Sarcoptes species mites were not found on microscopic examination of samples obtained by deep skin scraping of the alopecic area on the head. Cytologic examination of the skin This case report was provided by Maria Vandis, DVM, and Joyce S. Knoll, VMD, PhD, DACVP, Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536. scraping revealed low numbers of erythrocytes, multiple broken hair shafts and anucleate squamous epithelial cells, and small to moderate amounts of keratin debris. Samples from the thigh lesion were obtained by fine-needle aspiration, and the slides were stained with Wright’s-Giemsa. Cytologic examination revealed moderate numbers of erythrocytes and intact nucleated cells. Moderate numbers of inflammatory cells were found, with a predominance of nondegenerate neutrophils and lesser numbers of activated macrophages. A few small lymphocytes and eosinophils were also noted. Some macrophages contained phagocytosed cellular debris and rare hematoidin crystals. The samples from the thigh lesion also contained a small population of superficial squamous epithelial cells—both individual cells and variably sized aggregates—mixed with varying amounts of keratin debris. A few squamous epithelial cells contained cytoplasmic melanin granules, and others had multiple adherent bacteria. Fragmented fungal hyphae and small, solitary, irregularly shaped structures were also identified in the samples (Figure 1A), all with a basophilic interior and a prominent nonstaining cell wall. The hyphae were septate and exhibited occasional branching (45 to 60 degrees) (Figure 1B). The solitary structures were about 3-µm-x-3-to-5-µm. Most of the structures were round to oval, but some were cuboidal or cigar-shaped or handmirror-shaped with a clubbed end (Figure 1C). These structures appeared to be either detached globoid ends of hyphae or spores. DIFFERENTIAL DIAGNOSES The presumptive diagnosis was mixed inflammation secondary to infection with a nonpigmented fungus. Differential diagnoses for mycotic infections VETERINARY MEDICINE December 2007 771

Table of Contents Feed for the Digital Edition of Veterinary Medicine - December 2007

Veterinary Medicine - December 2007 Contents Letters Editors' Guest Thanking Our Valued Reviewers The Veterinary Medicine Interview: Dr. Joseph Harari Clinical Exposures Idea Exchange Answers to Three Commonly Asked Questions About Lyme Disease Practical Ideas for Managing Common Internal Medicine Problems A Tip for Interpreting Leptospira Species Titers Investigating Proteinuric Kidney Disease Counseling New Puppy Owners: Normal Play vs. Aggressive Tendencies 11 Guidelines for Conservatively Treating Chronic Kidney Disease CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller Merial Insert

Veterinary Medicine - December 2007

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