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Cutaneous Candidiasis in a dog caused by Candida guilliermondii

Article  in  The Veterinary record · July 2002

DOI: 10.1136/vr.150.23.728 · Source: PubMed

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Cutaneous candidiasis
in a dog caused by
Candida guilliermondii
R. S. MUELLER, S. V. BETTENAY,
M. SHIPSTONE

Y IFAST or-ganlisnlis ai C comniIlxoiv foLiuid on1 n1orm11al canline

skinr arid miutcosa. MVI o/7ssc''i(o pJiCIiydc'rlilatis is the IllOSt coll-
mlilCiIN isolatcd yeast oni skini arid mcicocutalnleCous uIictionis
in nlormtilal dlogs (Kciiiiis anid others 1996). 1 hlis coilillensal
organrisiii riiay proliferate atid becomiec a pathogenli whenr
nlorimial protectixve phxysical, chemlical or immiunllilological
micchianiisms ai-e distuLribed (Plant and others 1992). C (iudid(d
species are commerisal orgainisimis of caninie nuicosal
iiemhibraneis. There arc fex eports of patients with cutaniecuLs
candidiasis caused bly Crtudidla albricai0s ( Kral arid Uscavage
1960, Holovnmoeni and others 1982, BoordCauL aiid otheis
1 984, Pichler arid others 198- ) or Caudida parapsilosis ( Dale
197 2) in the xveteririarv literatul-e. This shiort coniiiIurnicatiori
descr ihces a CuLtallCoLs infection caciecl bl Caudida guillffic-
/i/(iio/l/i arid its successful treatiiierit.
An eight-ii-orith-old riialc incttered lack RuIssell terricr xxvas
precscited xxwith cliioinic sexere derimatitis itl the iriguiial area;
the deriiiatitis had dexveloped shortly after castr atioini. As a
rioutirtlic biochei-isti-Nx analysis arid a coriiplete blood count
xxwerc noriiial, a clipper biurin xxith seccridars infcctioni wvas
diagnosed and tr eated xxith a itiiihber of drugs sequenltialaI, FIG 1: Severe erythema, scaling and crusting in the inguinal
xxwithout effcct. Initially, a coiiibhiiatiori of ieo imycil, area of an eight-month-old male, neutered Jack Russell
poly rnixini B arid hyidrocortisorie was used topicall) for one terrier, between the prepuce and the scrotum bilaterally,
xxeek, follosswed a topical oiiitriieiit contaiining pred- due to Candida guilliermondii
irisolone, polvnii xin B arid niicoiiazole for another week aiid
then oral clax ularic acid/arnoxycilliti at 125 rug/kg exerv I and tape preparationis of- thetaffccted arca wx ere negatixve (Fig
hOur-S for one xxweek. A coiiilbiiiatiori (f predriisolorie at aii 4). I hle veast iinfectioin did niot r-ecur during the 12- mionitlh
anti-iriflarinmatorv dose of 1 mg/kg daily arid ariioxycilliii at follow-up period.
0 rug-/kg txxicc dav oiralLk xxas also riot effectiv e and the clog
a Ycast organisms are commonlk isolatcd fi-omii caninie skill.
xxTas subsecquerCtlx referred. MpacIhydomeOitis
a is a lipophilic, non m-mycclial and saprophytic I'C1
c imry Rccon) (2 002)
sical exaiiiiiiatioii revealed a bright arid alert dog, xvitli
Phy ezCast most comIIIonlvl fouLnd in the lip region, interdigital 150, 728-730
clinical abhrorruualities liruited to the skin. Severe erytheria,
scaling and crustillg xere the iniguiIal area betwxeen
present in R. S. Mueller, Di -imedv iet,
thle prepuce anid the scrotiiiii bilaterally (Fig
1). The crusts DAipV( 1,
D A( Sc,
Nxxre super-ficial aind could be peelcd off, leaving eroded skin. S. V. Bettenay, B\ Sc,
Iipi-fessiori ssmears of the affected skin revealed a small FA( SASc,
iulliber- of yeast oigariisriis (Fig 2). Due to the shape of the M. Shipstone, BS\Sc,
oirariismiis, C liidlil inftection xxas suspected. Skin biopsies
and furugal ccrltucresxS ere obtairied. The foriiialin-fixed biopsy
l)iD(AiCVD, FA( SSc, Animiial
Skin1and Allergy ( linic
speciriieus xvere pr-occssed routiruely and stained \v ith hlaerua- 70 llackbLiri Road,
toxx liti arid cosiri. Histopathologically, a uild, iioiiorLuclear,
superficial derniuatitis xxwas presenlt. Epidcernial hyperkeratosis
Mlounit Waxverlem,
Victoria 3149, Auistralia
xwas iild, hLut riiarked pairakeratosis was riotcd xxvith focal
accuLruulationi ot ienLtrophils aind yeast orgarnismuns in the Dr MIlueller's anid
str-atuimi coriieuIiL (Fig 3). Yeasts xxTere groxxrn on Sabouraucd D)r Bettcnay's prescnt
dextrose agtar at 28°C arid specialted Cgilillieru?ioudii usinlg
/t 32C identification strips xe/ system; bioMerieux).
as
address is Dc)par-tiiienit of
The dog xxwas tr eated x\itlh ketocoruazole (Nizoral; Janssenl)
( liiiical Scicnces, Collcge
of Veterinariy Medicinic
at 10 Iiig/kg txxice clailsl aid shluaiipoc (Nlalaseb; )crmicarc)
a

conitainin, clilorhexidliie, iiicoriazole arid selerCiurLII sulplride

anid Biomiiediical Scienices,
Colorado State UtJiversity,
dcails, arid thle illgllirual ar-ca imurproxved drarmuatically wNithini 10
Fort C ollis, ( 0 80523,
dax s. At that tiriie, the owxxrier discontinued all riedicatioiis as
UtSA
the dog xvas not eatinig xxell. Txxo xxeeks later, the dog xxas re-
presenited cdue to the incoruuplete resolution of clinic al signs. Dr Shipstonie's prcsenlt
AlthouLIghl rio crosiOnS Or CrstiSlg wxere rioted, the area xNas still address is f)erriiatology
ruuildlx eryvtheliiatOLus. Acetate tapc pIreparatioruS revealed
for Aniniiials, 263 Applebl
Ouccasiorial OlrgaliiSIiS.
east Tr ketooriasole
eatriierit valid
xxith
FIG 2: Yeast organisms found cytologically in the affected Road, Stafford Heights,
the saiie stiaiipoo xxwas recoruimericed and conitinLled for six inguinal area of the Jack Russell terrier. Modified Wright QLcCIeslaind 4053,
xxcecks. At thic end of thils period there xwcre rio clinical sigils stain. x 1000 Acist ralia
728 728~~~~~~~~~~~~~~~~ The Veterinary Record, June 8, 2002
 Downloaded from veterinaryrecord.bmj.com on July 15, 2011 - Published by group.bmj.com
FIG 3: Yeast organisms in the stratum corneum of the skin
biopsy taken from the affected inguinal area of the Jack
Russell terrier. Haematoxylin and eosin. x 1000
skin, ear canals and anal mucosa of normal dogs (Plant and
others 1992, Kennis and others 1996). It may proliferate
extensively when normal physical, chemical or immuno-
logical mechanisms are disturbed, and is often secondary to
allergic, endocrine or keratinisation diseases (Plant and
others 1992). Erythema, alopecia and scaling or greasy
exudation are common clinical signs, and pruritus varies
from mild to severe (Scott and others 2001). Treatment
with topical antifungal agents containing selenium sulphide,
chlorhexidine and/or miconazole, as well as oral azoles,
has been shown to improve clinical signs and decrease
the numbers of cutaneous organisms (Bond and others
1995).
Candida species are normal inhabitants of the alimentary,
upper respiratory and genital mucosa of people and animals
(Rinaldi 1993). C albicans and C parapsilosis are the most
common isolations. These yeasts may cause opportunistic
infections of the skin or mucocutaneous areas. C guillier-
mondii has been isolated from human skin and the gastro-
intestinal and genitourinary tracts (Rinaldi 1993). It has been
reported to cause fungaemia in immunocompromised
patients (Mardani and others 2000), osteomyelitis (Tietz and
others 1999), vaginitis (Mendoza and others 1999), endo-
carditis in intravenous drug addicts, and infection in patients
undergoing surgical procedures (Bodey and others 1982).
C guilliermondii has also been implicated in the patho-
genesis of onychomycosis (Malka and others 1998) and
infertility in men (Nagy and Sutka 1992). In laboratory
animals such as mice and guinea pigs, C guilliermondii has
been reported to be non-pathogenic (Arras and others 1999),
although positive seroconversion was detected in mice which
had been infected orally with this organism (Ishihara and
others 1998). In horses, it has been isolated frequently from
cervical cultures (Gebert and others 1998) and has been
reported to cause chronic relapsing endometritis (Plagemann
and others 1991). Cows with reproductive problems had a
higher incidence of antibodies against C guilliermondii than
The Veterinary Record, June 8, 2002
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FIG 4: Inguinal area of the Jack Russell terrier of Fig 1, after
systemic and topical antifungal treatment
the overall population tested (Tainturier and others 1995).
The fungus was also isolated from milk samples from cows
with mastitis (Kuo and Chang 1993). Although C albicans and
C parapsilosis have been implicated in canine skin disease
(Kral and Uscavage 1960, Dale 1972, Holoymoen and others
1982, Bourdeau and others 1984, Pichler and others 1985), to
the authors' knowledge, no other Candida species have been
reported to cause dermatitis in the dog.
The clinical signs, cytological and histopathologic presence
of yeast organisms in the skin lesions and response to anti-
fungal therapy indicate the causative role of C guilliermondii
in the dermatitis of this Jack Russell terrier. However, two
possible aetiologies have to be considered. The fungal
infection after an initial clipper burn could have been the
initial cause of the dermatitis, which never responded to
antibacterial and anti-inflammatory therapy. Disruption of
the epidermal barrier by mechanical means and inflamma-
tion may allow contaminating Candida organisms to over-
come normal cutaneous defence mechanisms. Schwartzman
and others (1966) induced experimental candidiasis in dogs
by clipping the skin and subsequently saturating it with
felt strips soaked with C albicans. Alternatively, the antibac-
terial therapy could have predisposed the patient to yeast
infection of the surgery site. Antibiotic therapy has been
reported to be a predisposing factor in Malassezia infections
(Plant and others 1992).
Treatment of yeast infections commonly involves azoles.
In human medicine, one study suggested that Cguilliermondii
has a moderate sensitivity to fluconazole and ketoconazole
(Uchida and others 1994). In other studies, it was highly
susceptible to fluconazole, ketoconazole and itraconazole
(Pfaller and others 1998). Ketoconazole has been used in
veterinary medicine for treatment of dermatophytes
(Angarano and Scott 1987), Malassezia infection (Mason and
Evans 1991) and was recommended as the therapy of choice
for candidiasis (Moriello 1986). It is less costly than itra-
conazole, readily available and, thus, was the authors' first
729
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SHORT COMMUNICATIONS

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730 The Veterinary Record, June 8, 2002

 Downloaded from veterinaryrecord.bmj.com on July 15, 2011 - Published by group.bmj.com

Cutaneous candidiasis in a dog caused by

Candida guilliermondii
R. S. Mueller, S. V. Bettenay and M. Shipstone

Veterinary Record 2002 150: 728-730

doi: 10.1136/vr.150.23.728

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