The patient, a 2-year-old castrated male German Shorthaired Pointer, initially presented to the Cornell University Hospital for Animals’ Emergency Service on 9/24/14 with a two-day history of vomiting, lethargy, and inappetance. The only abnormality detected on physical exam was a slight tackiness of the mucous membranes. Abdominal radiographs and point-of-care diagnostic testing were unremarkable. Hospitalization was declined, thus the patient was treated with subcutaneous fluids and an antiemetic and discharged with antibiotics and a gastroprotectant.

Due to lack of improvement, the patient presented to a local emergency clinic on 9/27/14 and was found to be febrile, dehydrated, and tachycardic. Pain was elicited on lateral flexion of the neck. Outpatient care was elected and the patient was discharged on antibiotics after receiving subcutaneous fluids and an injection of dexamethasone SP. The following day, the patient developed hemorrhagic diarrhea and returned to the local emergency service for evaluation. Physical examination revealed dehydration, neck pain, and mild to moderate peripheral lymphadenomegaly. Bloodwork revealed an inflammatory leukogram, mild hyperglobulinemia, elevated alkaline phosphatase, elevated amylase, and elevated lipase. Clotting times were normal, urinalysis was unremarkable, and a 4DX Snap test was negative. The patient was hospitalized overnight on antibiotics, gastroprotectants, intravenous fluids and an analgesic. Lack of improvement prompted referral to Cornell for further evaluation.

On presentation to the Cornell University Hospital for Animals’ Emergency Service, the patient was febrile and moderate pain was elicited on palpation of the cervical, thoracic, and lumbar spine. The mandibular and prescapular lymph nodes were enlarged. Based on the history and clinical findings, the patient’s problem list included the following: vomiting, diarrhea, coughing, fever, diffuse spinal pain, and peripheral lymphadenomegaly. The patient was transferred to the Neurology Service for further workup. Thoracic radiographs revealed a diffuse bronchial pattern and a caudodorsal interstitial lung pattern. Hemogram revealed mild non-regenerative anemia and neutrophilia with a left shift. Urinalysis revealed significant proteinuria, and cerebrospinal fluid cytology revealed mixed cell pleocytosis with a slight predominance of neutrophils. Fungal serology revealed detectable Cryptococcus antigen at a final serum dilution of 1:128. The patient was presumptively diagnosed with systemic cryptococcosis and began treatment with fluconazole. This case report will highlight the key features of canine cryptococcosis.