Rare Fungal Threat: First Report of Cladophialophora bantiana Causing Myelopathy in Dogs and Cats

Myelopathy caused by Cladophialophora bantiana in a dog and a cat

L. McLeay, P. Kenny, G. Child, S.L. Donahoe, E. Jenkins, A. Taylor, A. Lam, P. Martin, M. Krockenberger

Background
Cladophialophora bantiana is a neurotropic dematiaceous fungus that commonly causes cerebral phaeohyphomycosis in both humans and animals. While CNS involvement has been documented, this report presents the first known cases of spinal cord dysfunction (myelopathy) attributed to C. bantiana in a dog and a cat. The report aims to describe the clinical, imaging, pathological, and diagnostic findings associated with these two unique cases.

Methods
Two clinical cases were examined: Case 1 involved a 10-month-old Cavalier King Charles Spaniel with acute tetraparesis, and Case 2 involved a 4-year-old domestic short hair cat with paraparesis. Diagnostic investigations included neurological exams, MRI (dog), CSF analysis, urinalysis (cat), and post-mortem histopathology. Identification of the fungal pathogen was confirmed through panfungal PCR and sequencing of lesion tissues or fungal cultures.

Results
In Case 1, MRI revealed an intramedullary lesion in the cervical spinal cord with marked ring enhancement and surrounding edema. Despite empirical antibiotic and corticosteroid therapy, the dog's condition deteriorated, leading to euthanasia. Histopathology identified a pyogranulomatous myelitis with fungal elements, and PCR confirmed C. bantiana. In Case 2, the cat displayed thoracolumbar myelopathy with systemic signs. Post-mortem revealed vertebral osteomyelitis compressing the spinal cord and disseminated fungal lesions in multiple organs. Fungal hyphae were observed in urine and tissues, and PCR of the cultured organism confirmed C. bantiana.

Limitations
The primary limitation was the incomplete post-mortem examination in Case 1, which restricted the assessment of systemic involvement. Neither case could be definitively diagnosed ante-mortem due to the absence of reliable non-invasive diagnostic tools for C. bantiana and the high risk associated with surgical biopsy of CNS lesions.

Conclusions
These cases demonstrate that C. bantiana can cause spinal cord dysfunction in both immunocompetent dogs and cats, either via primary myelitis or vertebral osteomyelitis with secondary cord compression. Ante-mortem diagnosis remains challenging; however, tissue biopsy and molecular diagnostics are essential for confirmation. Clinicians should include C. bantiana in differential diagnoses for granulomatous or abscess-like CNS lesions, and systemic investigation, including urinalysis, may aid in detecting disseminated fungal infections.

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