Dermatitis and cellulitis in leopard geckos (Eublepharis macularius) caused by the Chrysosporium anamorph of Nannizziopsis vriesii

Cross-continental emergence of Nannizziopsis barbatae disease may threaten wild Australian lizards

Members of the genus Nannizziopsis are emerging fungal pathogens of reptiles that have been documented as the cause of fatal mycoses in a wide range of reptiles in captivity. Cases of severe, proliferative dermatitis, debility and death have been detected in multiple free-living lizard species from locations across Australia, including a substantial outbreak among Eastern water dragons (Intellagama lesueurii) in Brisbane, Queensland. We investigated this disease in a subset of severely affected lizards and identified a clinically consistent syndrome characterized by hyperkeratosis, epidermal hyperplasia, dermal inflammation, necrosis, ulceration, and emaciation. Using a novel fungal isolation method, histopathology, and molecular techniques, we identified the etiologic agent as Nannizziopsis barbatae, a species reported only once previously from captive lizards in Australia. Here we report severe dermatomycosis caused by N. barbatae in five species of Australian lizard, representing the first cases of Nannizziopsis infection among free-living reptiles, globally. Further, we evaluate key pathogen and host characteristics that indicate N. barbatae-associated dermatomycosis may pose a concerning threat to Australian lizards.

Outbreak of Paranannizziopsis australasiensis Infection in Captive African Bush Vipers (Atheris squamigera)

We report the epidemiological, clinical and pathological features of an outbreak of Paranannizziopsis australasiensis (order Onygenales) in captive African bush vipers (Atheris squamigera) (ABVs) that died suddenly. The snakes had multifocal, raised, white-grey to dark brown discoloured cutaneous patches. Microscopically, all had integumentary lesions characterized by multifocal to coalescent necroheterophilic epidermitis with superficial and intraepidermal fungal elements and bacteria. Concurrent epidermal hyperplasia, hyperkeratosis and intracellular and intercellular oedema, often leading to vesiculation, and fasciitis/superficial myositis, were consistent findings in all snakes, while ulceration (9/11) and dysecdysis (5/11) varied. A panfungal polymerase chain reaction targeting the internal transcribed spacer-2 region, and gene sequencing, confirmed P. australasiensis infection in three cases. This is the first report of P. australasiensis in the USA and the first record of paranannizziopsis infection in African bush vipers. P. australasiensis should be considered in the differential diagnosis of dermatomycosis in snakes and represents a potential threat to reptile conservation programmes.

Histopathology, Molecular Identification and Antifungal Susceptibility Testing of Nannizziopsis arthrosporioides from a Captive Cuban Rock Iguana (Cyclura nubila)

Chrysosporium-related fungi, the cause of superficial and deep mycoses, are an emerging infectious disease affecting not only reptiles but also immunocompromized humans. However, the information on Nannizziopsis arthrosporioides is extremely scarce. We herein characterized N. arthrosporioides isolated from a Cuban rock iguana (Cyclura nubila). Three skin ulcers were found in a Cuban rock iguana after captivity for 8 years. Microscopic examination revealed hyperplastic, hyperkeratotic, and ulcerative dermatitis coupled with numerous branched, septate fungal hyphae. The fungal culture yielded growth of zonate, felted cottony-powdery colonies with lobate margins on medium. Maximum-likelihood phylogeny tree based on the combined partial actin and partial β-tubulin genes demonstrated that current isolates were mostly close to N. arthrosporioides. Furthermore, antifungal susceptibility test demonstrated that N. arthrosporioides had lowest minimal inhibitory concentration (MIC) values to isavuconazole, efinaconazole, and luliconazole, which may be the potential treatment of choice for N. arthrosporioides infection. The current study describes the first confirmed case of dermatomycosis caused by N. arthrosporioides of a captive reptile in Asia with detailed descriptions of the clinical, histopathological, and mycological features. The current findings provide new information on global distribution and host range of N. arthrosporioides and can raise the concern on the transboundary or emerging disease of N. arthrosporioides in Asian region.

Diagnosis, treatment, and outcome of and risk factors for ophthalmic disease in leopard geckos (Eublepharis macularius) at a veterinary teaching hospital: 52 cases (1985-2013)

OBJECTIVE To describe diagnosis, treatment, and outcome of and risk factors for ophthalmic disease in leopard geckos (Eublepharis macularius) evaluated at a veterinary teaching hospital. DESIGN Retrospective case series. ANIMALS 112 of 144 (78%) leopard geckos that were evaluated at a veterinary teaching hospital in January 1985 through October 2013 and for which sufficient medical record information was available. PROCEDURES Information from medical records was used to identify leopard geckos with ophthalmic disease, characterize cases, and determine risk factors for the presence of ophthalmic disease. RESULTS Of the 112 leopard geckos, 52 (46%) had ophthalmic disease (mainly corneal or conjunctival disease). Female geckos were less likely to have ophthalmic disease, and there was a positive association between increasing age and ophthalmic disease. Use of a paper towel substrate, absence of any heat source, and lack of vitamin A supplementation were positively associated with a diagnosis of ophthalmic disease. Head dysecdysis was the only concurrent disorder significantly associated with ophthalmic disease. At necropsy, 5 affected leopard geckos had squamous metaplasia of the conjunctivae. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that ophthalmic disease is a common finding in leopard geckos. The cause of ocular surface disease in leopard geckos may be multifactorial, and hypovitaminosis A may be an important risk factor. Although animals receiving supplemental vitamin A were less likely to have ophthalmic disease, further understanding is required regarding the metabolism of and nutritional requirements for vitamin A in leopard geckos.

Disseminated Nannizziopsis obscura infection in a renal transplant patient- The first reported case

This is a presentation of a case of disseminated fungal infection in a renal transplant patient with Nannizziopsis obscura, a species not previously reported as having caused disseminated disease in humans and not previously reported in the UK. The fungus was isolated from a intramuscular collection and from a lymph node. The patient responded well to a course of posaconazole.

Nannizziopsis guarroi infection in 2 Inland Bearded Dragons (Pogona vitticeps): clinical, cytologic, histologic, and ultrastructural aspects

Chrysosporium-related infections have been increasingly reported in reptiles over the last 2 decades. In this report, we describe clinical, cytologic, histopathologic, and ultrastructural aspects of Chrysosporium-related infection in 2 Inland Bearded Dragons (Pogona vitticeps). Case 1 was presented for an enlarging raised lesion over the left eye and multiple additional masses over the dorsum. Case 2 was submitted to necropsy by the referring veterinarian for suspected yellow fungus disease. Impression smears of the nodules in case 1 revealed granulomatous to pyogranulomatous inflammation and many septate, variably long, 4-10 μm wide, often undulated hyphae, and very rare conidia. Postmortem impression smears of the superficial lesions of case 2 contained large numbers of solitary conidia and arthroconidia and low numbers of hyphae with similar morphology to case 1. Histopathology of the 2 cases revealed severe, multifocal, chronic, ulcerative, nodular pyogranulomatous dermatitis, with myriad intralesional septate hyphae, and arthroconidia. Fungal culture and molecular sequencing in both cases indicated infection with Nannizziopsis guarroi.

Vesicular, ulcerative, and necrotic dermatitis of reptiles

Vesicular, ulcerative, and necrotic dermatologic conditions are common in captive reptiles. Although these conditions have distinct differences histologically, they are commonly sequelae to each other. This article examines the anatomy and physiology of reptile skin; discusses reported causes of vesicular, ulcerative, and necrotic dermatologic conditions; and reviews various management options.

Molecular characterization of reptile pathogens currently known as members of the chrysosporium anamorph of Nannizziopsis vriesii complex and relationship with some human-associated isolates

In recent years, the Chrysosporium anamorph of Nannizziopsis vriesii (CANV), Chrysosporium guarroi, Chrysosporium ophiodiicola, and Chrysosporium species have been reported as the causes of dermal or deep lesions in reptiles. These infections are contagious and often fatal and affect both captive and wild animals. Forty-nine CANV isolates from reptiles and six isolates from human sources were compared with N. vriesii based on their cultural characteristics and DNA sequence data. Analyses of the sequences of the internal transcribed spacer and small subunit of the nuclear ribosomal gene revealed that the reptile pathogens and human isolates belong in well-supported clades corresponding to three lineages that are distinct from all other taxa within the family Onygenaceae of the order Onygenales. One lineage represents the genus Nannizziopsis and comprises N. vriesii, N. guarroi, and six additional species encompassing isolates from chameleons and geckos, crocodiles, agamid and iguanid lizards, and humans. Two other lineages comprise the genus Ophidiomyces, with the species Ophidiomyces ophiodiicola occurring only in snakes, and Paranannizziopsis gen. nov., with three new species infecting squamates and tuataras. The newly described species are Nannizziopsis dermatitidis, Nannizziopsis crocodili, Nannizziopsis barbata, Nannizziopsis infrequens, Nannizziopsis hominis, Nannizziopsis obscura, Paranannizziopsis australasiensis, Paranannizziopsis californiensis, and Paranannizziopsis crustacea. Chrysosporium longisporum has been reclassified as Paranannizziopsis longispora. N. guarroi causes yellow fungus disease, a common infection in bearded dragons and green iguanas, and O. ophiodiicola is an emerging pathogen of captive and wild snakes. Human-associated species were not recovered from reptiles, and reptile-associated species were recovered only from reptiles, thereby mitigating concerns related to zoonosis.