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Background Fungal rhinosinusitis in cats is an uncommon condition with sparse literature regarding the presentation, causative agents, diagnosis, treatment, and prognosis within the UK. Hypothesis/Objectives To describe and report the presenting clinical signs, diagnostic imaging findings, treatment approach, and outcome of cats diagnosed with fungal rhinosinusitis in the UK. Animals Thirty‐four client‐owned cats were diagnosed with fungal rhinosinusitis. Methods Retrospective multicenter observational study. Cases presenting at 10 UK referral centers between January 2013 and December 2022 were retrospectively recruited. Results Median duration of clinical signs was 3 months (0.5‐42‐months). The most common signs were sneezing (27/34, 79%) and nasal discharge (21/34, 62%). Turbinate lysis was present in 27/34 cases (79%) and always involved the caudal nasal cavity. Osteolysis of the frontal bone, orbit, or cribriform plate was observed in 16/34 cases (47%). At least two tests from fungal culture, panfungal PCR, and histopathology were performed in all cases, and in 8/34 cases (24%) only one was positive. The treatment approach varied, with debridement, topical clotrimazole, and systemic azole therapy used alone or in various combinations, and repeat treatment occurred in 9/34 cases (26%). Clinical remission > 90 days after treatment was found in 9/24 cases (38%), but case fatality rates were low, with 3/34 cases (9%) dying with clinical disease during available follow‐up. Conclusions and Clinical Importance Fungal rhinosinusitis should be considered in cats of any age with clinical signs of nasal disease. The prognosis from this data appears guarded for cats with fungal rhinosinusitis, with less than 50% of cats achieving long‐term clinical remission.

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.

Background: Sino‐nasal aspergillosis is a common nasal disease in dogs. Recommended treatment protocols typically involve trephination of the frontal sinuses or the use of an antifungal solution instilled into the frontal sinus under anesthesia, both of which have associated morbidity and complications. Objectives: To assess a minimally‐invasive topical treatment protocol for sino‐nasal aspergillosis in dogs. Animals: Twelve client‐owned dogs diagnosed with sino‐nasal aspergillosis that completed recommended treatment. Methods: Medical records were retrospectively reviewed to identify dogs with sino‐nasal aspergillosis that received treatment. Fungal plaques were manually debrided and irrigated via frontal sinuscopy in 12 dogs that then were treated topically with 1% topical clotrimazole cream. Irrigation and topical medication application was achieved using a catheter placed retrograde directly into the frontal sinuses using the Seldinger technique over a guidewire, thereby avoiding the need for frontal sinus trephination. Invasion into the calvarium was recorded before treatment but was not considered a criterion for exclusion. Debridement and cream deposition was repeated every 2 weeks as needed until negative culture and histopathologic findings were obtained. Results: All dogs were cured (negative results for Aspergillus on endoscopy, fungal culture, and histopathology) with a median of 2 treatments. Treatments were well tolerated, with minimal adverse effects reported. Three dogs had evidence of erosion into the calvarium on computed tomography imaging. Conclusions and Clinical Importance: This protocol appears to be an effective and well‐tolerated minimally invasive treatment for sino‐nasal aspergillosis, including in dogs with erosion into the calvarium. Only mild adverse effects were noted.

Curvularia spp. are globally distributed saprophytic fungi, classified in the literature as dematiaceous, or darkly pigmented fungi. These fungi have been increasingly recognized as causing cutaneous, ocular, respiratory, and central nervous system infections in humans, but have been infrequently documented as pathogens in the veterinary literature. A 5-yr-old male Chinese goral (Naemorhedus griseus) presented with bilateral fungal dermatitis of the pinnae, and subsequent pyogranulomatous rhinosinusitis. Clinical signs included epistaxis, mucosanguineous nasal discharge, and dyspnea. Sequential histologic examinations of cutaneous and nasal lesions revealed pyogranulomatous inflammation with extracellular and phagocytized nonpigmented yeasts. Fungal culture and polymerase chain reaction identified Curvularia sp. The absence of pigmentation in tissue in this case suggests that pigmentation may not be a consistent histologic finding for this fungus, emphasizing the importance of molecular identification to prevent misidentification. Despite intensive interventions in this goral, the disease progressed, and was ultimately fatal.

The historical and clinical findings in 200 referred cases of equine sinus disease were reviewed retrospectively. Univariable and multivariable analyses were performed to detect significant differences in historical or clinical features between various categories of sinus disease. The causes of sinus disease were classified as subacute primary (less than two months duration) (n=52), chronic primary (more than two months duration) (n=37), dental (n=40), sinus cyst (n=26), traumatic (n=13) or mycotic sinusitis (n=7), sinus neoplasia (n=10), dental-related oromaxillary fistula (n=8) and intrasinus progressive ethmoid haematoma (n=7). The majority of sinus disorders were of chronic duration at the time of referral and most (including 97 per cent of chronic primary sinusitis cases) had not responded to previous antibiotic therapy and/or sinus lavage in some cases. Clinical signs included unilateral nasal discharge in most cases, including purulent or mucopurulent discharge in all horses with primary, dental and mycotic sinusitis. Haemorrhagic nasal discharge was a feature of traumatic sinusitis and intrasinus progressive ethmoid haematomas. Firm facial swellings and nasal airflow obstruction were features of sinus cysts and neoplasms. Ipsilateral lymphadenitis was a more prominent feature of sinus disease with active infections such as primary, dental or mycotic sinusitis.

Sinusitis is a common finding in avian species; however, it presents unique treatment challenges in ratites. A 6-yr-old male greater rhea (Rhea americana) presented acutely with right infraorbital sinus swelling and chemosis. Oral antibiotics were prescribed based on bacterial culture results with incomplete resolution of clinical signs. A computed tomography scan of the skull demonstrated a mixed-density soft tissue mass with extensive destruction of the right nasal bone, hard palate, maxilla, and frontal bone. The affected tissue was surgically resected and histopathology was consistent with inspissated necrotic tissue. Aerobic culture of the mass grew a multidrug-resistant Escherichia coli and was treated with amikacin. Ten months postsurgery, no further clinical signs were observed. Advanced diagnostic imaging with computed tomography and surgical therapy facilitated complete resolution of this resistant bacterial sinusitis in a species that is not typically amenable to frequent handling and restraint.

We describe a novel heterothallic species in Aspergillus section Fumigati, namely A. felis (neosartorya-morph) isolated from three host species with invasive aspergillosis including a human patient with chronic invasive pulmonary aspergillosis, domestic cats with invasive fungal rhinosinusitis and a dog with disseminated invasive aspergillosis. Disease in all host species was often refractory to aggressive antifungal therapeutic regimens. Four other human isolates previously reported as A. viridinutans were identified as A. felis on comparative sequence analysis of the partial β-tubulin and/or calmodulin genes. A. felis is a heterothallic mold with a fully functioning reproductive cycle, as confirmed by mating-type analysis, induction of teleomorphs within 7 to 10 days in vitro and ascospore germination. Phenotypic analyses show that A. felis can be distinguished from the related species A. viridinutans by its ability to grow at 45°C and from A. fumigatus by its inability to grow at 50°C. Itraconazole and voriconazole cross-resistance was common in vitro.

A female Swainson's toucan (Ramphastos ambiguus swainsonii) was presented for examination with a 2-year history of mucoid nasal discharge and abnormal growth of the rhamphotheca. Nasal cytologic examination and culture results were consistent with mixed aerobic and anaerobic bacterial rhinitis. Radiographic and computed tomographic imaging demonstrated a deviated septum of the nasal diverticulum and multiple soft tissue densities in the caudal aspects of the maxillary and mandibular infraorbital diverticula of the infraorbital sinus. Results of rhinoscopy and biopsy confirmed bacterial rhinitis. Treatment included multiple nasal lavages with saline, gentamicin, and amphotericin B and systemic ciprofloxacin and tobramycin nebulizations for several weeks. Repeat radiographic imaging 4 years later showed resolution of most soft tissue opacities previously observed within the maxillary and mandibular diverticula but persistence of 3 areas of soft tissue, dense material within the maxillary sinus diverticulum. A sinus trephination procedure was performed through the maxillary bone for sinoscopy and sample collection and topical treatment. Results of aerobic bacterial cultures from the granulomas were negative. Biopsy results were consistent with keratin granulomas without bacterial or fungal infection. Two and a half years after trephination, the surgical site was fully healed with no recurrence of the nasal discharge. This is the first report, to our knowledge, of sinus trephination in a toucan and describes the advanced diagnostic and medical and surgical treatment of chronic rhinitis in this case.

A 31-yr-old male Sumatran orangutan (Pongo abelii) presented with 14 yr of chronic purulent nasal drainage and cough with intermittent exacerbation of symptoms requiring systemic antibiotic treatment. He was diagnosed with a cystic fibrosis (CF)-like condition. Evaluation consisted of bronchoscopy with bronchoalveolar lavage, culture, and computed tomography scanning of the sinuses and chest. Although the presence of low fecal elastase activity increased the suspicion for a diagnosis of CF, pilocarpine iontophoresis with sweat collection and analysis (“sweat testing”) was inconclusive. Medical management included twice-daily nebulization with bronchodilators and alternating month inhaled antibiotics, pancreatic enzyme replacement therapy, and simethicone as needed. Sinopulmonary and gastrointestinal symptoms improved substantially with treatment. Several years later, the animal died acutely of colonic volvulus. Necropsy and histopathology confirmed CF-like lung disease with chronic air sacculitis.

Involvement of the ventral conchal sinus (VCS) is an important diagnostic and prognostic feature in cases of the equine sinus disease. The authors aimed to ascertain if the caudo-dorsal extension of the VCS, the ventral conchal bulla (VCB) is identifiable on plain radiographs of cadaver skulls without sinus disease. Bilateral frontonasal sinus flaps were made in 10 equine cadaver skulls. Plain lateral, lateral oblique and dorso-ventral radiographs were then obtained followed by the same views taken with stainless steel wire outlining the caudal border of the VCB. Plain radiographs were randomised and blindly evaluated by two observers who marked where they believed the VCB to be positioned. This was then correlated with the true position of the VCB using radiographs with wires in place. The ease of identification of the VCB was classified as ‘easy’ or ‘difficult’. The VCB was correctly identified in 70 per cent of lateral radiographs, but only 45 per cent of lateral oblique radiographs and 17 per cent of dorso-ventral radiographs. If a clinician was confident that he or she could identify the VCB, they were usually correct. Conversely if the clinician judged VCB identification as ‘difficult’, they usually identified it incorrectly. In the authors' clinical experience, the VCB of horses with sinusitis involving this compartment is more radiologically evident than in clinically normal horses. Knowledge of the normal radiographic anatomy of this structure should aid clinicians in identifying horses with sinusitis affecting the VCS.