Chang-Hyeon Choi, Keon Kim, Chang-Yun Je, Kwang-Jun Lee, Woong-Bin Ro, Chang-Min Lee

Background

Cryptococcus neoformans is a yeast-like fungus commonly infecting immunocompromised hosts, with cats being particularly susceptible. Infection typically begins in the nasal cavity following inhalation of fungal spores and may disseminate systemically. Feline cryptococcosis usually manifests as nasal or neurological disease, but systemic lymphadenopathy without respiratory signs is exceedingly rare. Such atypical cases can closely mimic neoplastic diseases like lymphoma, complicating diagnosis.

Methods

A 7-year-old castrated male Persian cat presented with multiple cutaneous nodules and generalized lymphadenopathy. Diagnostic evaluations included physical examination, bloodwork, imaging (radiography and ultrasonography), ocular ultrasound, and fine needle aspiration (FNA) of affected lymph nodes. Cytology, culture, and serological tests for common feline infectious diseases (FeLV, FIV, FIP, and others) were performed to determine the underlying cause.

Results

Initial findings revealed hyperglobulinemia, low hematocrit, and medium-to-large lymphoid cells in peripheral blood. Imaging demonstrated widespread lymphadenopathy and retinal detachment without respiratory involvement. Cytological examination of lymph nodes identified encapsulated yeast-like organisms, and fungal culture confirmed C. neoformans. The cat was initially treated with itraconazole, later replaced by fluconazole due to its superior central nervous system penetration. Lymph node swelling improved within a week, but long-term follow-up was not possible due to owner constraints.

Limitations

Follow-up was discontinued early, preventing evaluation of long-term prognosis. Differential diagnoses such as lymphoma and feline infectious peritonitis were not completely excluded. Furthermore, due to quarantine regulations, fungal isolates could not be released for PCR-based serotyping.

Conclusions

This case underscores the diagnostic challenges of systemic cryptococcosis with atypical manifestations, particularly in the absence of respiratory or neurological signs. It emphasizes the necessity of including fungal infections in the differential diagnosis of lymphadenopathy in cats. Culture confirmation remains essential for diagnosis, and comprehensive diagnostic workups are crucial for distinguishing infectious from neoplastic processes.Disclaimer: The summary generated in this email was created by an AI large language model. Therefore errors may occur. Reading the article is the best way to understand the scholarly work. The figure presented here remains the property of the publisher or author and subject to the applicable copyright agreement. It is reproduced here as an educational work. If you have any questions or concerns about the work presented here, reply to this email.