Presumptive Nocardia spp. infection in a dog treated with cyclosporin and ketoconazole

Authors: Mansfield CS, Paul AEH, Thompson M
Publication: New Zealand Veterinary Journal, Volume 58, Issue 5, pp 265-268, Oct 2010
Publisher: Taylor and Francis

Animal type: Dog
Subject Terms: Allergy, Bacterial, Disease/defect, Infectious disease, Integument/skin/wool/hair/fur/feather, Nervous system/neurology, Pneumonia/pleurisy, Respiratory system, Skeletal/bone/cartilage, Treatment/therapy
Article class: Clinical Communication

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Abstract:

CASE HISTORY: A dog that had received 8 months of cyclosporin and ketoconazole therapy for treatment of atopic dermatitis subsequently developed severe neurological disease, that failed to respond to treatment with trimethoprim-sulphadiazine and clindamycin.
HISTOPATHOLOGICAL FINDINGS: Histopathological examination of the pulmonary parenchyma and spinal cord revealed loose aggregates of Gram-positive, partially acid-fast, fine, beaded, filamentous bacteria, most consistent with Nocardia spp.
DIAGNOSIS: A presumptive diagnosis was made of disseminated nocardiosis of the spinal cord and lungs.
CLINICAL RELEVANCE: Nocardia spp. is an opportunistic actinomycete that may cause disseminated disease, particularly in immunocompromised animals. Cyclosporin is used in veterinary medicine to control immune-mediated and allergic disorders, with few reported adverse side effects. This case gives further evidence that involvement of the spinal cord in nocardiosis of the central nervous system (CNS) carries a poor prognosis, and opportunistic infection by Nocardia spp. may be a potential complication of immunosuppressive cyclosporin therapy in the dog.
KEY WORDS: Nocardia spp., cyclosporin, spinal cord, dog

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