McRee Anna Elizabeth, Higbie Christine T, Nevarez Javier G, Rademacher Nathalie T, Tully Thomas N
J Zoo Wildl Med. 2017 Sep;48(3):851-858. doi: 10.1638/2016-0176.1.
In 2015, three psittacines were presented within 30 days, each with differing clinical signs and patient histories. A 13-yr-old male eclectus parrot (Eclectus roratus) was presented for weakness, depression, and acute anorexia. On presentation it was determined to have a heart murmur, severely elevated white blood cell count (93.9 10/μl) with a left shift (2.8 10/μl bands), and anemia (30%). Severe hepatomegaly was noted on radiographs, ultrasonography, and computed tomography. A cytological sample of the liver obtained through a fine needle aspirate revealed intracellular acid-fast bacilli identified as Mycobacterium avium. A 20-yr-old female double yellow-headed Amazon parrot (Amazona oratrix) was presented for a 1-mo history of lethargy and weight loss despite a good appetite. The parrot's total white blood cell count was 16.8 10/μl and the PCV was 35%. Following its death, a necropsy revealed a generalized granulomatous condition that involved the small intestines, lungs, liver, spleen, and medullary cavities of the long bones, with intracellular acid-fast bacilli identified as Mycobacterium genavense. The third case, an 18-mo-old female black-headed caique (Pionites melanocephala), was presented with a 1-day history of lethargy and depression. On presentation, the caique had a heart murmur, distended coelom, palpable thickening of the coelomic organs, and increased lung sounds. Following the caique's death, a complete necropsy revealed mycobacteriosis of the liver, spleen, small intestines, pericardial fat, and bone marrow. The infection was identified as Mycobacterium genavense. The importance of advances in Mycobacterium spp. identification, continued presence of this organism in captive avian populations, difficulty in obtaining a definitive antemortem diagnosis, and conflicting recommendations regarding treatment are thought-provoking areas of focus in this case series.
2015年,30天内送来3只鹦鹉,每只都有不同的临床症状和病史。一只13岁的雄性折衷鹦鹉(Eclectus roratus)因虚弱、抑郁和急性厌食前来就诊。就诊时发现它有心脏杂音、白细胞计数严重升高(93.9×10⁶/μl)且伴有核左移(2.8×10⁶/μl杆状核细胞)以及贫血(30%)。X线片、超声检查和计算机断层扫描显示肝脏严重肿大。通过细针穿刺获取的肝脏细胞学样本显示细胞内有抗酸杆菌,鉴定为鸟分枝杆菌。一只20岁的雌性双黄头亚马逊鹦鹉(Amazona oratrix)因尽管食欲良好但有1个月的嗜睡和体重减轻病史前来就诊。这只鹦鹉的白细胞总数为16.8×10⁶/μl,红细胞压积为35%。它死后,尸检显示全身性肉芽肿病变,累及小肠、肺、肝、脾和长骨髓腔,细胞内抗酸杆菌鉴定为日内瓦分枝杆菌。第三例是一只18个月大的雌性黑头凯克鹦鹉(Pionites melanocephala),有1天的嗜睡和抑郁病史。就诊时,这只凯克鹦鹉有心脏杂音、腹腔膨胀、可触及的腹腔器官增厚以及肺部呼吸音增强。这只凯克鹦鹉死后,完整的尸检显示肝脏、脾脏、小肠、心包脂肪和骨髓有分枝杆菌病。感染鉴定为日内瓦分枝杆菌。分枝杆菌属鉴定技术的进步、该病原体在圈养鸟类种群中的持续存在、生前明确诊断的困难以及治疗建议的相互矛盾,这些在本病例系列中都是发人深省的重点关注领域。