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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

A dog being treated for brain inflammation with immune-suppressing drugs developed a serious skin infection caused by two unusual fungi not previously reported together in veterinary medicine. The infection proved difficult to diagnose, requiring tissue samples and specialized laboratory testing to identify the fungi and determine which antifungal drugs would work best. Despite treatment with antifungal medications and reducing the immunosuppressive drugs, the infection did not improve and the dog’s underlying condition worsened, ultimately requiring euthanasia. This case shows the serious risks of fungal infections in animals on long-term immunosuppressive therapy and highlights the need for careful monitoring and early detection.

Background

An 8-year-old female Elo dog was diagnosed with meningoencephalitis of unknown origin (MUO) and treated with long-term immunosuppressive therapy using prednisolone and ciclosporin. After 48 weeks of therapy, the dog developed skin lesions on the tail and nasal cavity. This case represents the first veterinary report of a mixed deep fungal skin infection with two different rare fungi.

Objective

To describe the clinical presentation, diagnosis, and outcome of a dog with concurrent deep fungal infection caused by two rare fungi: Purpureocillium sodanum and Alternaria rosae. The case aims to highlight diagnostic challenges and therapeutic management in immunocompromised patients.

Results

Purpureocillium sodanum was identified in tail lesions with high resistance to amphotericin B but susceptibility to posaconazole and voriconazole. Alternaria rosae was found in nasal lesions with best susceptibility to posaconazole. Despite systemic itraconazole therapy and topical antifungal treatment combined with a 50% reduction in ciclosporin dose, fungal lesions did not regress. The underlying neurological condition worsened despite increased prednisolone dosing.

Conclusion

This case highlights the significant therapeutic challenges of treating secondary fungal infections in immunocompromised dogs while maintaining control of autoimmune disease. The report emphasizes the need for regular dermatological monitoring, early diagnosis, individualized immunosuppressive protocols, and multidisciplinary collaboration. Better surveillance and intervention strategies are needed to improve outcomes in patients on long-term combination immunosuppressive therapy.
  • Published in:Veterinary Sciences,
  • Study Type:Case Report,
  • Source: PMID: 41150098, DOI: 10.3390/vetsci12100958
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