Aspectos tomográficos, ultrassonográficos e tratamento de criptococcose intestinal em um canino

• Autor(a) principal: Souza, Jéssica Ávila de
• Data de Publicação: 2020
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Biblioteca Digital de Monografias da UFMT
• Texto Completo: http://bdm.ufmt.br/handle/1/3446
• topic: CNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIA; Tomografia; Ultrassonografia; Criptococcose; Itraconazol; Tomography; Ultrasonography; Cryptococcosis; Itraconazole

The cryptococcosis is a worldwide disease, caused by the fungal genera Cryptococcus. Its main way of infection is by respiratory exposure, however, the dissemination to blood, skin, bone, brain, and other body parts can rarely occur by the ingestion of these organisms. Although the gastrointestinal form is uncommon, it has been increasingly described. The purpose of this work is to describe the ultrasonographic and tomographic aspects of the intestinal cryptococcosis in a canine, with the intention to contribute to the differentiation of other focal enteric changes that tackle the species. Case: A female canine of the Rottweiler breed, one year old, weighing on average 25 kg and from a farm environment, was transported to the Veterinary Hospital of Universidade Federal do Mato Grosso in order to perform a computed tomography of the abdominal region. The animal presented a progressive weight loss, interspersed chronicle diarrhea with pasty feces and preserved appetite. In the physical examination, it had abdominal pain during the palpation of the right side in the medial abdominal region. In the ultrasonographic examination, it was evidenced a focal thickening in the small intestine wall, a reduction in the parietal stratification, a heterogeneous echotexture, and a hypoechoic echogenicity with a discrete quantity of an adjacent free liquid. In the tomographic evaluation, it was verified a mass of approximate 10 cm in the ventral medial abdomen in the small intestine, with rounded aspect in the cranial portion, density of 36 HU with post contrast enhancement. There was gas and hyperdense foreign body in the lumen, small intestinal loops with intense dilation that were filled with liquid and gas content, and with discrete quantity of adjacent free liquid. Based on the image results, the patient was submitted to an enterectomy and it was requested a histopathology of the affected area in the small intestine. The intestinal wall had a lesion with soft and irregular aspects and white coloration, and lumen with at least two foreign bodies. The microscopical evaluation identified a diffuse thickening of layers with macrophages, neutrophils and lymphocytes infiltration, besides an extensive necrosis of mucosa and submucosa that were interspersed with inflammation, presence of irregular or rounded extracellular structures, not colored by the hematoxylin and eosin technique, with thin and birefringent walls, and with budding areas, surrounded by a capsule, similar to Cryptococcus spp. The patient had hospital discharge with medical prescription of Tramadol, Dipyrone and Giardicid® for 30 days. After the biopsy result, it was added the administration of Itraconazole for 60 days, and corticoid for 20 days. Although evaluations were not performed for monitoring the patient, clinical changes were not evidenced during one year after the surgical procedure. Discussion: The clinical picture of the animal was characterized by a progressive weight loss, emesis and sporadic diarrhea and was little specific. However, the differential diagnose of the infection by cryptococcosis can be considered when associated to ultrasonographic and tomographic results, which evidenced the circumferential thickening of a portion of the small intestine with formation of an adjacent mass, retention of intestinal content and presence of free liquid, once they coincided with ultrasonographic images observed in other studies with canines. On the other hand, tomographic alterations could not be compared due to the lack of information about this illness in animals and humans. Thus, as in other studies, the surgery excision associated to the prolonged use of Itraconazole showed to be efficient in the treatment of this disease.