Gross, Histopathologic, and Parasitology Findings from Confiscated Asian Box Turtles (Cuora amboinensis)
IAAAM Archive
Pam Govett1,3,4; Dave Rotstein1,2; Taylor Reynolds1,2; John Cullen1,2; James Flowers1,2; Mike Levy1,2; Ryan DeVoe1,3,4; Shane Boylan5; Gregory Lewbart1,3
1Environmental Medicine Consortium, 2Department of Microbiology, Parasitology and Pathology, 3Department of Clinical Sciences 4North Carolina Zoological Park, and 5College of Veterinary Medicine, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA


Approximately 4300 illegally caught turtles were confiscated in Hong Kong and transported to Florida and Europe for triage and medical treatment for capture and transport related conditions. Animals were dispersed to various centers for long term care.

The Turtle Rescue Team at North Carolina State University received 36 Cuora amboinensis. Of these 36 turtles, 36% (13/36) have died. The majority of turtles were female [91% (11/12)]. The median time to death from the point of arrival was 7 days.

Necropsies included gross and histologic examination of carcasses and parasite identification. Most gross lesions involved the integument or digestive system. All animals had some degree of cutaneous hyperkeratosis and two (22%) had focal cutaneous ulcerations. Coelomic fluid ranging from a light yellow transudate to serosanguineous was observed in all turtles. Digestive system lesions included intraluminal parasites [33% (4/12)], hepatic granulomas [83% (10/12)], and hepatic lipidosis in one turtle. Trematodes were observed in the urinary bladder of two turtles.

Histologic examination of 10 animals was completed at the time of abstract preparation. Histologic examination of tissues revealed the presence of granulomas around nematodes and trematode eggs in liver, pancreas, kidney, intestine, lung, and skin in all animals. Granulomatous hepatitis was most commonly observed containing intraductal biliary nematodes, parenchymal nematodes, and/or trematode eggs [90% (9/10)]. Trematode eggs and nematodes were identified in the kidney [50% (5/10)], spleen [30% (3/10)], intestine [40% (4/10)], lung [30% (3/10)], pancreas [20% (2/10)], and skin [10% (1/10)]. In four turtles [40% (4/10)] with hepatic and renal parasitic granulomas, there were also bacteria-laden granulomas. An adult trematode was observed within the urinary bladder lumen in one turtle [10% (1/10)]. There was mild to moderate hepatic lipidosis or glycogen accumulation in 30% (3/10) animals. Heterophilic and lymphoplasmacytic interstitial pneumonia was observed in 40% (4/10) animals and was associated with the presence of fluke eggs in three [30% (3/10)] of these turtles. Severe, focal cutaneous ulceration with associated suppuration and intralesional bacterial cocci was observed in one turtle.

Parasites were collected from the colon and urinary bladder. The results are shown below in Table 1

Table 1. Parasites collected from Cuora amboinensis.





Stunkardia sp.1

Digenetic trematode


Spironoura sp.2

Oxyurid nematode

Urinary bladder

Polystomoides sp.3

Monogenetic trematode

It is suspected that dehydration, lack of good nutrition, parasitism, and inadequate husbandry prior to seizure led to immunosuppression, and in some cases, sepsis. Careful clinical and postmortem evaluation of these animals will contribute to our knowledge of the disease processes that affect this rarely seen species


This work was supported by the North Carolina State University College of Veterinary Medicine (NCSU-CVM), the NCSU-CVM Turtle Rescue Team, and the Tortoise Reserve Inc. The authors thank Kristen Hobbie, Kristi Karli, Dave Malarkey, Michael Stoskopf, Maureen Trogdon, the NCSU-CVM Turtle Rescue Team students and volunteers, and the NCSU-CVM histopathology staff for their advice, assistance and support.


1.  Palmieri JR, JT Sullivan. 1977. Stunkardia minuta sp. N. (Trematoda: Paramphistomidae) from the Malyan box-tortoise Cuora amboinensis. Journal of Helminthology 51:121-4.

2.  Schoenecker SA, GD Schmidt, CO Everard. 1977. Spironoura tikasinghi sp. N. (Nematoda: Kathlaniidae) from a turtle in Trinidad, W. I. Journal of Parasitology 63: 341-3.

3.  Gupta NK, R Randev. 1974. On the histomorphology of Polystomoides ludhianae n. sp. (Monogenea) recovered from the urinary bladder of Kachuga tectum and Kachuga smithi in north India. Parasitologia. 16: 225-229.

Speaker Information
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Pamela D. Govett, DVM

Taylor L. Reynolds