Abstract
In 2006, a bottlenose dolphin Tursiops truncatus maintained in a natural sea water tank with 4 million liters water, develop macroscopic skin lesions on the right flank and abdominal area. Initially diagnosed as lymphoplasmacytic perivascular dermatitis, the lesions they were not pathognomonics; however, they showed local suppurative ulcers and/or subcutaneous nodules without a specific microorganism or cause identified. Hematology and serum chemistry results were consistent with a nonspecific inflammatory response and included leukocytosis, neutrophilia, increased erythrocyte sedimentation rate, low serum iron and low alkaline phosphatase. No changes in behavior, appetite or energy were associated with the development of lesions. However and based on hematology and chemistry parameters, metrics of inflammation were linked to newly developing areas. Multiple diagnostic tests were performed on samples from the lesions including; PCR, cultures, histopathology, Immunohistochemistry and serology. Two samples were collected one year apart each. The samples were collected from different areas and from different lesions, using a 16 gauge x 16 cm biopsy Instrument guided by ultrasound. The samples were submitted for culture and histopathology and after 14 days on Sabouraud dextrose agar, PAS and blue cotton stains revealed a filamentous fungal growth. Histopathological sections show severe pyogranulomatous inflammation of deep dermis and subcutaneous tissue, with intralesional oval to elongate-shaped budding yeast-like structures. These forms were compatible with Sporothrix schenckii and they were confirmed by phenotypic characterization and DNA sequencing. Different antifungal approaches and treatments were implemented, with no obvious resolution; however, during the last 7 months oral terbinafine (2 mg/kg SID) plus local hyperthermia had positive local and systemic effects.
Acknowledgements
The authors wish to thank Michael G Rinaldi, Fungus Testing Laboratory, Leopoldo S Argumedo, Centro de Investigación y de Estudios Avanzados del IPN, Gerardo Salas, Universidad Nacional Autonoma de Mexico, Stephen Raverty, Provincial Animal Health Centre, Gregory D. Bossart, Animal Care, Research and Conservation Georgia Aquarium, Nathan P. Wiederhold, Fungus Testing Laboratory. Michael Kinsel Zoological Pathology Program University of Illinois.
* Presenting author
Literature Cited
1. Mariola MA, et al. Use of intralesional voriconazole for the treatment of cutaneous Scedosporium apiospermum infection. Clin Infect Dis. 2010;51(2):255–257.
2. El-Azhary, et al. Sporotrichosis masquerading as pyoderma gangrenosum: case report and review of 19 cases of sporotrichosis. J Eur Acad Derm Venereol. 2001:581–584.
3. Migaki G. Sporotrichosis in a dolphin. In: Proceedings of the IAAAM 8th Annual Conference, Boston, MA; 1977.
4. Cassio PF, et al. Cryosurgery as adjuvant therapy in cutaneous Sporotrichosis. Braz J Infect Dis. 2011;15(2):181–183.
5. Daxgerfield LF. Sporotrichosis among miners on the Witwatersrand gold mines. S Afr Med J. 1941.
6. Xiaohui Z, et al. In vitro activity of itraconazole in combination with terbinafine against clinical strains of itraconazole-insensitive to Sporothrix schenckii. Eur J Dermatol. 2011;21(4):573.
7. Kauffman CA, et al. Clinical practice guidelines for the management of sporotrichosis: update by the Infectious Diseases Society of America guidelines. Clin Infect Dis. 2007;45:1255–1265.
8. Marimon R, et al. Sporothrix brasiliensis, S. globosa, and S. mexicana, three new Sporothrix species of clinical interest. J Clin Microbiol. 2007;45:3198–3206.
9. Vásquez Mercado E. Sporotrichosis. Clin Dermatol. 2012;30:437–443.
10. Gremião I. Treatment of refractory feline sporotrichosis with a combination of intralesional amphotericin B and oral itraconazole. Aust Vet J. 2011;89(9):346–351.