Canine nasal aspergillosis: topical clotrimazole treatment
5-year-old German Shepherd with unilateral sinonasal aspergillosis confirmed by rhinoscopy and histology. CT shows turbinate lysis and frontal sinus involvement, with an intact cribriform plate.
Which treatment has the highest chance of success?
chevron_right Show answer and explanation
A. Oral itraconazole for 2 weeks as the sole treatment
Oral azoles as monotherapy have limited efficacy in nasal aspergillosis, need months of treatment and are costly. They are reserved as an adjunct or when topical treatment is not possible.
B. Oral glucocorticoids to reduce inflammation and pain
Glucocorticoids promote fungal infection and do not treat it. Pain is controlled with analgesics while the cause is treated.
C. Rhinotomy with complete turbinectomy as the first-line option
It is more invasive and has not shown better results than endoscopic debridement with topical treatment; it is reserved for refractory cases.
D. Rhinoscopic debridement of fungal plaques followed by topical clotrimazole in the nasal cavity and frontal sinus, repeated if plaques persist
Correct. Meticulous debridement of plaques is key, and topical clotrimazole (infusion or depot cream) acts directly on the fungus, which lives on the mucosal surface. More than one procedure is often required.
lightbulb Key takeaway
Before topical treatment, check the integrity of the cribriform plate on CT: if it is destroyed, the antifungal may reach the brain. After treatment, recheck with rhinoscopy; mild residual discharge may persist because of chronic rhinitis after turbinate destruction.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.