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      First autochthonous case of clinical Hepatozoon felis infection in a domestic cat in Central Europe

      case-report

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          Abstract

          Three different Hepatozoon (Apicomplexa, Hepatozoidae) species have been described infecting domestic cats in Europe (i.e. H. felis, H. canis and H. silvestris), however, reports on clinical hepatozoonosis are uncommon and treatment protocols are not clearly defined.

          A six-year-old male European short-hair cat from Austria presented poor general condition, lethargy, anorexia, icterus, a painful abdomen, fever, ruffled hair and a tick infestation, and it had never left Austria. Laboratory tests revealed leukopenia, thrombocytopenia and increased serum levels of symmetric dimethylarginine (SDMA) and bilirubin. In May Grünwald-Giemsa-stained blood smears, structures resembling Hepatozoon gamonts were observed inside neutrophil granulocytes. A PCR targeting a fragment of the 18S rRNA gene of Hepatozoon spp. and DNA sequencing allowed the diagnosis of H. felis-DNA in blood samples. The cat was treated with imidocarb dipropionate (6 mg/kg body weight, repeated after 14 days) and doxycycline monohydrate (5 mg/kg body weight twice a day, p.o., for four weeks) and recovered completely. A broad haematological and biochemical laboratory control after six months showed all evaluated parameters under normal ranges. Coinfection with other feline pathogens (i.e. feline leukaemia virus, feline immunodeficiency virus, feline Coronavirus, Leishmania and Dirofilaria immitis) could not be detected .

          This study reveals the presence of H. felis in Austria and provides more evidence on the geographical distribution and pathogenicity of this parasite for domestic cats. To the authors' knowledge, this is the first autochthonous case of feline hepatozoonosis in Central Europe.

          Graphical abstract

          Highlights

          • Clinical Hepatozoon felis infection in a domestic cat was diagnosed in Austria.

          • The diagnosis was achieved by microscopy of blood smears, PCR and DNA-sequencing.

          • Possible coinfections with other feline pathogens were ruled-out .

          • The cat recovered completely after treatment with imidocarb and doxycycline.

          • This represents the first autochthonous case of feline hepatozoonosis in Central Europe.

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          Most cited references41

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          The genus Hepatozoon (Apicomplexa: Adeleina).

          Hemogregarines of the genus Hepatozoon are intraerythrocytic apicomplexan parasites that have been described from all groups of tetrapod vertebrates. Gametogenesis, fertilization, and sporogonic development, which culminates in the formation of polysporocystic oocysts, occur in the gut or hemocoel of a hematophagous arthropod definitive host. Merogonic development occurs in the internal organs of vertebrate hosts after they ingest these infected arthropods. The presence of cystic stages, observed for many Hepatozoon species, increases life cycle complexity and exploits the feeding behavior of vertebrate hosts. The inconsistency of morphological characteristics of these parasites, especially those associated with gamont structure, coupled with low host specificity of the parasites for their invertebrate and vertebrate hosts, have rendered species differentiation difficult. A systematic review of the hemogregarine complex has resulted in the expansion of the genus Hepatozoon to include all members of the genus Haemogregarina that infect amphibians, snakes, lizards, crocodilians, birds, and mammals.
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            Perspectives on canine and feline hepatozoonosis.

            Gad Baneth (2011)
            Two species of Hepatozoon are currently known to infect dogs and cause distinct diseases. Hepatozoon canis prevalent in Africa, Asia, southern Europe, South America and recently shown to be present also in the USA causes infection mainly of hemolymphoid organs, whereas Hepatozoon americanum prevalent in the southeastern USA causes myositis and severe lameness. H. americanum is transmitted by ingestion of the Gulf Coast tick Amblyomma maculatum and also by predation on infected prey. H. canis is transmitted by Rhipicephalus sanguineus, in South America also by Amblyomma ovale, and has also been shown to be transmitted transplacentally. Hepatozoonosis of domestic cats has been described mostly from the same areas where canine infection is present and the exact identity of the species which infect cats, their pathogenicity and vectors have not been elucidated. The diagnosis of hepatozoonosis is made by observation of gamonts in blood smears, histopathology, PCR or serology. The main treatment for H. canis is with imidocarb dipropionate whereas H. americanum infection is treated with an initial combination of trimethoprim-sulfadiazine, pyrimethamine and clindamycin followed by maintenance with decoquinate. Treatment for both diseases has not been reported to facilitate complete parasite elimination and new effective drugs are needed for the management of these infections. Prevention of hepatozoonosis should be based on avoidance of oral ingestion of infected tick vectors and infected prey. Copyright © 2011 Elsevier B.V. All rights reserved.
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              Vector-borne infections in cats: molecular study in Barcelona area (Spain).

              Previous serological surveys have reported the presence of different organisms in cats from Spain but little reports exist about the exact identity of these organisms. The purpose of the study reported here was to assess the presence of DNA of several vector-borne infections in a population of cats from Barcelona area. One hundred blood samples obtained from cats admitted to the UAB-VTH were entered into the study and classified as healthy (n=48) or unhealthy (n=52). EDTA-blood samples were assayed for Leishmania infantum, Ehrlichia spp., Anaplasma spp., Rickettsia spp., Bartonella spp., Hepatozoon spp., Babesia spp. and Theileria spp. DNA by means of PCR amplification and amplicons obtained were sequenced. Prevalence of infectious agents found were Leishmania infantum (3%), Ehrlichia/Anaplasma sp. (1%), Hepatozoon felis (4%) and Bartonella clarridgeiae (1%). Cats being less than 5 years old had more probability of having at less one PCR positive result (P=0.028). The results of this study show a low prevalence of several vector-borne pathogens among cats from Barcelona area. Although higher feline seroprevalences are previously reported, they evidenced exposure and probably overestimate the real or active degree of infection. However, it is important to maintain a high index of suspicion on these infectious diseases, both in sick and asymptomatic cats, and molecular techniques could aid in the identification of these pathogens.
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                Author and article information

                Contributors
                Journal
                Parasitol Int
                Parasitol. Int
                Parasitology International
                Elsevier B.V.
                1383-5769
                1873-0329
                19 June 2019
                October 2019
                19 June 2019
                : 72
                : 101945
                Affiliations
                [a ]Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
                [b ]Tierarztpraxis Görner, Gölbeszeile 28, A-7000 Eisenstadt, Austria
                [c ]IDEXX Laboratories, Mörikestrasse 28/3, D-71636 Ludwigsburg, Germany
                Author notes
                Article
                S1383-5769(19)30138-2 101945
                10.1016/j.parint.2019.101945
                7108250
                31228586
                f3658380-167a-4f09-aa3b-70a5fb6a5105
                © 2019 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 3 April 2019
                : 8 June 2019
                Categories
                Article

                Parasitology
                hepatozoon felis,apicomplexa,pcr,austria,imidocarb
                Parasitology
                hepatozoon felis, apicomplexa, pcr, austria, imidocarb

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