A three-year-old, spayed female, Belgian Malinois from southwestern Alabama was presented to our referral hospital for a 75-day history of progressively lichenified, mildly ulcerated lesions on the left front limb. Histopathology and fungal culture revealed Pythium insidiosum. The limb was amputated and the patient was treated with itraconazole 8.8 mg/kg oral once daily and terbinafine 33 mg/kg oral once daily. Cutaneous vasculitis occurred on day 28 of treatment, which may have constituted either a fixed drug eruption or an immune complex reaction to infection or immunotherapy. The skin lesions were mild and completely excised, so drugs were continued for three-and-a-half months total with no other adverse reactions. At 12 months after presentation, the patient is currently disease-free with no signs of pythiosis recurrence.
- Infectious diseases
- Fungal diseases
- Clinical practice
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