Avian tuberculosis in a free-living Eurasian griffon vulture.

Although Mycobacterium spp. often cause disease in domestic birds (chickens and companion birds), there are few data on avian tuberculosis in wild populations, especially in birds of prey. We describe here a case of a young adult female, free-living Eurasian griffon vulture (Gyps fulvus) that was found dead. Granulomas were grossly evident in the lungs at autopsy, and tuberculosis was suspected. Ziehl-Neelsen staining revealed large numbers of intracellular acid-fast-positive bacteria within granulomas. Examination on Löwenstein-Jensen medium was negative, but mycobacteria growth indicator tube medium results were positive. For the molecular detection of Mycobacterium spp., the primer set IS901F and IS901R was used. Positive results were observed on gel electrophoresis, indicating the presence of Mycobacterium avium subsp. avium DNA. Although tuberculosis is not considered to be a common cause of death in wild birds, it undoubtedly deserves special attention because vultures are generally considered to be a species resistant to a large number of pathogens. Determination of the cause of death of griffon vultures is important for future conservation measures for this sensitive wild species.

Acute lameness in a cat with disseminated mycobacteriosis.

Mycobacterium avium infection was diagnosed in an adult cat showing acute lameness of the right hind limb, enlargement of the right popliteal lymph node and two cutaneous nodular lesions of the right chest wall. Conventional radiography of the proximal tibia showed a proliferative osteolytic lesion. Cytological examination of the right popliteal lymph node and the nodular skin lesions fine needle aspiration smears, demonstrated granulomatous inflammation with many negative staining bacilli within macrophages or in smears background. The diagnosis was confirmed by Ziehl­Neelsen staining of the smears and the identification of mycobacteria was performed by microbiological and molecular methods. Histopathology performed after the necropsy revealed disseminated mycobacteriosis with granulomatous mesenteric lymphadenitis, granulomatous pneumonia, hepatitis and tibial osteomyelitis. M. avium is a well­known agent of gastro­enteric, respiratory or disseminated disease in immunocompromised cats but there are few cases reported in literature of bone involvement in systemic mycobacteriosis.

Comparison of immunohistochemistry and Ziehl-Neelsen staining for detecting the distribution of Mycobacterium avium subsp avium in naturally infected domestic Pekin ducks (Anas platyrhynchos domestica).

In order to detect the distribution of Mycobacterium avium subsp avium (MAA) in naturally infected domestic Pekin ducks, immunohistochemistry (IHC) and Ziehl-Neelsen (ZN) staining were used and compared. Six organs, the liver, spleen, lung, kidney, duodenum and pectoralis muscle, were collected from naturally infected Pekin ducks. Paraffin embedded tissues were examined, and the results were compared. Statistical analysis was performed using Chi-Square test. The results showed that the detection rates by IHC were similar with ZN staining in liver, lung, spleen and pectoralis muscle, but the detection rates by IHC were much higher than ZN staining in kidney and duodenum (p = .013, p = .0044). The liver (87.5%) and lung (81.3%) had the highest detection rates. Acid-fast bacilli (AFB) were primarily found intracellularly in six organs using ZN staining. Similarly, the MAA antigens in those selected organs were also detected in the cytoplasm with different cell types. Specifically, MAA antigen was distributed in epithelioid macrophages and necrotic centres within the liver, lung, spleen and kidney, while they were observed in macrophages of the lamina propria and duodenal glands and degenerative myocytes in the pectoralis muscle. This comparative study provides an important insight into the distribution of MAA in infected domestic ducks and indicates that the detection rate by IHC was higher than that of ZN staining.

Small-Cell Lung Cancer Comorbid with Pulmonary Mycobacterium avium Infection: A Case Report.

BACKGROUND: Small-cell lung cancer (SCLC) rarely coexists with pulmonary Mycobacterium avium intracellular complex (MAC) infection. The key drug for SCLC treatment is etoposide, which is metabolized by cytochrome P-450 (CYP) 3A4. Meanwhile, the key drugs for pulmonary MAC infection are clarithromycin (CAM) and rifampicin (RFP), and their metabolism influences CYP3A4. Therefore, treatment of concurrent SCLC and pulmonary MAC infection is difficult, and to the best of our knowledge, no report of treatments for concurrent SCLC and pulmonary MAC infection has been published. Patient Concerns and Diagnoses: A 65-year-old man presented to our hospital with abnormal findings of chest computed tomography: (1) a hilar region nodule in the left lung and mediastinal lymphadenopathy and (2) a thick-walled cavity lesion in the right upper lobe of the lung. After further examinations, the former lesions were diagnosed as SCLC, cT4N3M0, stage IIIC and the latter as pulmonary MAC infection, fibrocavitary disease. INTERVENTIONS AND OUTCOMES: Concurrent treatment was conducted with discontinuation of CAM and RFP before and after etoposide administration. Specifically, intravenous cisplatin and etoposide were administered on day 1 and days 1-3, respectively, and CAM, RFP, and ethambutol (EB) were administered orally on days 6-22 every 4 weeks. Concurrent radiotherapy was added to the drug administration on days 1-27 of the first cycle. The chemotherapy was continued for 4 cycles, followed by continuation of CAM and RFP administration. EB was discontinued because of optic nerve disorder. The treatments were conducted completely and safely, and both of the SCLC lesions and the MAC lesion were improved. CONCLUSIONS: Treatments for concurrent SCLC and pulmonary MAC infection may be successfully conducted with discontinuation of CAM and RFP before and after etoposide administration.

Serum protein profiles in domestic pigeons naturally infected with Mycobacterium avium subsp. avium.

BACKGROUND: Avian tuberculosis is an important disease affecting all species of birds and is most often caused by Mycobacterium avium or Mycobacterium genavense. Blood proteins are important diagnostic constituents in gastrointestinal, hepatic, renal, and infectious diseases. OBJECTIVE: The aim of the study was to compare serum protein profiles of domestic pigeons (Columba livia var. domestica) infected with Mycobacterium avium subsp. avium (MAA), with healthy pigeons. METHODS: Serum samples were collected from 80 pigeons with clinical signs of tuberculosis, all kept in the same loft. All birds were necropsied and cultured for mycobacteriosis; positive cultures were typed for MAA by PCR reactions targeting 16S rRNA, IS901 and IS1245. The concentration of total serum proteins was determined by the biuret method and spectrophotometry. Individual protein fractions were analyzed by cellulose acetate electrophoresis and extrapolated based on total protein concentration. For statistical analysis, the infected birds were compared with healthy pigeons. RESULTS: A total of 37 pigeons with culture results positive for MAA were selected and allocated to 2 groups, a culture-positive group with macroscopic lesions of tuberculosis and another without macroscopic lesions. Six protein fractions were identified: prealbumin, albumin, alpha-1, alpha-2, and beta globulins and gamma globulins. Concentrations of total protein, beta globulins and gamma globulins were statistically significantly higher in the infected pigeons when compared with the control group. There were no significant differences between the groups of birds with or without macroscopic lesions. CONCLUSIONS: Statistically significant differences in total protein, and beta and gamma globulin concentrations in all infected pigeons suggest that serum protein electrophoresis represents a nonspecific but valuable indicator for tuberculosis in pigeons.

Diagnosis of mycobacterial infections in the exotic pet patient with emphasis on birds.

The term "mycobacteriosis" encompasses a variety of infectious diseases of animals caused by bacteria of the genus Mycobacterium, which are chronic and debilitating diseases. More than 35 Mycobacterium spp can cause mycobacteriosis. The wide range of possible clinical signs and physical exam findings can make the antemortem diagnosis inconsistent and challenging. Proper sample collection and test modality in relation to the state of the disease process are essential. Clinicians can determine a presumptive diagnosis of mycobacteriosis, but the definitive etiologic diagnosis of mycobacteriosis relies on the correct identification of the mycobacteria through microbiological and molecular diagnostic methods.

[Avian mycobacteriosis in humans remains a threat in the Czech Republic]. / Aviární myobakteriózy u lidí - stále hrozící nebezpecí v Ceské republice.

The members of Mycobacterium avium complex belong to the most common agents causing mycobacterioses in humans. They are classified as a potentially patogenic mycobacteria, although Mycobacterium avium subsp. avium represent veterinary and economic risks in birds (mainly poultry) as well as mammals (pigs etc.). Infected animals and their products (mainly eggs) often come from small household production and pose a risk for human health. The second member of this complex, Mycobacterium avium subsp. hominissuis, is commonly isolated from humans and pigs. For both hosts, the sources are particularly various components of the environment (peat, compost and surface water). The third member, Mycobacterium intracellulare is commonly found in soil and water which was not treated with chlorine. (Nowadays, ozone is used for the treatment of potable water). Consequently, infections of humans and animals caused by this agent are expected to rise.

Comparison of sampling methods, culture, acid-fast stain, and polymerase chain reaction assay for the diagnosis of mycobacteriosis in ring-neck doves (Streptopelia risoria).

Even when different diagnostic modalities are available, mycobacteriosis is difficult to diagnose in a live bird. To investigate the diagnostic value of sampling different tissues and using different diagnostic methods, we evaluated results of mycobacterial culture, Ziehl-Neelsen (ZN) staining, and single-amplification polymerase chain reaction assay (PCR) of 18 ring-neck doves (Streptopelia risoria) with confirmed natural infection with Mycobacterium avium avium. Results of testing liver biopsy, duodenal aspirate, and bone marrow aspirate samples and liver and spleen samples collected at necropsy were compared. Results showed the use of one single technique did not allow identification of all infected birds. In liver biopsy and bone marrow aspirate samples, culture had the highest sensitivity, whereas PCR assay and ZN staining had low sensitivity, and their combination was less sensitive than culture alone. Examination of ZN staining of the intestinal aspirate samples failed to detect infection in most birds. More splenic lesions contained acid-fast organisms than did liver lesions, suggesting that splenic biopsy may have the greatest potential for diagnosis of mycobacterial infection antemortem. Sensitivity was higher for postmortem examination of multiple liver sections than of a single biopsy section; therefore, obtaining multiple liver biopsy sections may increase detection of mycobacteria. Examination of multiple tissues and the use of several different diagnostic techniques significantly increases the probability of diagnosis of mycobacteriosis.

Comparison of the conventional culture, the manual fluorescent MGIT system and the automated fluorescent MGIT 960 culture system for the detection of Mycobacterium avium ssp. avium in tissues of naturally infected hens.

Different methods for the detection of Mycobacterium avium ssp. avium (MAA) in naturally infected hens were compared. They included the conventional culture method (solid Herrold's and Stonebrink media and liquid Sula medium) and newly developed liquid culture systems, the manual mycobacteria growth indicator tube (M-MGIT) and the fully automated BACTEC MGIT 960 system (A-MGIT). 152 tissues originating from 15 naturally infected hens have been processed. The overall detection rates (percentage of positive cultures from the number of positive cultures determined by all the methods together) were 60, 70 and 76 % for the conventional media, M-MGIT and A-MGIT systems, respectively, the mean time of mycobacteria detection being 32.6, 17.6 and 14.6 d, respectively. The lowest contamination rate (2.0 %) was found in A-MGIT compared with M-MGIT (4.6 %) and conventional media (10.4 %).

Mycobacterial infection in a fairy bluebird (Irena ract puella): a diagnostic conundrum.

An adult male, wild-caught fairy bluebird (Irena puella) was evaluated after diagnosis of hepatic mycobacterial disease in a bird sharing the same quarantine space. Initial results did not reveal leukocytosis or acid-fast organisms in a liver biopsy. However, Mycobacterium avium was found in the liver via polymerase chain reaction (PCR). After euthanasia, acid-fast stains remained negative in the liver, although PCR was positive and M. avium complex (identified by high-performance liquid chromatography) was isolated from the liver. PCR could offer a relatively sensitive and rapid diagnostic test in the investigation of mycobacterial disease in avian patients.

Diagnosis of avian tuberculosis in Swinhoe's pheasants using conventional and molecular-based techniques.

Avian tuberculosis was diagnosed via histopathology, microbiology, and molecular biology in two of six pheasants from a local sanctuary bird house in Taiwan. Swinehoe's pheasant (Lophura swinhoii) is a near-threatened species in Taiwan. The infected birds showed clinical signs such as fatigue, inappetence, diarrhea, and fluffing of feathers. On postmortem, nonmineralized caseogranulomas were present in the brain, heart, lung, liver, spleen, costal membranes, and intestinal tracts. The presence of granulomas in the lungs of the infected pheasants may suggest that exposure to the infective agent was via the respiratory route rather than the alimentary route. Histopathologic findings were typical of avian tuberculosis, including acid-fast bacilli and centrally located caseous necrosis surrounded by epitheloid macrophages, lymphocytes, and multinucleated giant cells. Laboratory confirmation was made based on lesions and via Ziehl-Neelsen acid-fast stain, polymerase chain reaction, nucleic acid sequencing, and a reliable assay protocol for identification of diseases bioactive amplification with probing assay.

Humoral response to Mycobacterium avium subsp. avium in naturally infected ring-neck doves (Streptopelia risoria).

Creation of a reliable and easy to use serologic test would greatly improve ante mortem diagnosis of Mycobacterium avium subsp. avium and aid in the control of avian mycobacteriosis, particularly in captive birds. In order to determine whether serodiagnostics could be of value in testing ring-neck doves (Streptopelia risoria) for M. a. avium infection, Western blot analysis was used to assess the humoral response of ring-neck doves exposed to M. a. avium, and to evaluate whether an association could be made between the humoral response and necropsy findings, histopathology, culture, and PCR testing. Western blot results were examined for reactivity patterns associating humoral response with infection status, severity and type of lesions (diffuse vs. multifocal granulomatous inflammation) and phenotype (white vs. non-white). A sensitivity of 88.24% and a specificity of 100% were achieved utilizing Western blot analysis to detect M. a. avium infection in ring-neck doves, offering a negative predictive value of 93% and a positive predictive value of 100%. While Western blot analysis results did not reflect lesion severity, lesion type did partially correspond with the humoral response. The findings of the present study indicate that serologic testing can be used as a valuable ante mortem screening tool for identifying ring-neck doves infected with M. a. avium.

Disseminated mycobacteriosis in a bald eagle (Haliaeetus leucocephalus).

A mature bald eagle (Haliaeetus leucocephalus) was diagnosed with mycobacterial infection after being presented for an inability to fly, emaciation, and a swelling of the left tibiotarsal-tarso metatarsal joint. Results of a complete blood cell count revealed a persistent, marked leukocytosis, with heterophilia, monocytosis, and anemia. Radiographs revealed lysis of the left distal tibiotarsus and soft-tissue swelling around the left tibiotarsal-tarsometatarsal joint, multiple pulmonary opacities, and an enlarged liver. Endoscopic evaluation and biopsy of caseated material within the left caudal coelom revealed acid-fast organisms. The eagle was euthanatized, and results of necropsy and histologic evaluation revealed caseated granulomas of the intestine, lungs, air sacs, and subcutaneous regions of the hock. Results of culture, a polymerase chain reaction testing, and direct deoxyribonucleic acid (DNA) sequencing for mycobacterial 16S ribosomal ribonucleic acid DNA determined this organism most likely to be Mycobacterium avium.

Concurrent West Nile virus and mycobacterium avium infection in a black-necked swan (Cygnus melanocoryphus).

An adult male black-necked swan (Cygnus melanocoryphus) was evaluated for a routine physical examination and West Nile virus vaccination. Nine days later, the swan was hospitalized for weakness, dehydration, tremors, and leukocytosis. Gradual clinical improvement was seen over a 2-wk course of supportive care. However, the animal became acutely weak and was found dead. Histopathology revealed severe granulomatous pneumonia and air sacculitis with dissemination to the liver, spleen, intestine, and coelom. Mycobacterial infection was confirmed by identification of acid-fast bacilli within tissue sections and by polymerase chain reaction. Concurrent West Nile virus infection was identified in sections of brain by using immunohistochemistry.

Ante mortem diagnosis of mycobacterial infection by liver biopsy in a budgerigar (Melopsittacus undulatus).

Avian mycobacteriosis is an important disease which affects exotic, wild and domestic birds. The disease is most commonly caused by the ubiquitous soil and water organisms Mycobacterium avium sp. avium and Mycobacterium genavense. Mycobacteriosis should be considered in the differential diagnosis of any pet bird with chronic disease characterized by weight loss, an inflammatory leukogram and abdominal enlargement. Ante mortem diagnosis of avian mycobacteriosis in birds remains difficult. The present case report describes that even in very small species such as a budgerigar the investigating of a biopsy sample is an efficient way to rule out or confirm the disease in cases where other methods fail to be conclusive.

Infección por Mycobacterium avium en un paciente trasplantado renal / Mycobacterium avium infection in a renal transplant recipient

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Mycobacteriosis in gang gang cockatoos (Callocephalon fimbriatum).

This report presents three cases of mycobacteriosis in gang gang cockatoos (Callocephalon fimbriatum) that highlight the potential variation in clinical presentation of this important avian disease. The first case was a female gang gang cockatoo with widespread skeletal disease that presented with a chronic history of weight loss and nonpainful, bilaterally symmetric, distal-wing and leg nodular swellings. The second case was a mature female in good muscle condition with a nodular granulomatous pericarditis and myocarditis causing severe hydropericardium and cardiac tamponade; it was presented for respiratory distress. The third case was one of alimentary mycobacteriosis that presented with a chronic history of weight loss. Some difficulties associated with confirming a premortem diagnosis of mycobacteriosis are discussed.