Case of the week 9.21.20
Publication Date: 2020-09-18
History
6 year old miniature Schnauzer, wheezing, tachypnea 4 weeks ago which resolved, repeat event 2 days ago.
3 images
Findings
Study: Opposite lateral and VD radiographs of the thorax are available for interpretation.
Findings: There is a marked, diffuse bronchial and interstitial pattern tending towards a reticular pattern with severe peribronchial cuffing. The cardiac silhouette is normal. The pulmonary vasculature is largely obscured. The mediastinum and pleural space are normal. There are a few, non-obstructive, incidental mineral opaque foci in the stomach.
Diagnosis
Marked pulmonary pattern is most consistent with lower airway disease of infectious (such as bacterial, fungal, or parasitic) or non-infectious (such as allergic) etiology. A neoplastic etiology, such as lymphoma or schirrhous carcinoma, cannot be entirely excluded.
Discussion
The patient underwent a transtracheal wash and the fluid sample was most suggestive of a fungal infection such as blastomycosis infection. The patient has been started on antifugi therapy.
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