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Deep Fungal Infection of the Skin with Two Rare Fungi in a Dog Being Treated with Immunosuppressant Therapy: A Case Report

Summary

An 8-year-old dog receiving long-term immunosuppressive medication for brain inflammation developed rare fungal skin infections caused by two unusual fungi not previously reported together in veterinary medicine. Diagnosis required multiple tests including tissue samples, staining techniques, and genetic testing. Despite treatment with antifungal medications and careful adjustment of immunosuppressive drugs, the infections did not improve, highlighting the difficult balance between fighting infections and controlling the underlying immune disease.

Background

Dogs treated with immunosuppressive therapy for meningoencephalitis of unknown origin (MUO) using combinations of prednisolone and ciclosporin are at increased risk for opportunistic fungal infections. Secondary fungal infections have been documented in immunocompromised dogs, but co-infections with multiple rare fungal species remain uncommon.

Objective

To describe the clinical presentation, diagnostic findings, and management of a rare case of concurrent deep fungal skin infection with two different opportunistic fungi in an immunosuppressed dog, and to highlight the therapeutic challenges of treating secondary fungal infections while maintaining immunosuppression for underlying autoimmune disease.

Results

Purpureocillium sodanum was identified in tail lesions and Alternaria rosae in nasal lesions. This represents the first documented co-infection with these two specific fungi in veterinary medicine. Susceptibility testing revealed amphotericin B resistance in P. sodanum and variable azole susceptibility in both species. Despite systemic itraconazole therapy and topical antifungals with ciclosporin dose reduction, fungal lesions did not regress.

Conclusion

Secondary deep cutaneous fungal infections pose significant therapeutic challenges in immunocompromised dogs. This case emphasizes the need for surveillance of high-risk patients, early diagnosis through combined diagnostic approaches, targeted antifungal therapy based on susceptibility testing, and carefully individualized immunosuppressive medication adjustment to optimize outcomes while controlling underlying disease.
  • Published in:Veterinary Sciences,
  • Study Type:Case Report,
  • Source: PMID: 41150098, DOI: 10.3390/vetsci12100958
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