Dimorphic fungal infection presenting as dysphagia in a dog

A 3‐year‐old, female, spayed dalmatian was evaluated for a 1‐month history of dysphagia. It exhibited repeated hard swallowing with apparent pain and anxiety after eating, as well as infrequent episodes of regurgitation that were alleviated by adding water to kibble. Computed tomography of the thorax revealed marked hilar lymphadenopathy with secondary oesophageal compression. Blastomyces and Histoplasma urine antigen tests were both positive. While cytology or histology were not performed to differentiate between blastomycosis and histoplasmosis, the clinical picture was strongly supportive of a dimorphic fungal infection. The dog was treated presumptively for dimorphic fungal infection with itraconazole and a short course of prednisone and experienced a full recovery. This case illustrates that fungal infection should be considered as a differential diagnosis for dogs presenting with dysphagia in endemic regions.