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Utility of antigen testing for the diagnosis of ocular histoplasmosis in four cats: a case series and literature review.
J Feline Med Surg. 2017 Oct; 19(10):1110-1118.JF

Abstract

Case series summary This case series describes the clinical utility of antigen testing for the diagnosis of feline ocular histoplasmosis. Four cats with suspected (n = 2) or confirmed (n = 2) ocular histoplasmosis are described: three from Oklahoma and one from California. In one case, serial urine antigen tests, as well as a serum antigen test for Histoplasma capsulatum, were negative; however, light microscopy identified microorganisms consistent with H capsulatum in ocular tissues at necropsy. In a further two cats with recurrent ocular histoplasmosis following long-term systemic antifungal therapy, Histoplasma species urine antigen concentrations were negative, but both cats improved clinically following systemic antifungal therapy and remained in apparent clinical remission after treatment cessation (9-16 months). The final cat displayed profound bilateral endophthalmitis; however, Histoplasma species antigen testing of vitreous humor and subretinal fluid from the left eye was negative. Intralesional organisms were detected on histopathology of both eyes, and H capsulatum was subsequently isolated and sequenced from tissue of one eye. Relevance and novel information These cases highlight the potential difficulty in definitively diagnosing ocular histoplasmosis in cats when conducting antigen testing of serum, urine and even ocular fluids. Although antigen testing has previously proven useful in the diagnosis of disseminated feline histoplasmosis, it may not be adequate in cats with only ocular signs.

Authors+Show Affiliations

1 Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA.2 Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA. Current address: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.1 Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA.3 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA. Current address: Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.4 Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA.4 Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA.4 Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA.5 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA.6 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27527560

Citation

Smith, Kathryn M., et al. "Utility of Antigen Testing for the Diagnosis of Ocular Histoplasmosis in Four Cats: a Case Series and Literature Review." Journal of Feline Medicine and Surgery, vol. 19, no. 10, 2017, pp. 1110-1118.
Smith KM, Strom AR, Gilmour MA, et al. Utility of antigen testing for the diagnosis of ocular histoplasmosis in four cats: a case series and literature review. J Feline Med Surg. 2017;19(10):1110-1118.
Smith, K. M., Strom, A. R., Gilmour, M. A., LaDouceur, E., Reilly, C. M., Byrne, B. A., Affolter, V. K., Sykes, J. E., & Maggs, D. J. (2017). Utility of antigen testing for the diagnosis of ocular histoplasmosis in four cats: a case series and literature review. Journal of Feline Medicine and Surgery, 19(10), 1110-1118. https://doi.org/10.1177/1098612X16662310
Smith KM, et al. Utility of Antigen Testing for the Diagnosis of Ocular Histoplasmosis in Four Cats: a Case Series and Literature Review. J Feline Med Surg. 2017;19(10):1110-1118. PubMed PMID: 27527560.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of antigen testing for the diagnosis of ocular histoplasmosis in four cats: a case series and literature review. AU - Smith,Kathryn M, AU - Strom,Ann R, AU - Gilmour,Margi A, AU - LaDouceur,Elise, AU - Reilly,Christopher M, AU - Byrne,Barbara A, AU - Affolter,Verena K, AU - Sykes,Jane E, AU - Maggs,David J, Y1 - 2016/08/15/ PY - 2016/8/17/pubmed PY - 2017/11/3/medline PY - 2016/8/17/entrez SP - 1110 EP - 1118 JF - Journal of feline medicine and surgery JO - J Feline Med Surg VL - 19 IS - 10 N2 - Case series summary This case series describes the clinical utility of antigen testing for the diagnosis of feline ocular histoplasmosis. Four cats with suspected (n = 2) or confirmed (n = 2) ocular histoplasmosis are described: three from Oklahoma and one from California. In one case, serial urine antigen tests, as well as a serum antigen test for Histoplasma capsulatum, were negative; however, light microscopy identified microorganisms consistent with H capsulatum in ocular tissues at necropsy. In a further two cats with recurrent ocular histoplasmosis following long-term systemic antifungal therapy, Histoplasma species urine antigen concentrations were negative, but both cats improved clinically following systemic antifungal therapy and remained in apparent clinical remission after treatment cessation (9-16 months). The final cat displayed profound bilateral endophthalmitis; however, Histoplasma species antigen testing of vitreous humor and subretinal fluid from the left eye was negative. Intralesional organisms were detected on histopathology of both eyes, and H capsulatum was subsequently isolated and sequenced from tissue of one eye. Relevance and novel information These cases highlight the potential difficulty in definitively diagnosing ocular histoplasmosis in cats when conducting antigen testing of serum, urine and even ocular fluids. Although antigen testing has previously proven useful in the diagnosis of disseminated feline histoplasmosis, it may not be adequate in cats with only ocular signs. SN - 1532-2750 UR - https://www.unboundmedicine.com/medline/citation/27527560/Utility_of_antigen_testing_for_the_diagnosis_of_ocular_histoplasmosis_in_four_cats:_a_case_series_and_literature_review_ L2 - https://journals.sagepub.com/doi/10.1177/1098612X16662310?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -