Kundu Mila C, Ringenberg Michael A, d'Epagnier Denise L, Haag Heather L, Maguire Sean
Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania, Veterinary Sciences, Bristol-Myers Squibb, New Brunswick, New Jersey.
Integrated Biological Platform Sciences, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania.
Comp Med. 2017 Oct 1;67(5):452-455.
Coccidioides spp. are saprophytic, dimorphic fungi that are endemic to arid climates, are capable of infecting many species, and result in diverse clinical presentations. An indoor-housed laboratory rhesus macaque presented with weight loss and decreased activity and appetite. During the diagnostic evaluation, a bronchiolar-alveolar pattern in the cranial lung lobes, consistent with bronchopneumonia, was noted on radiographs. Given the poor prognosis, the macaque was euthanized. Confirming the radiographic assessment, gross necropsy findings included multifocal to coalescing areas of consolidation in the right and left cranial lung lobes. Microscopically, the consolidated regions were consistent with a pyogranulomatous bronchopneumonia and contained round, nonbudding, fungal yeast structures considered to be morphologically consistent with Coccidioides immitis. Culture and colony morphology results were confirmed through additional diagnostic testing. Sequencing of the D1-D2 domain of the 28S large ribosomal subunit positively matched with a known sequence specific to C. immitis. Serology for Coccidioides spp. by both latex agglutination (IgM) and immunodiffusion (IgG) was positive. In this rhesus macaque, the concordant results from histology, culture, DNA sequencing, and serology were collectively used to confirm the diagnosis of coccidioidomycosis. This animal likely acquired a latent pulmonary infection with Coccidioides months prior to arrival, when housed outdoors in a Coccidioides-endemic area. The nonspecific clinical presentation in this macaque, coupled with the recent history of indoor housing and lag between clinical presentation and outdoor housing, can make similar diagnostic cases challenging and highlights the need for awareness regarding animal source when making an accurate diagnosis in an institutional laboratory setting.
球孢子菌属是腐生的二态真菌,在干旱气候地区流行,能够感染多种物种,并导致多种临床表现。一只饲养在室内的实验恒河猴出现体重减轻、活动减少和食欲下降。在诊断评估过程中,X光片显示颅侧肺叶出现细支气管肺泡型,符合支气管肺炎。鉴于预后不良,对该恒河猴实施了安乐死。尸检结果证实了X光片评估结果,大体尸检发现左右颅侧肺叶有多灶性至融合性实变区域。显微镜下,实变区域符合脓性肉芽肿性支气管肺炎,包含圆形、无芽的真菌酵母结构,形态学上与粗球孢子菌一致。通过额外的诊断测试确认了培养和菌落形态结果。28S大核糖体亚基D1-D2结构域的测序与已知的粗球孢子菌特异性序列完全匹配。乳胶凝集试验(IgM)和免疫扩散试验(IgG)检测球孢子菌属的血清学结果均为阳性。在这只恒河猴中,组织学、培养、DNA测序和血清学的一致结果共同用于确诊球孢子菌病。这只动物可能在到达前几个月,饲养在球孢子菌流行地区户外时,就已感染了潜伏性肺部球孢子菌。这只恒河猴的非特异性临床表现,加上近期的室内饲养史以及临床表现与户外饲养之间的时间间隔,可能会使类似的诊断病例具有挑战性,并凸显在机构实验室环境中进行准确诊断时了解动物来源的必要性。