A 1.5-year-old male castrated French Mastiff was presented with a 1.5 month history of non-pruritic cutaneous lesions on the face, trunk, hind limbs, paws and penis. Skin lesions appeared following a driving trip along the eastern seaboard. Initial lumbar nodules became ulcerative, erupting multifocally. Treatment with antibiotics had no effect.
On presentation, he was febrile (104.2 F), with diffuse cutaneous lesions and popliteal lymphadenopathy. Thoracic radiographs demonstrated a poorly defined soft tissue nodule and mild interstitial pulmonary pattern. Abdominal ultrasound disclosed mild focal thickening in the colon with jejunal and medial iliac lymphadenopathy.
Fine needle aspirates, impression smears and biopsies of cutaneous lesions and lymph nodes demonstrated round yeast organisms with thick refractile cell walls and broad-based budding morphology. These were integrated within marked pyogranulomatous inflammation.
Urine antigen testing and fungal cultures identified Blastomyces dermatitidis. The patient was prescribed itraconazole. Sequential reassessment physical examinations chronicled healing cutaneous lesions and overall improved systemic health.