{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:29:50Z","timestamp":1777858190883,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Feline Medicine and Surgery Open Reports"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>An 11-year-old neutered male domestic longhair cat was diagnosed with histoplasmosis from fine-needle aspirates of an abdominal lymph node. Lymph node size initially decreased with fluconazole therapy (11.8 mg\/kg PO q12h); however, after 13 months of continuous fluconazole therapy, lymphadenomegaly worsened and samples were collected for culture and antifungal susceptibility. The Histoplasma capsulatum isolate had a very high fluconazole minimum inhibitory concentration (MIC) of 64 \u00b5g\/ml and an itraconazole MIC of 0.06 \u00b5g\/ml. The owner declined a change to itraconazole and, ultimately, the cat developed neurologic signs and was euthanized. Owing to the initial response to fluconazole followed by treatment failure and high MIC value, acquired fluconazole resistance was suspected. Clinical breakpoints for fluconazole for the dimorphic fungi are not available to define true antifungal resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance and novel information<\/jats:title>\n                    <jats:p>This is the first published report of reduced susceptibility to fluconazole in a cat being treated for histoplasmosis. Fluconazole failure and increases in MIC between pretreatment and long-term treatment isolates are known to occur in humans with histoplasmosis. Practitioners should be aware of this possibility when treating cats with fluconazole (particularly in cases with long-term [&gt;1 year] fluconazole therapy or in cases with disease recrudescence).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2055116917743364","type":"journal-article","created":{"date-parts":[[2017,11,28]],"date-time":"2017-11-28T04:08:06Z","timestamp":1511842086000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Reduced susceptibility to fluconazole in a cat with histoplasmosis"],"prefix":"10.1177","volume":"3","author":[{"given":"Janelle S","family":"Renschler","sequence":"first","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary D","family":"Norsworthy","sequence":"additional","affiliation":[{"name":"Alamo Feline Health Center, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rubie A","family":"Rakian","sequence":"additional","affiliation":[{"name":"Department of Cellular and Integrative Physiology, University of Texas Health Science Center, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey I","family":"Rakian","sequence":"additional","affiliation":[{"name":"Department of Cellular and Integrative Physiology, University of Texas Health Science Center, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence J","family":"Wheat","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew S","family":"Hanzlicek","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,11,28]]},"reference":[{"key":"bibr1-2055116917743364","volume-title":"CLSI document M38-A2","author":"CLSI. Reference method for broth dilution antifungal susceptibility testing of filamentous fungi; approved standard.","year":"2008","edition":"2"},{"key":"bibr2-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1016\/0034-5288(94)90133-3"},{"key":"bibr3-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1086\/323781"},{"key":"bibr4-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1111\/j.1939-1676.1994.tb03260.x"},{"key":"bibr5-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1177\/1098612X12452494"},{"key":"bibr6-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1177\/1098612X13489226"},{"key":"bibr7-2055116917743364","author":"Renschler JS","year":"2017","journal-title":"J Am Anim Hosp Assoc"},{"key":"bibr8-2055116917743364","unstructured":"Bromel C, Greene CE. Histoplasmosis. In: Greene CE (ed). Infectious diseases of the dog and cat. 4th ed. St Louis, MO: Saunders-Elsevier, 2012, pp 614\u2013621."},{"key":"bibr9-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)80311-8"},{"key":"bibr10-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)00151-4"},{"key":"bibr11-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.41.2.410"},{"key":"bibr12-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl133"},{"key":"bibr13-2055116917743364","first-page":"171","volume":"180","author":"Kelly SL","year":"1999","journal-title":"FEMS Microbiol Lett"},{"key":"bibr14-2055116917743364","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1128\/JCM.02117-09","volume":"48","author":"Pfaller MA, Diekema DJ","year":"2010","journal-title":"J Clin Microbiol"},{"key":"bibr15-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis697"},{"key":"bibr16-2055116917743364","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw691"},{"key":"bibr17-2055116917743364","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S118892"},{"key":"bibr18-2055116917743364","first-page":"396","volume":"56","author":"Sykes JE","year":"2017","journal-title":"Med Mycol"}],"container-title":["Journal of Feline Medicine and Surgery Open Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2055116917743364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2055116917743364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2055116917743364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:09:18Z","timestamp":1777507758000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2055116917743364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1177\/2055116917743364"],"URL":"https:\/\/doi.org\/10.1177\/2055116917743364","relation":{},"ISSN":["2055-1169","2055-1169"],"issn-type":[{"value":"2055-1169","type":"print"},{"value":"2055-1169","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"article-number":"2055116917743364"}}