Cryptococcosis in a cat seropositive for feline immunodeficiency virus

A 5-year-old female Siamese cat was presented to the veterinary teaching hospital with a history of bronchopneumonia for 20 days. The cat had not responded to antibacterial chemotherapy and had developed a pronounced submandibular lymphadenopathy. Characteristically encapsulated yeast cells with narrow-necked buds were clearly seen in a fine-needle aspirate of the lymph node with an India ink preparation. Cryptococcus neoformans var. neoformans was identified. Susceptibility tests on the isolated strain were performed using antifungal tablets. The strain was sensitive to amphotericin B, fluconazole, itraconazole and ketoconazole and was resistant to 5-fluorocytosine. The cat was positive for feline immunodeficiency virus. Nevertheless, the cat was treated with ketoconazole for 3 months and apparently recovered. Three months later the animal was presented in a precomatose state. The owners refused to treat the animal and the cat was destroyed.