Presentation
Presents with lethargy and inappetance.
Patient Data
In the thorax, there is a diffuse mixed pulmonary pattern with miliary nodular and bronchial components. There are also alveolar infiltrates in the ventral portion of the left cranial lung lobes, best noted on the left lateral projection. There is ill-defined soft tissue opacity dorsal to the carina which may represent lymphadenopathy. Within the abdomen, the liver is enlarged causing focal poor peritoneal detail.
Case Discussion
Disseminated coccidioidomycosis was suspected based on the nodular pulmonary pattern, possible thoracic lymphadenopathy and multi-organ involvement. Other differentials could include primary pulmonary neoplasia and metastatic disease. The ventral distribution of the alveolar component may indicate an additional secondary bacterial pneumonia.
This dog had a positive titer for coccidioidomycosis. A bronchoalveolar lavage confirmed septic inflammation in the lungs. The hepatomegaly was presumed to be due to disseminated fungal infection.
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