Update on pythiosis immunobiology and immunotherapy

Table 1 Review of animal pythiosis cases reported in the literature when treated with immunotherapy

Species/n	Lesions	Adjunctive therapy	Immunotherapy type3, doses	Outcome	Ref.
Horses
40	Various4	No or surgery	UF, 31 doses at 7-d intervals	C (53%), I (33%)	[103]
5	Limbs	ATM, surgery	UF, 3 doses at 7-d intervals	C (20%), 60(E), 20 (D)	[60]
5	Various4	No	SA, 2 doses at 15-d intervals	C (60%)	[88]
1	Limb, bones	No	SA, 2 doses at 7-d intervals	E	[109]
71	Various4	Nr	FH or SA, 1 or 2 doses at 7-d intervals	C (66%)	[104]
1	Limb, bones	Surgery, ATM	Nr, 3 doses postsurgical	D	[110]
2	Abdomen	Surgery, ATM	SH, 3 doses at 7-d intervals	C (50%), E (50%)	[111]
19	Various4	No	LMH, 3 to 9 doses at 14-d intervals	C (50%-83%)	[107]
18	Various4	Surgery, ATM	SA + SH, 21 doses at 15-d intervals	C (72%)	[17]
1	Limbs, sub-maxillary	Surgery	Nr	E	[23]
1	Limb	ATM	LMH, 7 doses at 14-d intervals	D	[112]
1	Hind pastern, fetlock	ATB	SA, 3 doses at 1, 7 and 21 d	E	[113]
1	Face	Surgery, ATM	LMH, 5 doses at 14-d intervals	E	[114]
1	Face	ATM	LMH, 5 doses at 14-d intervals	C	[64]
12	Limb, abdomen	No	LMH, 4-5 doses at 14-d intervals	C	[115]
11	Limbs, abdomen	No or surgery	LMH, 2-5 doses at 14-d intervals	C (70%-90%)	[24]
8	Limbs, abdomen	No or surgery	LMH, Nr	C (75%)	[7]
47	Various4	No or surgery	LMH, Nr	C (79%-84%)	[9]
Dogs
1	Cutaneous	AMB, surgery	UF, 1 dose	C	[38]
6	Cutaneous, intestinal	ATM, surgery	SA + SH, 21 doses at 15-d intervals	C (33%)	[17]
2	Cutaneous	Itraconazole	SA, 1 or 2 doses at 7-d intervals	E	[31]
1	Cutaneous	No	SA, 2 doses at 14-d intervals	C	[35]
1	Gastrointestinal	ATF, surgery	Nr, 3 doses at 1, 7 and 21 d	C	[32]
1	Gastrointestinal	ATF	SA, 6 doses at 15-d intervals	C	[108]
Camels
1	Face, stomach	Surgery, ATM	SA + SH, 21 doses at 14-d intervals	D	[68]
2	Vulvar	Surgery, ATM	SA, 3 doses at 1, 10, 17 d	C (50%)	[21]
Sheep
6	Oronasal	No	LMH, 1-5 doses at 14-d intervals	C (16.7%)	[41]

¹At least;

²Same animal, cured twice with immunotherapy with reinfection within an interval of two years;

³Manufacturing process for immunotherapy;

⁴Not reported individually (subcutaneous). Nr: Not reported; AMB: Amphotericin B; UF: Ultrasonication of hyphae; SA: Soluble antigens; SH: Sonicated hyphae; FH: Fragmented hyphae; LMH: Lyophilized macerated hyphae; C: Cured; I: Clinically improved; D: Died; E: Euthanized; ATM: Antimicrobials; ATB: Antibacterials; ATF: Antifungals.

Table 2 Review of human pythiosis cases reported in the literature when treated with immunotherapy

n	Lesions	Adjunctive therapy	Immunotherapy type2, doses	Outcome	Ref.
1	Vascular	ATM, surgery	SA, 2 doses at 14-d intervals	C	[19]
8	Vascular	Surgery/amputation, ATF	SA, 21 doses at 14-d intervals	C (50%)	[18]
1	Vascular	Above-knee amputation	SA, Nr	C	[116]
1	Vascular	ATM, limb amputation	SA, Nr	D	[117]
1	Ocular	ATM, enucleation	Nr	D	[118]
1	Vascular	Above-knee amputation	Nr	C	[119]
1	Vascular	ATM, above-knee amputations	Nr	C	[120]
1	Vascular	ATM, above-the-knee-amputation	Nr, 4 doses at 7-d intervals	C	[95]
1	Vascular/disseminated	ATM	SA, 2 doses at 7-d intervals	D	[121]
3	Ocular	ATM, surgery	Nr, 3 doses	C (66%)	[122]

¹At least;

²Manufacturing process for immunotherapy. Nr: Not reported; SA: Soluble antigens; C: Cured; D: Died; ATM: Antimicrobials; ATF: Antifungals.