Feline XXXX : impact of current research on clinical management.

@entity1 @entity137 @entity66 @entity3217 @entity2379 @entity1327 @entity4895 @entity14851 @entity1328 @entity468 @entity5638
DISEASE SUMMARY: @entity1328 , principally caused by @entity1327 and @entity14851 , is the most common systemic @entity3217 of @entity468 worldwide. @entity468 may be infected following inhalation of spores from the environment, with the nasal cavity suspected as being the initial site of colonization and subsequent infection. Other sites of infection in @entity468 are the skin, lungs, lymph nodes, central nervous system (CNS), eyes and, occasionally, periarticular connective tissue. @entity1328 can be diagnosed using serology (antigen testing), cytologic examination of smears, histopathology or culture. Treatment of @entity66 is generally successful using @entity5638 antifungal drugs; however, @entity468 with CNS involvement or disseminated disease require additional treatment with @entity2379 , with or without @entity4895 . The prognosis is variable, depending on host and pathogen factors. Some @entity468 require long-term (>1 year) treatment or indefinite therapy. @entity1 GROUP: @entity468 of any breed, gender and age may be affected. Retroviral status does not appear to be a risk factor for developing @entity1328 and indoor @entity468 are not protected from disease. GLOBAL IMPORTANCE: Feline @entity1328 occurs worldwide, but is most frequently reported in Australia, western Canada and the western United States. Species and molecular type vary in different geographical regions and may affect clinical presentation and antifungal susceptibility patterns. CLINICAL CHALLENGES: Serologic tests that detect cryptococcal antigen in serum are sensitive and specific, but false negatives can occur in @entity468 with @entity66 . Long-term drug therapy can be expensive and has the potential for @entity137 . The extent to which the pathogenicity and antifungal susceptibility is affected by molecular type is currently under study. EVIDENCE BASE: This review draws on recent literature relating to epidemiology, CNS involvement and advanced diagnostic imaging to update clinicians regarding research findings relevant to clinical practice.
