Clayton Leigh Ann, Stamper M Andrew, Whitaker Brent R, Hadfield Catherine A, Simons Brian, Mankowski Joseph L
National Aquarium, Baltimore, MD 21202, USA.
J Zoo Wildl Med. 2012 Dec;43(4):961-5. doi: 10.1638/2012-0110R.1.
Mycobacterium abscessus pneumonia was diagnosed antemortem in a 23-yr-old male Atlantic bottlenose dolphin (Tursiops truncatus). Clinical signs included lethargy, hyporexia, coughing, and bloody respiratory discharge. Diagnostic findings included neutrophilic leukocytosis, anemia, elevated erythrocyte sedimentation rate, and repeated forceful exhaled breath (sputum) cytology, with acute inflammatory cells and acid-fast positive beaded rods. The bacteria were initially identified free in the sputum sample and subsequently were seen within neutrophils. A culture was positive for a rapidly growing, white, colony-forming organism confirmed as M. abscessus by polymerase chain reaction and DNA sequencing. Clinical signs initially resolved with multidrug therapy. Concurrent Pseudomonas aeruginosa infection complicated clinical management and contributed to terminal decline. The dolphin was euthanized 5 mo after initial diagnosis. Necropsy results demonstrated acid-fast positive bacteria in lung tissue and supported the diagnosis of M. abscessus pneumonia. Acid-fast stains and mycobacteria cultures should be considered when evaluating ill dolphins.
在一头23岁的雄性大西洋宽吻海豚(瓶鼻海豚)身上生前诊断出脓肿分枝杆菌肺炎。临床症状包括嗜睡、采食减少、咳嗽和血性呼吸道分泌物。诊断结果包括中性粒细胞增多、贫血、红细胞沉降率升高,以及反复用力呼气(痰液)细胞学检查发现急性炎症细胞和抗酸阳性的串珠状杆菌。细菌最初在痰液样本中发现为游离状态,随后在中性粒细胞内可见。培养物对一种快速生长的白色菌落形成生物体呈阳性,通过聚合酶链反应和DNA测序确认为脓肿分枝杆菌。临床症状最初通过多药治疗得到缓解。同时存在的铜绿假单胞菌感染使临床管理复杂化,并导致病情最终恶化。这头海豚在初次诊断后5个月实施了安乐死。尸检结果显示肺组织中有抗酸阳性细菌,支持脓肿分枝杆菌肺炎的诊断。在评估患病海豚时应考虑进行抗酸染色和分枝杆菌培养。