Pulmonary thromboembolism associated with Blastomyces dermatitidis in a dog

An 8-year-old, male castrated golden retriever presented for cough and increased respiratory effort. Radiographs revealed an alveolar pattern in the right caudal lung lobe and an opacity at the Carina suspected to be enlarged tracheobronchial lymph nodes. The disease progressed to involve the right middle lung lobe. Cytopathology of a fine-needle aspirate and bronchoalveolar lavage fluid were nondiagnostic. Surgical removal of the right caudal lung lobe and biopsy of the perihilar lymph nodes revealed pulmonary thromboembolism and reactive lymph nodes. The dog died several days postoperatively, and necropsy revealed diffuse pulmonary thromboembolism. Additionally, Blastomyces dermatitis organisms were identified in a pyogranulomatous mass surrounding the trachea near the Carina. In an extensive literature search, no reports of pulmonary thromboembolism associated with blastomycosis were identified. It is suspected that the inflammation secondary to blastomycosis caused the thromboembolism.