17d. NHP Bacterial and Mycotic diseases

What are the zoonotic bacteria/mycotic/parasites in NHPs?

-Shigella flexneri

-colibacillosis

-salmonella

-Campylobacter

-Yersinosis

-Helicobacter

-Cryptosporidium parvum

-Plasmodium spp.

-Strongyloides

-Oxyuriasis

-Oesophagostomum

-Schistomiasis

What are the common characteristics of GI bacteria in NHP? Transmission?

-All enterics are G-

-all zoonotic except Lawsonia

-All fecal-oral

-mesenteric lymphadenopathy, splenomegaly unless stated otherwise

What is the etiology of Shigella? What animals are the reservoir for Shigella?

-S. flexneri (most common) , S. sonnei, S. boydii

-Shigella is zoonotic

-NHPs and Humans are only reservoirs

Why are carriers common with Shigella infection?

-antibody production does not produce immunity

-reinfection or chronic (+/- asymptomatic) carriers common

What are the clinical signs associated with Shigella?

1° Acute severe diarrhea, i.e. dysentery (foul smelling, liquid stool w/ mucous, blood, or mucosal fragment), anal atonia and rectal prolapse, dehydrated

2° Sub-acute to chronic intermittent to episodic diarrhea

3° Oddball - gingivitis, abortions, air sac infections (AOTUS), post infection immune mediated arthritis (3-4wk after diarrhea)

What CS is usually missing in NWM with Shigella that OWM normally have?

-diarrhea (lethargic, depression, dehydration)

What pathology lesions are associated with Shigella?

-cecum and colon, will not effect SI

-Pseudo-membrane, edema and hemorrhage of intestinal wall w/ focal ulceration erosions

-bloody large colon

-Gingivitis, Sequella: Reiter's syndrome, Immune-mediated arthritis (due to delayed hypersensitivity; swollen and inflamed joints; neutrophilic inflammation)

-SI intussusception or rectal prolapse

How do you diagnose shigella?

-neutrophilia

-Culture - PLATE QUICKLY (asympto colonization possible)

--must culture 3 consecutive days in a row to reduce false negatives

--MacConkey, Ketoen, Cary Blair

-PCR of virulence gene

What is the name of the virulence gene for Shigella?

ipaH

How to treat Shigella?

-abx based on C/S

-fluid and electrolyte imbalance

What exotoxin does Shigella release?

Shiga exotoxin

classic picture of shigella in NHP

What are the etiological agents of Camylobacteriosis in NHPs?

C. jejuni and C. coli

How prevalent is Campylobacteriosis in NHP colonies?

up to 100%, but often asymptomatic

How is Campylobacteriosis transmitted?

Fecal-oral

What are the clinical signs associated with Campylobacteriosis?

-Severe watery diarrhea, possibly mucohemorrhagic

-hyponatremia, hypochloremia, acidosis, high anion gap

-normal WBC or leukocytosis w/ left shift

What pathology lesions are associated with Campylobacteriosis?

-Not always pathogenic in OWMs

-Cynos - thinning and distended bowel wall, w/ pasty to fluid yellow gray feces and wasting

-shortened villi of the jejunum and ileum, necrotic cells in the lamina propria, epithelial hyperplasia of the cecum/colon

-Edema and hemorrhage of intestinal wall w/ focal ulcerations/erosions

---less severe than Shigella spp & SI is involved

How to diagnose campylobacteriosis?

-warthin starry silver stain

What is the treatment for Campylobacteriosis?

-fluid and electrolyte replacement

-Antibiotics questionable, infections usually self-limiting

-reinfection frequent

-Erythromycin but some resistance

What is a frequent normal fecal isolate in NHP?

E. coli

Name four E.coli and the toxin that it produces

-Shiga toxin-producing E. coli (STEC) aka Enterohemorrhagic (EHEC) - Shiga toxin

-Enteropathogenic E. coli (EPEC) - infantile diarrhea without toxin

-Enterotoxogenic E. coli (ETEC) - heat labile and/or heat stabile enterotoxin

-Enteroinvasive E. coli (EIEC)- invades colonic epithelium (watery +/- bloody diarrhea)

What E. coli is often an opportunistic bacteria in SIV infected macaques?

Enteropathogenic (EPEC)

CS of E. coli vary with species.

-Chimps (Pan)

-Squirrel monkeys (Saimiri)

-Tamarins (Sanguines)

-Marmosets & Cotton top tamarins (Callithrix)

-SIV Rhesus w/ EPEC (Macaca)

-EPEC - mild to moderate watery diarrhea for 10d

-E O13 - acute death w/ no CS

-E hemolytic - watery diarrhea

-EPEC - diarrhea, severe hematochezia and hypotentison, hyperthermia

-EPEC - opportunistic, persistent diarrhea and wasting

Pathology associated w/ E. coli?

-diffuse mucosal hemorrhage in GI

-inflammation of colon

-splenomegaly

-congested and enlarged mesenteric LN

-pulmonary hemorrhages & edema

How to diagnose e. coli?

-culture, serotype

-toxin gene PCR (can be normal is animal is asympto)

What is the treatment for COLIBACILLOSIS?

-Rehydration

-Antibiotics based on C/S

-Enrofloxacin good empiric choice

Prevention: Good sanitation, let it burn out in quarantine

Salmonella spp. responsible for SALMONELLOSIS in NHP

-S. enterica (most common serovar isolates from NHPs are S. typhimurium and S. choleraesuis)

-S. bongori

How is SALMONELLOSIS transmitted?

Fecal-oral,

Contaminated food/water, fomites, wild rodent reservoir

What are the clinical signs associated with SALMONELLOSIS?

-Watery diarrhea, +/- blood or mucous, often pyrexia

-Septicemia, abortion, osteomyelitis, pyelonephritis

When does Salmonellosis become a problem?

-import new cynos

-chronic carrier possible

What pathology lesions are associated with SALMONELLOSIS?

-Edema, and shortening of villi, with elongation of crypts, in jejunum.

-Splenomegaly and lymphadenopathy

-Focal Necrosis of liver and spleen (septicemia)

-Rare ulceration of ileum and colon

How to diagnose SALMONELLOSIS?

Rectal swab, stool or lesion culture

Selenite F. Broth, Brilliant green agar

How to treat salmonellosis?

fluids and selective care w/ abx (abx only for severe diarrhea and septicemia)

Name 2 Yersinia that have medical significance for NHP

Y. pseudotuberculosis and Y. enterocolitica

Yersinia causes enteric and systemic dz in _____ monkeys

NWM and OWM

How is Yersinia spp. transmitted?

Fecal-oral, wild bird & rodent reservoir

Yersinia infection is often associated with what type of weather?

wet months in outdoor colonies

What are the clinical signs associated with Yersinia spp. infection?

Macaque (Macaca)

Squirrel monkeys (Saimiri)

Fulminating enteric and systemic disease

-Diarrhea, vomiting, severe abdominal pain, anorexia, depression, mild dehydration, bloodstained feces, sudden death

-Abortion, stillbirth, failure to cling, cervical LN enlargement

What pathology lesions are associated with Yersinia spp. infection?

Triad of lesions

-Liver/spleen necrosis and abscess formation

-Mesenteric lymphadenopathy

-Ulcerative enteritis/enterocolitis of terminal ileum and ascending colon

-Squirrel monkeys have enlarged Cervical LNs

How to diagnose Yersinia spp?

-CS & necropsy

-culture (slow growing)

+/- cold enrichment of samples

How to treat yersinia?

-advanced cases, no help

-fluids & abx (aminoglycosides and TMS)

Psychrotropes: Cold tolerant, but optimum growth around room temp. Cold enrichment sometimes used; Slow growing, cold enrichment, 4-7˚ C, may be needed. Name three Psychotropes bacteria

Bordetella

Listeria

Yersinia

Which HELICOBACTER SPP. is important in NHP? Zoonotic potential

H. pylori

How is HELICOBACTER SPP. transmitted?

Suspect oral from dam

What are the clinical signs associated with HELICOBACTER SPP.?

-common incidental

-Gastric mucosa, accompanied by lymphocytic plasmacytic gastritis

-Inappetence and occasional vomiting

H cinaedi and H. macacae - colitis and typhylitis of macaques

What pathology lesions are associated with HELICOBACTER SPP.?

Stomach and possibly colon

Gross: Seldom apparent, gastritis

Histo: Mononuclear cell infiltration of the gastric lamina propria, +/- superficial erosions, and epithelial hyperplasia

What stains HELICOBACTER SPP.?

Silver stain

PCR

Helicobacter can cause ____ in captive rhesus macaques. Leads to colitis & typhlitis w/ mononuclear inflammation of laminia propria

chronic idiopathic diffuse colitis

What cuases fatal proliferative enteritis of the rhesus macaque?

Lawsonia intracellularis

What are the clinical signs associated with Lawsonia intracellularis?

-rhesus - fatal proliferative enteritis in juveniles

-cotton topped tamarin (Sanguines) - chronic diarrhea

-Depression, transient diarrhea, abdominal distention, hypothermia, anemia

-found dead

The only enteric bacterial disease we discussed that is not zoonotic or have zoonotic potential!

What pathology lesions are associated with Lawsonia intracellularis?

-last 5cm of distal Ileum thickened

-Gross: Segmental thickening and pallor of distal ileum

-Histo: Loss of villous-crypt architecture, blunting and fusion of villi, epithelia proliferation

What stains Lawsonia intracellularis?

Ziehl-Neelsen (acid fast) or Warthin-Starry (silver stain)

What can be used to treat Lawsonia intracellularis?

Azithromycin

Speed Run: Shigella spp.

CS

-macaque

-marmoset

-tamarin

Clin path

Treatment

-diarrhea. blood, mucus, mucosal fragments, depression, hunched

-lethargy, dehydration, depression

-pale MM, blood in feces

leukocytosis w/ left shift

enro, neomycin, quarantine

Speed Run Campylobacter spp.

CS

-macaque

-baboon-marmoset

Clin path

Treatment

-mucohemorrhagic diarrhea

-chronic diarrhea

-watery or mucohemorrhagic diarrhea

-hyponatremia, hyochloremia acidosis

-normal WBC to leukocytosis w/ left shirt

-self limiting, rehydrate, erythro

Speed Run E. coli

CS

-Chimp

-Squirrel

-Owl

-Tamarin

Patho

Treatment

-mild-severe watery diarrhea, or dysentery

-infant death

-profuse, foul smelling, blood tinged diarrhea, dehydration, depression

-watery diarrhea

-normal WBC to leukocytosis w/ left shift

-erythromycin, ampicillin, gentamycin TMS, intestinal protectant, rehydrate

Speed run salmonella

CS

-Macaque

Clin Path

Treatment

-ciarrhea, pyrexia, infants have watery diarrhea, blood, mucus

-?

-multidrug resistant, carrier state can develop

Speen Run Yersinia

CS

-Macaque

-Squirrel monkey

-Owl monkey

Clin Path

Treatment

-diarrhea, vomition, blood stained feces, depression, abdominal pain, dehydration, abortions, still birth

-weak, inactive, enlarged cervical LN

-weakness, depression, diarrhea, abdominal distension, splenomegaly

-Leukocytosis, hyponatremia, hyochloremia, prerenal azotemia, hyperfibrinogenemia

-neutrophilia w/ left shift

-enro, tetracycline, aminoglycosides, TMS, gentamycine, rehydrate, oral intestinal protectant

Speed Run Helicobacter

CS

-Macaque

-cotton topped tamarin

Clin path

treatment

-Gastri - anorexia and vomitting, intestinal - chronic diarrhea

-chronic diarrhea

-none

-triple antibiotic therapy (amoxacillin, metro, bismuth

Speed Run Lawsonia

CS

-Macaque

Clin Path

Treatment

-mild to transient diarrhea, abdominal distension, death, no CS

-anemia

-tatracycline

(OWM or NWM) are most affected by Streptococcus pneumoniae?

OWM

How is Streptococcus pneumoniae transmitted?

-URT, middle ear, oral

-stress related

-decreased immunocompetence (weaning)

What are the clinical signs associated with Streptococcus pneumoniae? Zoonotic

-Macaque - rapid, death w/in hours, conjunctivitis, ataxia, muscle tremors, head pressing

-Chimps - URT, cough, nasal discharge, neuro, LRT pneumonia

-Primary cause of bacterial meningitis (Pneumococcal meningitis) in NHPs

-Respiratory signs may precede dissemination to meningitis (neurologic signs) or serositis

What pathology lesions are associated with Streptococcus pneumoniae?

-Degenerative neutrophils, gram positive diplococci in smears of cerebrosoinal fluid

-Meningitis: thickening and opacification of meninges, purulent exudate over cortex/ ventricles

-Pneumonia: congestion of lungs, pulmonary edema, consolidation of ventral lung lobes

-Diffuse, supperative serositis, supperative arthritism panopthalmitis

-Micro - fibrinopurulent leptomeningitis extended into cerebral and cerebellar cortices

How to diagnose Streptococcus pneumonia?

-culture of blood, spinal fluids, URT

-PCR for specic genes

What genes specifically should one be looking when running a PCR to diagnose Streptococcus pneumonia?

-lytA

-ply

-spn9802

-spn9828

What Streptococcus cause tocix shock? Which ones causes bronchipneumonia?

-Toxic shock - S. pyogenes

-Bronchopneumonia - S. equi zooepidemicus

What can be used to treat Streptococcus pneumoniae?

-penicillins

-aggressive abx, fluids, diazepam

Brain of rhesus monkey with vascular congestion due to streptococcal meningitis

Pathogenic strains of Klebsiella pneumoniae are ___, ___, and ____

heavily encapsulated

fimbrae

hypermucoviscosity

How is Klebsiella pneumoniae transmitted?

-Aerosol

-normal flora in upper and lower GIT of NHPs

What are the clinical signs associated with Klebsiella pneumoniae?

-pneumonia, meningitis, air sacculitis, septicemia, peritonitis, enteritis

-NWM particularly susceptible to septicemia or peritonitis with no C/S 

-Affects young animals more

-Can be asymptomatic and persistent infections

Which two NHP have serious disease when infected with Klebsiella pneumoniae?

AGMs (Chlorocebus spp.) and NWM.

What pathology lesions are associated with Klebsiella pneumoniae?

-Rhesus

-Owl Monkey

-Baboons

Rhesus - exudative bronchopneumonia & hemopurulent meningitis

Owl monkeys (aotus) - purulent meningitis, consolidative pneumonia, intestinal hemorrhage, peritonitis, air sacculitis

Baboons - thickened air sacs w/ fibrosupperative exudate

How to diagnose Klebsiella pneumoniae?

isolate

What is the String test for Klebsiella pneumoniae? Which virulence is it associated with?

-Hypermucoviscous phenotype (HMV)

-has been associated with virulence determinates for capsular phenotypes K1 and K2

How to treat Klebsiella pneumoniae?

-too acute to tx

-vaccinate w/ autogenous bacterins (effective in Marmosets, owls, and squirrels)

Which NHP spp has more severe disease with Bordetella bronchiseptica infection?

More severe disease seen in Titi monkeys (Callicebus sp)

Which NHP does Bordetella bronchiseptica normally cause death in animals <1yr of age?

Marmoset (Callithrix)

Bordetella bronchiseptica is an _____, meaning it's normally found in the nasopharynx

commensal

-causes issues when there is stress

What are the CS associated with bordetella bronchiseptica?

-bilateral mucopurulent nasal discharge, dyspnea, pyrexia

What pathology lesions are associated with Bordetella bronchiseptica?

Marmoset

-bronchopneumonia affecting all lung lobes (purulent microscopically)

-BRIGHT AND ALERT

Owls

-serous to mucopurluent nasal and occular discharge, dyspnea, depression,m anorexia, weight loss

-bronchopneumonia

How to diagnose bordetella bronchiseptica?

isolate

What can be used to treat Bordetella bronchiseptica?

-Oxytetracycline will resolve clinical disease, but not eliminate from nasal passage

-Autogenous bacterin reported in marmoset

Pastuerella multocida is an opportunistic pathogen of ___ and ___ NHPs. Will also infect ____ if they are post op, have chronic catheter.

-Squirrels (Saimiri) and Owls (Aotus)

-Baboons (Papio)

What are the clinical signs associated with PASTUERELLA MULTOCIDA?

-Squirrels

-Owls

Squirrel monkeys - unsteady gait, nystagmus, head tilt, circling

What pathology lesions are associated with PASTUERELLA MULTOCIDA? in squirrel monkey, Owl monkeys, baboons or wild chimps?

-Squirrel monkeys - meningitis, otitis media, lymphadenitis, myocarditis

-Owl monkeys - pneumonia, pleuritis, meningitis

-Baboons - infections secondary to surgery, chair restraint and chronic catheterization

-Wild chimps - respiratory infection

How is Nocardia asteroides transmitted?

Inhalation, ingestion, skin wounds

-Soil saprophytes

-oral microflora

What are the clinical signs associated with Nocardia asteroides?

-Dyspnea

-epistaxis, mucohemorrhagic nasal discharge

-abdominal distension

-Intermittent diarrhea, chronic weight loss, lethargy, coma

-Immune suppression ↑ risk.

-Pythiosis, wooden tongue, lumpy jaw

What pathology lesions are associated with Nocardia asteroides?

-Bacteria that acts like a fungus

-multinodular to diffuse red to gray areas of consolidation

-pulmonary hemorrhage, edema, abscesses, cavitary lesions,

-***Radiographically indistinguishable from TB

-Histo: Multifocal to coalescing pyogranulomas containing

-sulfur granules and colonies of filamentous bacteria

-Multinucleate giant cells often found at periphery

If a macaque has _____ they will have multi organ multifocal abscesses

-disseminated nocardiosis

What kind of bacteria is moraxella catarrhalis?

G- dipplococcus

What NHP is Moraxella catarrhalis associate with?

-cynomologus

What are the clinical signs associated with MORAXELLA CATARRHALIS?

-epistaxis & mucohemorrhagic nasal discharge

-sneezing

-periorbital swelling

When is moraxella catarrhalis most commonly seen?

-dry winter months

How to tx Moraxella catarrhalis?

-penicillin

-recurrent infection if low humidity

-self limiting

classic image of cyno macaque with epistaxis from moraxella catarrhalis

Speed Run: Streptococcus pneumoniae

-CS

--Chimp

--Macaque

-Path

-Tx

-slight cough, mucopurulent nasal discharge, conjunctivitis, pyrexia, leukocytosis, meningitis, lethargiy, vestibular signs, head holding, seizures

-panopthalmitis, conjutivitis, lethargy, incoordination, hypothermia, depressed reflexes, ataxia, muscle tremors, head pressing, nuchal rigidity, nystagmus, leukocytosis w/ left shift

-Leukocytosis

-penicillin/ampicillin/diazepam, penicillin/ampicillin/chloramphenical

-ceftriaxone

Speed Run: Klebsiella pneumoniae

-CS

--chimp

--macaque

--squirrel

--callitrichid (marm & tamarins)

--owl

-Clin path

-tx

-cough, clear mucopurulent nasal discharge, rales, pulmonary congestions

-anorexia, adipsia, listless, reluctance to move, droopy eyelids

-swollen throat, abscesses in throat, infant death

-death, no CS; anorexia, pyrexia, coughing, cervical mandibular swelling, nasal discharge, facial edema, painful distinded abdomen

-leukocytosis from neutrophilia

-autogenous bacterin, tetracycline, cephalopthin/gentamicin, TMS, amikacin

Speed Run: Bordetella bronchiseptica

-CS

--marmoset

--Owl

-Clin path

-Tx

-mucopurulent nasal discharge, dyspnea during handling, pyrexia, bright and alert, death in animals <1yr

-serous to mucopurulent nasal and ocular discharge, dyspnea, depression, anorexia, weight loss, self limiting

-not listed

-chloramphenicol, amoxicillin, or tetracycline