canine and feline superficial fungal skin infections

3
This article was downloaded by: [California Poly Pomona University] On: 14 November 2014, At: 04:23 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Veterinary Quarterly Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/tveq20 Canine and feline superficial fungal skin infections D. N. Carlotti a a Clinique vétérinaire Alienor d ‘Aquitaine , 100 avenue d ‘Aquitaine, STEEULALIE (BORDEAUX), F 33560, France Published online: 01 Nov 2011. To cite this article: D. N. Carlotti (1997) Canine and feline superficial fungal skin infections, Veterinary Quarterly, 19:sup1, 45-46, DOI: 10.1080/01652176.1997.9694805 To link to this article: http://dx.doi.org/10.1080/01652176.1997.9694805 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

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Page 1: Canine and feline superficial fungal skin infections

This article was downloaded by: [California Poly Pomona University]On: 14 November 2014, At: 04:23Publisher: Taylor & FrancisInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: MortimerHouse, 37-41 Mortimer Street, London W1T 3JH, UK

Veterinary QuarterlyPublication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/tveq20

Canine and feline superficial fungal skin infectionsD. N. Carlotti aa Clinique vétérinaire Alienor d ‘Aquitaine , 100 avenue d ‘Aquitaine, STE‐EULALIE(BORDEAUX), F ‐ 33560, FrancePublished online: 01 Nov 2011.

To cite this article: D. N. Carlotti (1997) Canine and feline superficial fungal skin infections, Veterinary Quarterly,19:sup1, 45-46, DOI: 10.1080/01652176.1997.9694805

To link to this article: http://dx.doi.org/10.1080/01652176.1997.9694805

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”)contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensorsmake no representations or warranties whatsoever as to the accuracy, completeness, or suitabilityfor any purpose of the Content. Any opinions and views expressed in this publication are the opinionsand views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy ofthe Content should not be relied upon and should be independently verified with primary sources ofinformation. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands,costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly orindirectly in connection with, in relation to or arising out of the use of the Content.

This article may be used for research, teaching, and private study purposes. Any substantial orsystematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distributionin any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found athttp://www.tandfonline.com/page/terms-and-conditions

Page 2: Canine and feline superficial fungal skin infections

INFECTIOUS DISEASES

four weeks on agar plates containing fresh sheep or rabbit blood.Molecular techniques such as 16S rRNA gene sequencing, DNAhybridization, and RFLP analysis provide the most accuratemeans of species identification.

ANIMAL RESERVOIRS AND VECTORS OF BARTONELLATraumatic contact with a cat is a risk factor for CSD. As the etiolo-gic agent remained unknown for several decades, no studies wereperformed on the possible presence of bacteria in cats. B. henselaewas first demonstrated in the blood of a healthy cat in 1992. Twoyears later, Koehler established that the domestic cat is a vastreservoir of B. henselae. They isolated B. henselae from 41% ofpet and impounded cats from the Greater San Francisco BayRegion. We also found a high prevalence of B. henselae, and of thenewly identified Bartonella species with spacer RFLP type G(together 22%), in 113 Dutch shelter cats. It was shown that catsmay be infected with several Bartonella species, but not a mixtureofB. henselae of RFLP type A with B. henselae of RFLP type B.In bacteremic Dutch cats, B. henselae of RFLP type B was foundtwice as often as B. henselae of RFLP type A. However, we foundB. henselae of type A three times more often than B. henselae oftype B in Dutch CSD patients. This may imply a higher virulenceor infectivity of B. henselae of type A in humans than of B. hense-lae of type B.We detected DNA from B. henselae, from Bartonella of type G,and possibly from other yet unidentified Bartonella species, infleas from Dutch cats. More than half of the Dutch Ixodes ricinusticks we analyzed by PCR contained DNA from Bartonellaspecies, most probably including B. henselae. Two cases of B.henselae bacteremia following tick bites have been reportedpreviously. Thus, fleas and/or ticks may also play a role in the

transmission of Bartonella species to humans. We described aDutch patient with endocarditis due to B. quintana. The patienthad sustained an insect bite about a year before his illness. Thisinsect may have acted as a vector for B. quintana.

TREATMENT AND ERADICATION OF B. HENSELAE IN-FECTION IN CATSThe course of B. henselae infection in cats was determined byexperimental infection. It was shown that the level of bacteremiafluctuates considerably and that bacteremia may persist for morethan 33 weeks, with the presence of high antibody levels during atleast half a year after infection. Prolonged antibiotic treatmentwith a combination of doxycycline and erythromycin proved to besuccessful in clearing the bacteremia in four cats during the en-suing 10-week period of monitoring. In two other cats, bacteremiarecurred at 10 weeks after completion of the antibiotic therapy. B.henselae may be located intracellularly, out of reach of antibiotics.The results of this study and the recent work of others suggest thatthe extensive feline reservoir of B. henselae may be reduced byseveral measures. Prolonged antibiotic therapy with doxycycline-erythromycin clears bacteremia in cats, but even a 1-2 week courseof doxycycline treatment has a clear effect. Fleas can transmit B.henselae among cats, so control of flea infestation may reduce cat-to-cat transmission of B. henselae, leading to a lower prevalence incats. Development of a vaccine for cats may also contribute to a re-duction of the feline reservoir.

REFERENCEI. Bergmans AMC. Cat scratch disease: studies on diagnosis and identifica-

tion of reservoirs and vectors. Utrecht, The Netherlands: University ofUtrecht, 1996: 152 pp. Dissertation.

CANINE AND FELINE SUPERFICIALFUNGAL SKIN INFECTIONS

D. N. Carlotti1

INTRODUCTIONSuperficial fungal skin infections in dogs and cats include derma-tophytosis, Malassezia dermatitis and candidiasis (5, 11).

Although relatively rare, dermatophytosis is important because ofits zoonotic implication. Malassezia dermatitis seems to be morecommon or more commonly recognized at the present time than inthe past. In contrast, cutaneous candidiasis is an uncommondisease in dogs and cats.

DERMATOPHYTOSISDermatophytes live in epidermal, follicular, hair and nail keratin.Microsporum canis, which is zoophilic, is responsible for the vastmajority of feline dermatophytosis, with a predisposition of long-haired cats. In dogs, Microsporum gypseuni (zoophilic), Micro-sporum persicolor (zoophilic) and Trichophyton mentagrophytes(zoophilic and telluric) are also frequently isolated (2).Clinical signs of dermatophytosis are highly variable and not

Clinique vetérinaire Alienor d 'Aquitaine, 100 avenue d 'Aquitaine, F - 33560STE-EULAL1E (BORDEAUX), France.

restricted to the classical numular lesion which extends slowlywith erythema, scaling, and alopecia. There are also less typicalforms such as localized or extensive keratoseborrhoeic alopecia,kerion, onyxis and perionyxis, cellulitis (dog) and miliary dermati-tis (cat). Pruritus is usually not very prominent, except in case offeline miliary dermatitis.Diagnosis of dermatophytosis is based upon the history, thoroughclinical examination and demonstration of the fungal infectionwith four main complementary aids: Wood's light examination,direct examination of hair and scales, fungal cultures and histo-pathology.Samples are collected by use of forceps, a sterile carpet square ortoothbrush, or by skin scrapings. About 50% of Microsporumcanis strains produce pteridin (in hyphae only) and thus_a specificfluorescence under Wood's light. Direct examination of hair istypical (except for Microsporum persicolor which does not invadehair). Appropriate media (Sabouraud's dextrose agar with anantibiotic and actidione, or Dermatophyte Test Medium) areinoculated and kept at room temperature. Macroscopic and aboveall microscopic examination of the colonies (by the tape-strip

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INFECTIOUS DISEASES

technique = Roth's flag technique) will lead to identification of theoffending species. Table 1 shows the pattern of spores on hair shaftand the cultural characteristics of the four main dermatophytesisolated from dogs and cats. Staining of skin biopsies with HES orPAS (better) may show the arthroconidia and hyphae in hairand/or keratin.Therapy of dermatophytosis is not always easy, particularly for agroup of animals. Microsporum canis is not part of normal flora ofcats (7) and cats without lesions should be screened. Separationand cautious handling of animals is important. Therapy must con-tinue at least one month after obtaining a sample for culture whichremains negative. Clipping worsens clinical signs but removesinnumerable infected hairs and thus is beneficial. Shampooing,even with anti fungal products, may enhance the dispersal ofspores (8) but is beneficial to remove infected scales and crusts.Lime sulfur and enilconazole are the most effective topicalproducts (14) but efficacy of topical therapy is controversial (1, 4).It can be used alone in in-contact healthy animals but should beused in conjunction with systemic antifungal therapy in affectedanimals. Griseofulvin (microsize) is effective at the dose of 50mg/kg/day (9),with possible side effects linked to an individualidiosyncrasy (6) or FIV infection (12). Ketoconazole is licensedfor dogs in several European countries and has been used in cats aswell. Itraconazole (5 to 10 mg/kg once daily) seems to be moreeffective and better tolerated (9). Terbinafine could also beeffective at a dose of 20 mg/kg every 48 hours. In chronic derma-tophytosis, immunodeficiency must be suspected.Spores can persist a long time in the environment which is animportant source of exposure and recontamination, probablythan asymptomatic carriers. Therefore it is important to clean it,the best product being undiluted sodium hypochlorite (bleach),1% formalin (10) and a special formulation of enilconazole devel-oped for this purpose (ClinafarmR), which is also effective in thevapor phase (foggers)(13).Prophylaxis of dermatophytosis is based on sampling and quaran-tine. Recently, killed Microsporum canis vaccines have appearedbut true prophylactic activity is unknown and ''$ige'stionable.However, it could be a helpful treatment.

Dermatophyte Pattern of spores

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MALASSEZIA DERMATITISMalassezia pachydermatis is a lipophilic yeast whichcan multiplyon the skin and become pathogenic as suggested by good clinicalresponse to a sole antifungal therapy. Glucocorticoid and antibiotictherapy enhances the multiplication of the yeast althoughStaphylococcus intermedius and Malassezia pachydermatis coulddevelop in synergy. Basset Hounds and West Highland WhiteTerriers are predisposed and the disease also occurs in cats.Erythema, scaling, hyperpigmentation and lichenification are seenin conjunction with pruritus and greasy seborrhoea. Lesions areeither localized or generalized. Otitis externa is common (5).Diagnosis is based upon history, physical examination, cytology,histopathology and response to therapy. Cytology seems to be themost reliable technique to confirm the infection. An underlyingdisease should be looked for in all cases (allergic skin disease,endocrine disorders and/or keratinization disorders) althoughprimary Malassezia dermatitis does exist. Therapy is based onsystemic ketoconazole, at least when the disease is extensive, andtopical agents (e.g. enilconazole in lotion and chlorhexidineshampoos) (3).

CANDIDIASISCandida albicans is always a pathogen on the skin of dogs and catsand colonizes the skin folds, the mucocutaneous junctions, externalear canal and oral cavity (11). Lesions are erythema, ulcers andsometimes, on the skin, pustules and crusts. A whitish coating mayalso be seen. Diagnosis is based upon history, physical examination

- and complementary aids: cytology, fungal culture (which is essen-° tial to identify the species Candida albicans), and histopathology.

Therapy should begin with clipping, cleansing and drying of theaffected area. Sensitivity testing is recommended for both topicaland systemic therapy, which should be used in conjunction in mostof the cases. Underlying causes should be treated appropriately.

REFERENCES1. Borgers M, Xhonneux B, and Cutscm J van. Oral itraconazole versus to-

pical bifonazole treatment in experimental dermatophytosis. Mycoses1993; 36: 105-15.

2. Carlotti DN, and Couprie B. Dermatophyties du chien et du chat: actu-al i tes. Prat Med Chir Anim Comp 1988; 23: 450-7.

3. Carlotti DN, Laffort-Dassot C. Dermatite a Malassezia chez le chien:etude bibliographique et retrospective de 12 cas generalises traités par desderives azolés. Prat Med Chir Anim Comp 1996; 31: 297-307.

4. DeBoer DJ, and Moriello KA. Inability of two topical treatments to influ-ence the course of experimentally induced dennatophytosis in cats. J AmVet Med Assoc 1995; 207: 52-7.

5. Griffin CE, Kwochka KW, and MacDonald JM. Infectious Diseases. In:Current Veterinary Dermatology; The Science and Art of Therapy. St.Louis: Mosby Year Book, 1993; 3-49.

6. Kunkle GA, and Meyer DJ. Toxicity of high doses of griseofulvin in cats.J Am Vet Med Assoc 1987; 191; 322-32.

7. Moriello KA, and DeBoer DJ. Fungal flora of pet cats. Am J Vet Res1991; 52: 602.

8. Moriello KA, and DeBoer DJ. Feline dermatophytosis. Recent advancesand recommendations for therapy. Vet Clin North Am: Small Anim Pract1995; 25: 901-21.

9. Moriello KA, and DeBoer DJ. Efficacy of griseofulvin and itraconazolein the treatment of experimentally induced dermatophytosis in cats. J AmVet Med Assoc 19957207: 439-44.

10. Moriello KA, and DeBoer DJ. Environmental decontamination ofMicrosporum canis: in vitro studies on the efficacy of disinfectants. Proc3rd World Congress of Veterinary Dermatology, Edinburgh, 1996: p39.

11. Scott DW, Miller WH, and Griffin CE. Muller and Kirk's Small AnimalDermatology, 5th ed . Philadelphia: WB Saunders, 1995.

12. Shelton GH, Grant CK, Linenberger ML et al. Severe neutropenia asso-ciated with griseofulvin therapy in cats with feline immunodeficiencyvirus. J Vet Int Med 1990; 4: 317.

13. Gestel J van, Cutsem J van, and Thienpont D. Vapour phase activity ofImazalil. Chemotherapy 1981; 27: 270-6.

14. White-Weithers N, and Medleau L. Evaluation of topical therapies for thetreatment of dermatophytosis in dogs and cats. J Am Anim Hosp Assoc1995; 31: 250.

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