Affiliation:
1. Division of Diagnostic Imaging Department of Clinical Sciences Utrecht University Utrecht The Netherlands
2. Division of Internal Medicine (Cardiology and Pulmonology) Department of Clinical Sciences Utrecht University Utrecht The Netherlands
3. Division of Pathology Department of Biomolecular Health Sciences Utrecht University Utrecht The Netherlands
4. Department of Clinical Microbiology and Infectious Diseases Canisius‐Wilhelmina Hospital (CWZ) Nijmegen The Netherlands
5. Radboudumc‐CWZ Center of Expertise for Mycology Nijmegen The Netherlands
Abstract
AbstractA 4‐year‐old, male, neutered Maine Coon presented with a 9‐month history of weight loss, tachypnoea, dyspnoea and lethargy. The patient had been in the owner's possession since kittenhood in Texas, and 20 months before presentation had moved to Europe, living first in France and then the Netherlands. A bronchoalveolar lavage performed by the referring veterinarian cultured positive for Mycoplasma (unknown species), and treatment was initiated with minimal response. Sequential referring radiographs showed progressive diffuse pulmonary broncho‐interstitial changes. At presentation, focused echocardiogram suggested moderate likelihood of pulmonary hypertension. Repeat thoracic radiographs showed markedly progressed pulmonary changes, with a new miliary component. Bloodwork showed hypergammaglobulinaemia. Pending additional diagnostic results, the patient passed away within 4 days. Postmortem examination was compatible with severe chronic pyogranulomatous pneumonia with pleuritis, splenitis, hepatitis and adrenalitis, with histopathological identification of intracytoplasmic fungal elements. Sequencing of pulmonary granulomatous tissue confirmed the presence of Histoplasma capsulatum.