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Aspergillus fungi are the cause of an array of diseases affecting humans, animals and plants. The triazole antifungal agents itraconazole, voriconazole, isavuconazole and posaconazole are treatment options against diseases caused by Aspergillus. However, resistance to azoles has recently emerged as a new therapeutic challenge in six continents. Although de novo azole resistance occurs occasionally in patients during azole therapy, the main burden is the aquisition of resistance through the environment. In this setting, the evolution of resistance is attributed to the widespread use of azole-based fungicides. Although ubiquitously distributed, A. fumigatus is not a phytopathogen. However, agricultural fungicides deployed against plant pathogenic moulds such as Fusarium, Mycospaerella and A. flavus also show activity against A. fumigatus in the environment and exposure of non-target fungi is inevitable. Further, similarity in molecule structure between azole fungicides and antifungal drugs results in cross-resistance of A. fumigatus to medical azoles. Clinical studies have shown that two-thirds of patients with azole-resistant infections had no previous history of azole therapy and high mortality rates between 50% and 100% are reported in azole-resistant invasive aspergillosis. The resistance phenotype is associated with key mutations in the cyp51A gene, including TR34/L98H, TR53 and TR46/Y121F/T289A resistance mechanisms. Early detection of resistance is of paramount importance and if demonstrated, either with susceptibility testing or through molecular analysis, azole monotherapy should be avoided. Liposomal amphotericin B or a combination of voriconazole and an echinocandin are recomended for azole-resistant aspergillosis. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’.

ABSTRACT A 3.5‐year‐old castrated male domestic medium hair cat was evaluated for dry cough and labored breathing. A cranial mediastinal mass was seen on thoracic radiographs. On computed tomography, the mass displaced the cranial vena cava and dorsally displaced and compressed the intrathoracic trachea. The patient was taken to surgery for attempted mass removal. Intraoperatively, the mass was adhered to the cranial vena cava, aortic arch, left subclavian artery, and had partially engulfed the brachiocephalic trunk. The cat was euthanized and on necropsy the mass was found to invade the lumen of the vena cava and the tracheal lumen. An Aspergillus lentulus fungal granuloma was diagnosed histologically and by fungal culture and PCR. We highlight the difficulty in determining the extent of invasion with invasive aspergillosis and provide evidence that invasive aspergillosis can occur in otherwise healthy, young cats with no concurrent immunosuppressive treatments or comorbidities.

ABSTRACT Background Discospondylitis refers to inflammation of the intervertebral disc and adjacent vertebral endplates. The literature on mycotic discospondylitis (MD) in dogs is limited. Objective To describe clinical and advanced diagnostic imaging findings, therapeutic strategies, and outcomes in dogs with a confirmed diagnosis of MD. Animals Eleven client‐owned dogs with a diagnosis of MD. Materials and Methods Medical records from five veterinary neurological referral centers were retrospectively reviewed between 2017 and 2024. The confirmed diagnosis of MD was based on clinical and magnetic resonance imaging (MRI) findings and the detection of fungal hyphae in urine, intervertebral disc, or cerebrospinal fluid (CSF). Results German shepherd (GS) were the most prevalent breed (7/11). Pain was the main clinical sign reported in all dogs, associated with gait abnormalities in 9 dogs. T3‐L3 neuroanatomical localization was described in 10 dogs. MRI showed multiple intervertebral disc involvement in 7 dogs. Fungal hyphae were identified in urine sediment in 5 dogs and by CT‐guided needle aspiration of the affected disc in 2 dogs. Aspergillus spp. was the most common etiological agent being reported in 7 dogs. Ten dogs were dead at the end of data analysis, with a median survival time of 30 days. Conclusion and Clinical Importance This case series demonstrates the necessity of accurate diagnosis to set an appropriate treatment, despite the poor prognosis after antifungal therapy.

Background Disseminated aspergillosis (DA) in dogs has a guarded prognosis and there is a lack of a gold standard treatment protocol. Objective To retrospectively assess survival times and factors influencing survival times. Animals Dogs diagnosed with DA from January 2007 to June 2017. Methods Disseminated aspergillosis case data were retrieved from 13 Australian veterinary referral centers, with a diagnosis confirmed with culture or PCR. Factors influencing survival time after diagnosis were quantified using a Cox proportional hazards regression model. Results Thirty‐four dogs met the study inclusion criteria. Twenty‐two dogs were treated with antifungal treatment and 12 dogs received no antifungal treatment. Accounting for censoring of dogs that were either still alive on the date of data collection or were loss to follow‐up, dogs treated with itraconazole alone (n = 8) had a median survival time (MST) of 63 (95% CI: 20−272) days compared to 830 (95% CI: 267‐1259) days for the n = 14 dogs that received multimodal antifungal therapy (χ2 test statistic 8.6; df = 1; P < .01). The daily hazard of death (DHOD) for dogs with abnormally high serum creatinine concentration at the time of diagnosis was 7.4 (95% CI: 1.9‐29) times that of dogs with serum creatinine within the reference interval. Conclusion and Clinical Importance Serum creatinine concentration at the time of diagnosis is a useful prognostic indicator for survival after a diagnosis of DA. The MST for dogs treated with multimodal antifungal therapy is longer than itraconazole alone and warrant further investigation (P < .01).

Harbour porpoises ( Phocoena phocoena ) in the North Sea live in an environment heavily impacted by humans, the consequences of which are a concern for their health. Autopsies carried out on stranded harbour porpoises provide an opportunity to assess health problems in this species. We performed 61 autopsies on live-stranded harbour porpoises, which died following admission to a rehabilitation centre between 2003 and 2016. The animals had stranded on the Dutch ( n  = 52) and adjacent coasts of Belgium ( n  = 2) and Germany ( n  = 7). We assigned probable causes for stranding based on clinical and pathological criteria. Cause of stranding was associated in the majority of cases with pathologies in multiple organs ( n  = 29) compared to animals with pathologies in a single organ ( n  = 18). Our results show that the three most probable causes of stranding were pneumonia ( n  = 35), separation of calves from their mother ( n  = 10), and aspergillosis ( n  = 9). Pneumonia as a consequence of pulmonary nematode infection occurred in 19 animals. Pneumonia was significantly associated with infection with Pseudalius inflexus, Halocercus sp., and Torynurus convolutus but not with Stenurus minor infection. Half of the bacterial pneumonias (6/12) could not be associated with nematode infection. Conclusions from this study are that aspergillosis is an important probable cause for stranding, while parasitic infection is not a necessary prerequisite for bacterial pneumonia, and approximately half of the animals (29/61) probably stranded due to multiple causes. An important implication of the observed high prevalence of aspergillosis is that these harbour porpoises suffered from reduced immunocompetence.

Aspergillosis is a major health problem in captive penguins due to the inhalation and the development of airborne spores of opportunistic environmental molds of the genus Aspergillus. Diagnosis is often delayed and treatments, based on the use of azole antifungals, are not fully effective. This study assesses the risk of exposure to Aspergillus sp. and determines the environmental reservoirs in the direct environment of a colony of Humboldt penguins (Spheniscus humboldti) in a zoological park in Paris, and the risk of contamination with resistant isolates. Every 15 days between February and May 2022, environmental samples (air and subtract from the nests, pond water, pigeon and penguin droppings) were carried out in the penguin enclosure as well as clinical samples (one-time non-invasive sampling on chicks), and screened for Aspergillus sp. conidia. From 191 environmental samples, 264 strains of Aspergillus including 221 strains of A. fumigatus were isolated, mostly from ambient air, in the nests, and pond water. No “at risk” areas in the penguin environment have been highlighted, nor an increased risk because of the proximity with urban wild birds. However, the load of airborne Aspergillus in the nests increased significantly with outdoor temperature. Of the 221 strains isolated, we identified only one azole-resistant strain, displaying the TR34/L98H mutation in the cyp51A gene. This low prevalence of resistant strains may probably be partly explained by the urban location of the zoological park, surrounded by kilometers of urban areas without agricultural activities.

ABSTRACT Disseminated aspergillosis is uncommon in dogs and typically caused by Aspergillus terreus. This report describes a systemic aspergillosis linked to discospondylitis in an 8‐year‐old spayed female German Shepherd presented with a 2‐week history of neck pain, progressive proprioceptive ataxia and ambulatory paraparesis and lameness of the left front limb. For the first time, an atypical strain of Aspergillus floccosus, section Terrei, was identified by culture and molecular methods. This finding emphasises the importance of molecular biology in fungal species identification, which is essential for accurate diagnosis and appropriate treatment. Our report further highlights that fungal infections should always be considered in German Shepherds with neurological signs, and the importance of maintaining antifungal therapy even in patients with few or no clinical or laboratory signs of active infection to prevent deterioration and death. A case of disseminated aspergillosis in dog was described due to an atypical strain of Aspergillus floccosus. Aspergillosis should be considered in the differential diagnosis of dogs with neurological signs and nonspecific changes in CBC or CMP, particularly in German Shepherd dogs. Molecular identification is crucial for an appropriate diagnosis of cryptic Aspergillus species. Finally, the importance of maintaining antifungal therapy was underlined.

Aspergillus fumigatus is a saprophytic fungal pathogen that causes opportunistic infections in animals and humans. Azole resistance has been reported globally in human A. fumigatus isolates, but the prevalence of resistance in isolates from animals is largely unknown. A retrospective resistance surveillance study was performed using a collection of clinical A. fumigatus isolates from various animal species collected between 2015 and 2020. Agar-based azole resistance screening of all isolates was followed by in vitro antifungal susceptibility testing and cyp51A gene sequencing of the azole-resistant isolates. Over the 5 year period 16 (11.3%) of 142 A. fumigatus culture-positive animals harbored an azole-resistant isolate. Resistant isolates were found in birds (15%; 2/13), cats (21%; 6/28), dogs (8%; 6/75) and free-ranging harbor porpoise (33%; 2/6). Azole-resistance was cyp51A mediated in all isolates: 81.3% (T-67G/)TR 34 /L98H, 12.5% TR 46 /Y121F/T289A. In one azole-resistant A. fumigatus isolate a combination of C(-70)T/F46Y/C(intron7)T/C(intron66)T/M172V/E427K single-nucleotide polymorphisms in the cyp51A gene was found. Of the animals with an azole-resistant isolate and known azole exposure status 71.4% (10/14) were azole naive. Azole resistance in A. fumigatus isolates from animals in the Netherlands is present and predominantly cyp51A TR-mediated, supporting an environmental route of resistance selection. Our data supports the need to include veterinary isolates in resistance surveillance programs. Veterinarians should consider azole resistance as a reason for therapy failure when treating aspergillosis and consider resistance testing of relevant isolates.

ABSTRACT A 12‐year‐old terrier was referred for investigation of a 4‐month history of coughing, sneezing and nasal discharge. Clinical findings were consistent with sinonasal Aspergillus fumigatus infection with evidence of intracranial extension on computed tomography. Endoscopic debridement followed by topical clotrimazole and systemic antifungal therapy resulted in clinical improvement. Magnetic resonance imaging after 4 weeks showed reduced intracranial disease but demonstrated evidence of temporal myositis. Repeated debridement and topical treatment were performed at 4 and 8 weeks in conjunction with long‐term voriconazole therapy. Further interventions were declined; the dog remains clinically well after 4 months with unilateral nasal discharge. As in human patients, invasive subtypes of sinonasal aspergillosis may also occur in dogs and be associated with poorer response to treatment. A 12‐year‐old terrier with sinonasal Aspergillus fumigatus infection had evidence of intracranial extension on computed tomography and was treated with endoscopic debridement, topical clotrimazole and systemic antifungal therapy. Magnetic resonance imaging after 4 weeks showed reduced intracranial disease but demonstrated evidence of temporal myositis; repeated debridement and topical treatment were performed in conjunction with long‐term systemic voriconazole therapy. As in human patients, invasive subtypes of sinonasal aspergillosis may also occur in dogs and be associated with poorer response to treatment.

Background Cribriform lysis has been considered a contraindication for topical treatment of sinonasal aspergillosis (SNA) because of concerns about drug extravasation with resultant neurologic signs or death. Objective/Hypothesis To describe dogs with SNA and cribriform plate lysis treated with topical antifungal medications. Our hypothesis was that the conventional dogma that topical therapy should be avoided in these cases is incorrect. Animals Nine client‐owned dogs with SNA and lysis of the cribriform plate, lysis of the floor of a frontal sinus or both detected by computed tomography (CT). Methods A retrospective review of medical records was performed. Dogs that met inclusion criteria (ie, SNA confirmed by at least 1 laboratory test, braincase affected on CT, and topical treatment applied) were included. Size of lesions, ancillary diagnostic test results, topical therapy, and adjuvant PO treatments were recorded. Outcome was determined by phone calls. Results Four dogs were alive at the time of the manuscript submission with follow‐up ranging from 188 to 684 days without neurological signs observed. All dogs were discharged without major complication 1‐7 days postoperatively. One dog that had presented with a history of seizures experienced seizure activity 2 months after treatment. Conclusions and Clinical Importance Topical therapy did not result in complications in these dogs in which lytic regions as large as 16 × 22 mm2 were noted. Sinonasal aspergillosis associated lysis of the cribriform plate; lysis of the floor of a frontal sinus or both detected on CT is not necessarily a contraindication to topical therapy.