Clinical features, MRI findings, cytopathology and outcome of a dog with cryptococcosis with central nervous system involvement in the Netherlands

Abstract

A 2‐year‐old, female, spayed Cocker Spaniel–Poodle mix presented with neurological signs that started with vocalising, tremors, low head carriage and lethargy, and progressed to decreased mentation, non‐ambulatory tetraparesis and epileptic seizures. Magnetic resonance imaging of the neurocranium revealed bilateral, multifocal, ill‐defined, intra‐axial hyperintensities on T2‐weighted images, with an asymmetric distribution. Post‐contrast enhancement of the meninges was observed. These findings were indicative of meningoencephalitis, and treatment with corticosteroids and clindamycin was started with initial clinical improvement. After 36 hours, the patient experienced significant clinical deterioration, including a generalised epileptic seizure, followed by cardiopulmonary arrest. Cerebrospinal fluid, collected before death but analysed postmortem, showed increased protein and leukocyte counts, with the presence of eosinophilic inflammation and yeasts consistent with Cryptococcus spp. Though rare in this area, clinicians should be aware that cryptococcal meningoencephalitis is a possible differential diagnosis for dogs presenting with progressive central nervous system signs in Western Europe.