Abstract：
BACKGROUND: Cryptococcus is one of the most common systemic mycosis worldwide, infecting young adults of the large to giant breed dogs. Infection is commonly acquired from the environment via the sinonasal cavity as the main portal of entry. It either remains there, or spreads to the central nervous system (CNS) and the eye (optic nerve and retina) by penetration of the cribriform plate, or haematogenously to other viscera. Lung involvement is uncommon in cats and dogs in contrast to human and equine patients. Whilst there is a wide genetic diversity amongst Cryptococcus neoformans and Cryptococcus gattii isolates along the West Coast and Northern parts of Australia, the molecular diversity of C. gatti is considered very low on the East Coast of Australia, with a huge preponderance of VGI cases. We report on a young small breed brachycephalic dog that presented with extreme gastrointestinal and respiratory signs, but no CNS involvement. It is the first reported case of C. gattii VGII genotype in a companion animal from Queensland.
METHODS: A 9-month old female entire French Bulldog presented initially for diarrhoea. Clinical progression was accompanied by the development of respiratory signs, so the patient was referred to a 24 h care facility. Following hospitalisation, the patient became hypoxemic requiring mechanical ventilation. A bronchoalveolar lavage performed antemortem confirmed abundant Cryptococcal spp. Further culturing and genotyping identified the species as Cryptococcus gattii VGII. Post-mortem findings indicated gross gastrointestinal and mesenteric involvement, with possible dissemination to the local mesenteric lymph node and lungs.
CONCLUSIONS: This case describes a rare example of a Cryptococcus spp suspected of disseminating from the gastrointestinal tract to the lungs, without involvement of the CNS. The observation of this finding in a small brachycephalic breed is unusual, and the finding of genotype VGII on the East Coast of Queensland is extremely unusual as there is no prior travel history of the dog or owners. The presence of a miliary lung pattern with primary gastrointestinal disease in a small breed dog warrants adding cryptococcosis to the differential diagnosis.
METHODS: A 9-month old female entire French Bulldog presented initially for diarrhoea. Clinical progression was accompanied by the development of respiratory signs, so the patient was referred to a 24 h care facility. Following hospitalisation, the patient became hypoxemic requiring mechanical ventilation. A bronchoalveolar lavage performed antemortem confirmed abundant Cryptococcal spp. Further culturing and genotyping identified the species as Cryptococcus gattii VGII. Post-mortem findings indicated gross gastrointestinal and mesenteric involvement, with possible dissemination to the local mesenteric lymph node and lungs.
CONCLUSIONS: This case describes a rare example of a Cryptococcus spp suspected of disseminating from the gastrointestinal tract to the lungs, without involvement of the CNS. The observation of this finding in a small brachycephalic breed is unusual, and the finding of genotype VGII on the East Coast of Queensland is extremely unusual as there is no prior travel history of the dog or owners. The presence of a miliary lung pattern with primary gastrointestinal disease in a small breed dog warrants adding cryptococcosis to the differential diagnosis.
摘要：
背景：隐球菌是全球最常见的全身性真菌病之一，感染大型到巨型犬种的年轻人。感染通常是通过鼻窦腔作为主要入口从环境中获得的。它要么留在那里，或通过穿透筛板扩散到中枢神经系统（CNS）和眼睛（视神经和视网膜），或其他内脏造血。与人和马患者相比，猫和狗的肺受累并不常见。尽管澳大利亚西海岸和北部的新生隐球菌和加蒂隐球菌分离株之间存在广泛的遗传多样性，在澳大利亚东海岸，C.gatti的分子多样性被认为非常低，大量的VGI病例。我们报道了一只年轻的小型短头犬，它表现出极端的胃肠道和呼吸道症状，但没有中枢神经系统的参与。这是昆士兰州伴侣动物中首例报道的C.gattiiVGII基因型病例。
方法：一名9个月大的雌性法国斗牛犬最初因腹泻而出现。临床进展伴随着呼吸体征的发展，因此，患者被转介到24小时护理机构。住院后，患者出现低氧血症,需要机械通气.在死前进行的支气管肺泡灌洗证实了丰富的隐球菌属。进一步的培养和基因分型将该物种鉴定为gattii隐球菌VGII。验尸结果显示严重的胃肠道和肠系膜受累，可能播散到局部肠系膜淋巴结和肺。
结论：本案例描述了一个罕见的隐球菌，怀疑从胃肠道传播到肺部，没有中枢神经系统的参与。在一个小的短脑品种中观察到这一发现是不寻常的，在昆士兰州东海岸发现基因型VGII非常不寻常，因为没有狗或主人的先前旅行史。小型犬类中存在伴有原发性胃肠道疾病的网状肺模式，因此需要将隐球菌病添加到鉴别诊断中。
方法：一名9个月大的雌性法国斗牛犬最初因腹泻而出现。临床进展伴随着呼吸体征的发展，因此，患者被转介到24小时护理机构。住院后，患者出现低氧血症,需要机械通气.在死前进行的支气管肺泡灌洗证实了丰富的隐球菌属。进一步的培养和基因分型将该物种鉴定为gattii隐球菌VGII。验尸结果显示严重的胃肠道和肠系膜受累，可能播散到局部肠系膜淋巴结和肺。
结论：本案例描述了一个罕见的隐球菌，怀疑从胃肠道传播到肺部，没有中枢神经系统的参与。在一个小的短脑品种中观察到这一发现是不寻常的，在昆士兰州东海岸发现基因型VGII非常不寻常，因为没有狗或主人的先前旅行史。小型犬类中存在伴有原发性胃肠道疾病的网状肺模式，因此需要将隐球菌病添加到鉴别诊断中。
