Premium
MAGNETIC RESONANCE IMAGING FEATURES AND OUTCOME FOR SOLITARY CENTRAL NERVOUS SYSTEM COCCIDIOIDES GRANULOMAS IN 11 DOGS AND CATS
Author(s) -
Bentley R. Timothy,
Heng Hock Gan,
Thompson Craig,
Lee ChunSheng,
Kroll Robert A.,
Roy Michael E.,
Marini Lauren,
Heo Jin,
Wigle William L.
Publication year - 2015
Publication title -
veterinary radiology and ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.541
H-Index - 60
eISSN - 1740-8261
pISSN - 1058-8183
DOI - 10.1111/vru.12258
Subject(s) - medicine , coccidioides , magnetic resonance imaging , cytology , cats , pathology , serology , central nervous system , radiology , coccidioides immitis , dermatology , antibody , immunology
Little published information is available to guide therapy for canine and feline patients with Coccidioides infections involving the central nervous system (CNS). The purpose of this cross‐sectional retrospective study was to describe magnetic resonance imaging (MRI) features and outcome for a group of dogs and cats with solitary CNS Coccidiodes granulomas. Nine canine and two feline cases met inclusion criteria; four diagnosed and treated with surgery and fluconazole and seven diagnosed by serology or cytology and treated medically. Three cases had left Coccidioides endemic areas long before developing neurological disease. The MRI lesions shared many features with neoplastic masses. The extra‐axial granulomas often had a lack of a distinct border between the mass and neural parenchyma. Four cases were extra‐axial and seven were intra‐axial, but distinguishing between extra‐axial and intra‐axial locations was sometimes challenging. The surgical cases had good outcomes and histology allowed definitive diagnosis. Medically managed patients also had generally good outcomes, with resolution of clinical signs in most cases. Findings indicated that distinction between neoplasia and focal Coccidioides granulomas based on MRI features is likely to be imprecise. Demonstration of the organism by cytology or histology is required for definitive diagnosis. The role of surgery for improving the outcome of brain or spinal coccidioidomycosis granulomas warrants further study.