Abstract：
OBJECTIVE: To determine associations between antibody serologic tests and tracheobronchial lymphadenopathy (TBL) in dogs with pulmonary coccidioidomycosis and identify variables associated with time to resolution of TBL.
METHODS: 32 client owned dogs with newly diagnosed pulmonary coccidioidomycosis from October 2020 to February 2021.
METHODS: Prospective cohort study. Thoracic radiographs and anti-Coccidioides spp antibody serology were performed at baseline and once every 3 months until remission or for a maximum of 12 months. Radiographic tracheobronchial lymph node height, length, and area were measured and recorded as ratios via comparison with the length of the T4 vertebral body (LT4) and length of the manubrium. Severity of TBL was also subjectively categorized as mild, moderate, or severe.
RESULTS: Tracheobronchial lymphadenopathy was identified in 81% (26/32; 95% CI, 64% to 93%) of dogs. There was no relevant association between TBL presence or severity and antibody serology results. Tracheobronchial lymphadenopathy resolved in 72% (n = 18) of dogs at the 3-month evaluation. The median time to resolution of TBL after initiation of fluconazole was 96 days (range, 72 to 386 days). Univariate analysis identified increasing TBL severity (hazard ratio, 0.40; 95% CI, 0.19 to 0.84; P = .02) and length:LT4 ratio (hazard ratio, 0.41; 95% CI, 0.20 to 0.82; P = .01) as variables associated with reduced probability of resolution of TBL.
CONCLUSIONS: Antibody serologic test results are not clinically useful to predict TBL presence or severity in dogs with pulmonary coccidioidomycosis, and larger tracheobronchial lymph nodes are more likely to take longer to resolve. Resolution of TBL occurs in most dogs within 3 to 6 months after fluconazole administration.
METHODS: 32 client owned dogs with newly diagnosed pulmonary coccidioidomycosis from October 2020 to February 2021.
METHODS: Prospective cohort study. Thoracic radiographs and anti-Coccidioides spp antibody serology were performed at baseline and once every 3 months until remission or for a maximum of 12 months. Radiographic tracheobronchial lymph node height, length, and area were measured and recorded as ratios via comparison with the length of the T4 vertebral body (LT4) and length of the manubrium. Severity of TBL was also subjectively categorized as mild, moderate, or severe.
RESULTS: Tracheobronchial lymphadenopathy was identified in 81% (26/32; 95% CI, 64% to 93%) of dogs. There was no relevant association between TBL presence or severity and antibody serology results. Tracheobronchial lymphadenopathy resolved in 72% (n = 18) of dogs at the 3-month evaluation. The median time to resolution of TBL after initiation of fluconazole was 96 days (range, 72 to 386 days). Univariate analysis identified increasing TBL severity (hazard ratio, 0.40; 95% CI, 0.19 to 0.84; P = .02) and length:LT4 ratio (hazard ratio, 0.41; 95% CI, 0.20 to 0.82; P = .01) as variables associated with reduced probability of resolution of TBL.
CONCLUSIONS: Antibody serologic test results are not clinically useful to predict TBL presence or severity in dogs with pulmonary coccidioidomycosis, and larger tracheobronchial lymph nodes are more likely to take longer to resolve. Resolution of TBL occurs in most dogs within 3 to 6 months after fluconazole administration.
摘要：
目的：确定抗体血清学测试与肺球虫菌病犬气管支气管淋巴结病（TBL）之间的关系，并确定与TBL消退时间相关的变量。
方法：从2020年10月至2021年2月，有32只新诊断为肺球孢子菌病的客户拥有的狗。
方法：前瞻性队列研究。基线时进行胸片和抗球虫抗体血清学检查，每3个月一次，直至缓解或最多12个月。放射学气管支气管淋巴结高度，长度,通过与T4椎体长度（LT4）和柄骨长度进行比较，测量和记录为比率。TBL的严重程度也被主观归类为轻度，中度,或严重。
结果：在81%（26/32；95%CI，64%~93%）的犬中发现气管支气管淋巴结病。TBL的存在或严重程度与抗体血清学结果之间没有相关关联。在3个月的评估中，72％（n=18）的狗的气管支气管淋巴结病得以解决。开始氟康唑后TBL消退的中位时间为96天（范围，72至386天）。单变量分析确定TBL严重程度增加(风险比，0.40；95%CI，0.19至0.84；P=.02)和长度：LT4比率(危险比，0.41；95%CI，0.20至0.82；P=0.01）作为与TBL分辨率概率降低相关的变量。
结论：抗体血清学检测结果对预测肺球孢子菌病犬的TBL存在或严重程度没有临床价值，和较大的气管支气管淋巴结更可能需要更长的时间来解决。大多数狗在氟康唑给药后3至6个月内发生TBL的消退。
方法：从2020年10月至2021年2月，有32只新诊断为肺球孢子菌病的客户拥有的狗。
方法：前瞻性队列研究。基线时进行胸片和抗球虫抗体血清学检查，每3个月一次，直至缓解或最多12个月。放射学气管支气管淋巴结高度，长度,通过与T4椎体长度（LT4）和柄骨长度进行比较，测量和记录为比率。TBL的严重程度也被主观归类为轻度，中度,或严重。
结果：在81%（26/32；95%CI，64%~93%）的犬中发现气管支气管淋巴结病。TBL的存在或严重程度与抗体血清学结果之间没有相关关联。在3个月的评估中，72％（n=18）的狗的气管支气管淋巴结病得以解决。开始氟康唑后TBL消退的中位时间为96天（范围，72至386天）。单变量分析确定TBL严重程度增加(风险比，0.40；95%CI，0.19至0.84；P=.02)和长度：LT4比率(危险比，0.41；95%CI，0.20至0.82；P=0.01）作为与TBL分辨率概率降低相关的变量。
结论：抗体血清学检测结果对预测肺球孢子菌病犬的TBL存在或严重程度没有临床价值，和较大的气管支气管淋巴结更可能需要更长的时间来解决。大多数狗在氟康唑给药后3至6个月内发生TBL的消退。
