This 3 year old M German Shepherd has a history of chronic active rhinitis, culture Mersa Staph pseud intermedius. Presented with moderate to severe epistaxis, painful around nose, weight loss
CBC/Chem: WBC 18,660, EOS 1570 on 6/30/16
This 3 year old M German Shepherd has a history of chronic active rhinitis, culture Mersa Staph pseud intermedius. Presented with moderate to severe epistaxis, painful around nose, weight loss
CBC/Chem: WBC 18,660, EOS 1570 on 6/30/16
CT of the head and thorax – Severe bilateral nasal turbinate lysis is noted throughout the nasal cavities as well as focal lysis and deviation of the nasal septum. Multifocal miniscule permeative lysis of the nasal bones is seen as well as thickening of the mucosal lining of the remaining turbinates and nasal bones. Both frontal
sinuses present irregular mucosal thickening. An osteolytic defect within the internal lamina of the left frontal sinus creates an open connection with the cranial fossa even though the cribriform plate is intact. Pockets of air are trapped withih the epidural space of the cranial fossa dorsal to the left cerebral hemisphere and create a mass effect onto the convexity of the cerebrum level with the occipital and parietal lobe. Increase of nasal secretions is noted. The nasal fundus and the nasopharynx are obstructed. The submandibular and medial retropharyngeal lymph nodes present moderate enlargement with maintained short-to-long-axis ratio but non-uniform contrast enhancement. The computed tomography of the thorax is within normal limits. The pulmonary interstitium and mediastinal lymph nodes are negative for metastatic spread.
This is consistent with fungel rhinitis – most likely Aspergillus – even though the cultures were negative.
Unfortunately treatment options – such as a combination of local treatment after trepanation and systemic antifungal treatment (which ist he most promising therapy currently known) – are precluded owing to the involvement oft he cranial fossa.
The prognosis is guarded to poor.
