Cutaneous mycobacteriosis in a captive Amazonian manatee Trichechus inunguis

Abstract

An adult male Amazonian manatee Trichechus inunguis under human care presented with 3 circular cutaneous lesions on the dorsal aspect of the rostrum and between the nostrils (plenum). Initially these lesions were superficial, hypopigmented, without warmth and non-painful. Microbiological cultures of skin swabs isolated Candida sp. and Pseudomonas aeruginosa, and topical treatment with antiseptic, antifungal, anti-inflammatory and antibiotic medication was instituted. This treatment strategy did not lead to any clinical improvement, and after 6 mo, the lesions progressed to a confluent abscess (5.0 × 3.0 cm) with increased temperature and obvious discomfort on palpation. An impression smear of a cutaneous biopsy was submitted for Ziehl-Neelsen staining and after detection of acid-fast bacilli, the cutaneous biopsy and a swab from the lesion were sent for histopathology, culture and sensitivity testing. After 5 d of incubation and through PCR-restriction analysis of the isolates, Mycobacterium fortuitum and M. abscessus were identified. Sensitivity testing indicated that the isolates were susceptible to ciprofloxacin and clarithromycin, and after draining of the lesion and administration of systemic antibiotic treatment, there was rapid clinical improvement. This report describes non-healing lesions in an aquatic animal and illustrates the importance of evaluating the presence of non-tuberculous mycobacteria, opportunistic pathogens which are ubiquitous in the aquatic environment, in protracted, non-responsive cases. We also highlight the importance of a correct diagnosis and treatment approach, and we review concerns that these bacteria are zoonotic agents and are frequently resistant to conventional antibiotics.

Global Environmental Nontuberculous Mycobacteria and Their Contemporaneous Man-Made and Natural Niches

“…Nonetheless, NTM have been known to infect animals such as chickens and quails (Meissner and Anz, 1977; Morita et al, 1999). Drug-susceptible M. fortuitum and M. abscessus were identified in a cutaneous lesion on the snout and nostrils of a captive Trichechus inunguis (manatee) in the Amazon (Reisfeld et al, 2018). In captive non-domesticated hoofed animals and in immunosuppressed dogs and cats, M. avium has been reported as disseminated disease (Thorel et al, 2004).…”

Advances in the knowledge of the biology and conservation of the Amazonian manatee (Trichechus inunguis)

“…data). Reisfeld et al (2018) also reported the treatment of Mycobacterium fortuitum and M. abscessus isolated from a persistent cutaneous lesion in the rostrum of an adult male Amazonian manatee with oral administration of ciprofloxacin and clarithromycin (6 mg/ kg), once daily for two months based on the antibiogram test in combination to other supportive drugs.…”

Mycobacterium abscessus, an Emerging and Worrisome Pathogen among Cystic Fibrosis Patients

“…Mab and other NTM subspecies are also commonly found in urban water plumbing and water systems, sometimes in symbiosis with Amoebae [18,19,20,21,22,23,24,25,26,27]. Moreover, Mab has been isolated from fish [28,29,30,31,32,33] and animals [34,35,36,37,38,39,40], who could also represent reservoirs for human infections. This makes exposure common and disinfection difficult, which is very problematic in healthcare settings [7,15,16,19,23].…”