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INFECTIOUS meningoencephalitis affecting companion animals is rare in the UK, with fungal infection particularly uncommon (Duchene and others 2010). Distinguishing such diseases from the more common sterile inflammatory disorders of the brain, such as granulomatous meningoencephalitis, is critical, as treatment of the latter depends on immunosuppression. This short communication describes a case of cryptococcal meningoencephalitis, emphasising that unusual infections can occur in the UK and that accurate diagnosis is possible by adopting a logical approach to such cases.
A five-year-old intact male English springer spaniel was presented for investigation of acute onset blindness, depression and ataxia. The problem had started 10 days previously with depression, inappetence and reluctance to walk; three days later the dog was also severely ataxic and appeared blind. Ophthalmological examination showed bilateral chorioretinitis but there was no response to treatment with dexamethasone (Dexadreson; Intervet), clindamycin (Antirobe; Pfizer), cefuroxime (Zinacef; GlaxoSmithKline) and supportive care.
On presentation to the neurology service at the Small Animal Teaching Hospital, University of Liverpool, a general clinical examination was unremarkable apart from severe bilateral otitis externa. Neurological examination showed the dog to be severely obtunded but rousable. The dog was tetraparetic, with impaired postural responses in all four limbs, particularly the pelvic limbs; segmental spinal reflexes were impaired in the pelvic limbs but intact in the thoracic limbs. Examination of the cranial nerves showed a left-sided head tilt and a horizontal nystagmus with the slow phase towards the right. There was bilateral mydriasis and the pupillary light reflexes and menace responses were absent; ocular examination revealed chorioretinitis. These findings indicated …