Section: Veterinary Care In-depth
Veterinary care should include diagnostic tests and subsequent treatment recommendations. Diagnostic tests are needed to identify cryptococcosis and exclude other diseases that may cause similar symptoms. Tests may include:
A complete medical history and physical examination including neurologic and ophthalmologic (eye) examinations
A complete blood count (CBC or hemogram)
A serum biochemical profile
Bile acid determinations to evaluate liver function
Urinalysis
Fecal examination
The need for additional diagnostic tests will be determined based on the results of the medical history, physical examination and initial laboratory tests:
Blood lead determination if lead poisoning is suspected
Cerebrospinal fluid analysis
Computerized tomography (CT), which is a radiographic imaging test to evaluate the nervous system tissues
Magnetic resonance imaging (MRI), which is a sophisticated computer process that produces highly detailed images of cross-sections of the body without radiation exposure
Your veterinarian may recommend additional diagnostic tests based on the results of initial examinations. These tests may help diagnose other concurrent medical problems or allow your veterinarian to understand the impact of the underlying disease on your pet. Such tests insure optimal medical care and are selected on a case-by-case basis.
Latex agglutination test may be performed either on serum or cerebrospinal fluid to detect the capsule antigen of Cryptococcus neoformans. False negative results may occur due to localized infection and false positive results may occur due to contamination of the specimen with talc from latex gloves used during cerebrospinal fluid collection. The latex agglutination test is correlated with disease severity. Animals with disseminated skin or lymph node involvement have higher titers than those that do not. Generally, the titer decreases by two- to four-fold per month during successful therapy.
Antibodies against Cryptococcus neoformans also can be measured. Most affected animals (over 80 percent) have high antibody titers at the time of diagnosis. Antibody titers in these patients remain high or decrease slowly after treatment.
Microscopic examination of exudates from the nasal cavity or skin nodules often allows identification of the organism.
Microscopic examination of a biopsy specimen by a veterinary pathologist also allows identification of the organism and the characteristic "pyogranulomatous" inflammation. Organisms usually are present in large numbers.
The organism can be isolated and identified in culture using exudate or tissue samples. The cultures are not hazardous because the cultured organisms do not aerosolize.
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