Today's Veterinary Practice

MAR-APR 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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PEER REVIEWED 80 AVIAN ASPERGILLOSIS electrolyte abnormalities can be seen as well. Protein electrophoresis can be used to obtain an overview of inflammatory changes. 1,2 A decreased albumin:globulin ratio (<0.5) should raise suspicion for aspergillosis. 1 Cytology and fungal culture can be useful for detecting fungal spores. To reduce sample contamination, an aseptic technique must be used. Cytology may show septate, 5- to 10-mcm-thick hyphae with straight parallel sides, ball-shaped terminal ends, and 45° branching. 2 Culture of samples taken from granulomas or the respiratory tract can help confirm aspergillosis. 1 Serologic assays can be used to monitor treatment response and fungal exposure. An active Aspergillus infection can be better diagnosed with paired-titer serology than with a single titer because of the ubiquitous nature of the fungus. 1,2 Noninvasive imaging—radiography, computed tomography (CT), and magnetic resonance imaging (MRI)—can help determine the location and distribution of potential lesions; however, images from these technologies cannot confirm the disease. Lateral and dorsoventral radiography is helpful for evaluating the lungs and air sacs (lower respiratory tract). 2 A late-stage infection can have radiographic evidence of multiple soft tissue densities (granulomas; FIGURE 1 ). Asymmetry, the thickness of air sac walls, hyperinflammation, consolidation, and soft tissue density in the lungs/air sacs can be observed. 1,2 Radiographic evidence is not ideal for detecting short- term improvement. 3 CT and MRI can be useful for viewing exact lesion locations ( FIGURE 2 ); however, such testing is associated with a higher financial burden and often requires anesthesia or heavy sedation. Endoscopy, while invasive, provides the substantial benefit of enabling acquisition of representative samples (biopsy and/or culture) from lesions ( FIGURE 3 ). It also helps visualize granulomas and air sac plaques. 1,2 Granulomas can be localized in the nares, trachea, lungs, and/or air sacs. 1 In addition, endoscopy allows direct treatment of granulomas by endoscopic removal and application of antifungal agents via the treatment channel of the endoscope. 1,2 FIGURE 3. (A) Endoscopic photo of an aspergillosis granuloma in a wild red-tailed hawk. (B) Close-up view of the same granuloma. A B FIGURE 4. Necropsy photo of aspergillosis lesions in the coelomic cavity (liver, air sacs, heart lesions) of the hawk in Figure 3. Signs of ocular aspergillosis typically include discharge, dull/ cloudy cornea, blepharospasm, photophobia, swelling, and/or conjunctival yellow exudate. 2,4

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