Gastric ulceration associated with Nakaseomyces glabrata (formerly Candida glabrata) in a cat with Feline Infectious Peritonitis (FIP)

Authors: Pritchard E, Soh R, Chau J, Roser M
Publication: Australian Veterinary Practitioner, Volume 54, Issue 1, pp 16-30, Mar 2024
Publisher: Australian Veterinary Association

Animal type: Cat
Article class: Clinical Article

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Abstract:

This report outlines the first reported case of gastric ulceration and sepsis associated with Nakaseomyces glabrata (formerly Candida glabrata), toxoplasmosis, and Enterococcus faecium in a cat with feline infectious peritonitis (FIP). A five-year-old castrated domestic shorthaired cat presented with pyrexia, anaemia, hyperglobulinaemia, hyperbilirubinaemia and abdominal effusion. Abdominocentesis identified a high protein transudate and coronavirus confirmed on RT-qPCR testing. Toxoplasma serology was positive for IgG and IGM. The cat was treated with clindamycin, remdesivir and low-dose dexamethasone. After initial improvement, on day eight the cat developed signs of sepsis and free abdominal gas was found on radiographs and using ultrasound. At exploratory laparotomy, a perforating gastric ulcer was surgically resected. Cytology, histopathology and culture of the peritoneal effusion identified yeasts and cocci cultured as Enterococcus faecium and Nakaseomyces glabrata. The cat was treated with chloramphenicol, fluconazole, and subsequently posaconazole. Following a second acute decline and exploratory laparotomy to remove new perforating gastric lesions, the cat deteriorated and died. Antiviral medications have enabled successful treatment of most cases of FIP, although the role of co-morbidities in cats refractory to treatment is not yet well understood. Systemic candidiasis is rarely reported in cats, but in humans is found with immunocompromise, human immunodeficiency virus and diabetes mellitus. Gastrointestinal Nakaseomyces glabrata is associated with oesophageal and gastric ulceration, has high mortality and inherent antifungal resistance. Systemic fungal infection and toxoplasmosis should be considered as potential comorbidities in cats with FIP. Immunologic changes seen with FIP may increase the risk of systemic yeast infections.

Keywords: Nakaseomyces glabrata, FIP, gastric ulcer, Candida glabrata

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