An 8-yr-old intact male buff-cheeked gibbon (Nomascus gabriellae) had a four-day history of vaguely abnormal behavior, a mildly decreased appetite, and a one day history of dull mentation. Mild generalized muscle wasting and weight loss were appreciated on physical examination. Routine immunodiffusion serology for Coccidioides spp. returned IgG and IgM positive at 1:64. Oral fluconazole was initiated at 20 mg/kg twice daily, however the condition of the gibbon markedly declined within 48 hr and he became stuporous. MRI brain sequences were consistent with an infectious meningoencephalitis and secondary obstructive hydrocephalus. A ventriculoperitoneal shunt (UNI-SHUNT with reservoir, Codman & Shurtleff, Inc., Raynham, Massachusetts, USA) was placed to reduce the imminent risk of mortality from increased intracranial pressure. Post-operative treatment was centered on oral fluconazole (to be continued lifelong; 10 mg/kg p.o. b.i.d.) and a slowly tapered course of prednisolone (initial 0.5 mg/kg p.o. b.i.d.). Improvement of mentation, neurologic deficits, and strength was slow but consistent. Daily training sessions with his zoo keepers and enrichment items were utilized to both objectively monitor his progress and to aide in his rehabilitation. The gibbon was fit to be returned to exhibit eight weeks post shunt placement, with only slight residual behavior changes appreciated. This case of coccidioidomycosis in a non-human primate demonstrates the complications that can occur with dissemination to the central nervous system. In this particular case, placement of a ventriculoperitoneal shunt was a life-saving procedure and should be considered in other cases of obstructive hydrocephalus.
The authors thank the Veterinary Neurological Center for their time, equipment, and expertise that were donated to the management of this case. Additionally, the authors thank the hospital staff and primate keepers at The Phoenix Zoo for their time and on-going dedication to the care of this animal.