The Use of Bronchoscopy and Fungal Serology to Diagnose Aspergillus fumigatus Lung Infection in a Bottlenose Dolphin (Tursiops truncatus)
IAAAM Archive
Thomas H. Reidarson1, DVM; Jim McBain1, DVM; James H. Harrell2, MD
1Sea World of California, San Diego, CA; 2University of California Medical Center, Division of Pulmonary and Critical Care Medicine, University of California, San Diego, CA

A five year old male bottlenose dolphin developed a harsh cough in August of 1995. The dolphin was born at Sea World of Texas in August of 1991 and was moved to Sea World of California in September of 1993. Prior to this illness the dolphin's medical history was unremarkable.

On physical examination the dolphin appeared slightly underweight and had prolonged inspiration and expiration. Laboratory tests indicated inflammatory disease, and radiographs demonstrated a 4-5 cm focal alveolar pattern in the left caudal lung lobe surrounded by mild to moderate interstitial changes. Blowhole samples for cytology were unremarkable and cultures grew normal blowhole flora consisting of Morganella morganii, Staphylococcus intermedius, and Vibrio alginolyticus.

The dolphin was initially treated for a bacterial pneumonia with cefuroxime at 20 mg/kg BID. Although laboratory work improved, the cough persisted. Additional blowhole samples yielded culture growth of Pseudomonas aeruginosa, Streptococcus pyogenes, and Staphylococcus epidemitis. Immunodiffusion serology identified two antibody bands specific to Aspergillus fumigatus. Retrospective samples revealed a single band when the dolphin first presented with clinical signs and no bands three months prior.

The dolphin was placed on itraconazole at 5 mg/kg BID and amoxicillin/clavulinic acid at 5 mg/kg BID. Due to a worsening cough, bronchoscopy was performed using a BFP200 Olympus video chip bronchoscope. Three 20 cc bronchoalveolar lavages were taken and a brush biopsy of a 1 cm raised light yellow lesion on the left side of the mainstem bronchus was performed. Lavage cytology demonstrated branching mycelia surrounded by neutrophils which were identified as Aspergillus fumigatus.

Antibiotic therapy was discontinued while anti-mycotic therapy has been maintained. Examination two months later has demonstrated a resolution of the bronchial lesions and absence of fungal elements from lavage cytology. As of March 1996, the dolphin's cough has significantly improved, his weight is normal, and his blood test results are near normal. Antifungal therapy is planned for a minimum of 6-9 months.

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Thomas H. Reidarson, DVM
Sea World of California
San Diego, CA, USA


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