Abstract

An 8-year-old female Atlantic bottlenose dolphin living in a natural saltwater lagoon presented with abnormal breathing (coughing, chuffing, wheezing, increased tidal respiratory cycle) and abnormal posturing (head shaking, mouth open, body arching). Computed tomography and bronchoscopy demonstrated raised 5–8 mm nodules on the tracheal and primary bronchial mucosa. When conventional bronchoscopic instrumentation (biopsy cup, cytology brush) failed to provide a definitive diagnosis, a transbronchial aspiration needle (TBNA) was used to obtain a sample from deep within the mucosal nodules. Briefly, the dolphin was pre-medicated with oral diazepam and placed on a foam pad in a controlled environment. Bronchoscopy was performed using a 6 mm diameter, 102 cm pediatric gastroscope (EG-1870K; Pentax Medical Corp., Montvale, NJ). A 19 gauge transbronchial aspiration needle (eXcelon Single-Use Transbronchial Aspiration Needle, Boston Scientific, Marlborough, MA; needle length 15 mm, catheter length 130 cm, sheath outer diameter 1.8 mm) was passed through the instrument channel of the bronchoscope and directed to the lesions for needle aspiration. Cytology of the samples revealed branching septate fungal hyphae.

Failure to achieve a definitive diagnosis using bronchoscopic cytology brushes and biopsy cups was likely due to the depth of the fungal hyphae within the mucosal nodules, which were easily reached with the 15 mm TBNA needle. TBNA can also be used to obtain lung and pulmonary lymph node samples via bronchoscopy, providing future possibilities for advanced diagnostic sampling of bottlenose dolphins with pulmonary disease.

* Presenting author