%0 Journal Article
%T Successful Long-Term Use of Itraconazole for the Treatment of Aspergillus Diskospondylitis in a Dog
%A Emiko Van Wie
%A Annie V. Chen
%A Stephanie A. Thomovsky
%A Russell L. Tucker
%J Case Reports in Veterinary Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/907276
%X A 5-year-old spayed female German shepherd dog was admitted with a history of generalized stiffness. Neurologic examination revealed mild paraparesis with multifocal spinal pain. Spinal radiographs and magnetic resonance imaging revealed diskospondylitis at L6-7 and multiple sites throughout the thoracolumbar spine. Biopsy of the intervertebral disk at L6-7 revealed a positive culture for Aspergillus species, and the dog was placed on itraconazole indefinitely. Clinical signs were significantly improved after two weeks of itraconazole. The dog was reevaluated 8 years later for unrelated reasons. No spinal pain was detected. Spinal radiographs revealed a fused L6-7 disk space and collapsed and sclerotic disk spaces at multiple sites. Itraconazole was tolerated by the dog with normal yearly liver enzyme values. To our knowledge, this is the first reported case of successful long-term use of itraconazole for the treatment of Aspergillus diskospondylitis in a dog. 1. Introduction Diskospondylitis is an infection of the intervertebral disk with concurrent osteomyelitis in adjacent vertebral endplates. The most common cause of diskospondylitis is hematogenous spread of bacteria or fungi from urinary tract infections, dental infections, or endocarditis [1, 2]. Migrating foreign bodies, such as grass awns, have also been incriminated as a source of infection. Staphylococcus aureus is the most common cause of canine diskospondylitis. Aspergillus is a fungus that is ubiquitous in the environment and an opportunistic pathogen. Aspergillus terreus is the most common species associated with disseminated aspergillosis [2]. Female German shepherd dogs are the most commonly affected breed with disseminated aspergillosis. It is speculated that German shepherd dogs have a hereditary immune defect that plays a significant role in the pathogenesis [1, 3]. In disseminated cases, it is not uncommon to find radiographic changes consistent with multiple sites of diskospondylitis [3, 4]. Aspergillosis can be localized to the spine only. There have been four published canine cases of Aspergillus diskospondylitis, without the presence of systemic involvement, in the veterinary literature [1, 5, 6]. All four cases were seen in German shepherd dogs; these dogs were euthanized due to poor prognosis or neurologic deterioration. The purpose of this report is to describe a case of nondisseminated Aspergillus diskospondylitis in a dog that was successfully treated with long-term itraconazole. 2. Case Presentation A 5-year-old (41.2-kg) spayed female German shepherd dog was evaluated for
%U http://www.hindawi.com/journals/crivem/2013/907276/