Todays case is a 7-year-old female neutered Labrador Retriever with 1-month history of coughing 3-4 times per day and a fever. Low oxygen saturation, unresponsive to antibiotics and Ketoconazole. What are your top differential diagnoses?
Findings
There is a marked increase in soft tissue opacity dorsal to the cardiac silhouette, and ventral to the trachea on the lateral projections. These masses are causing ventral deviation of the main stem bronchi and dorsal deviation of the trachea, as well as splaying and narrowing of the lumen of the mainstem bronchi and widening of the cranial mediastinum on the d/v projections. There is additional pulmonary infiltrate radiating from the central masses to the periphery of the lungs along the airways. The cardiac silhouette is normal in size and shape.
Differential Diagnosis
The primary differential diagnosis is granulomatous changes secondary to fungal infection. Lymphoma or other round cell neoplasia is less likely. Lesion sampling and serology are recommended.
Diagnosis
Disseminated fungal infection. Based on morphology, the fungus was Aspergillus sp. or a Zygomycete.