DAO prepress abstract  -  DOI: https://doi.org/10.3354/dao03196

Cutaneous mycobacteriosis in an Amazonian manatee Trichechus inunguis under human care

Laura Reisfeld*, Cássia Yumi Ikuta, Laura Ippolito, Bruna Silvatti, José Soares Ferreira Neto, José Luiz Catão-Dias, Fernando C. W. Rosas, José Anselmo D’Affonsêca Neto, Vera M. F. da Silva

*Email: laurareisfeld@yahoo.com

ABSTRACT: An adult male Amazonian manatee (Trichechus inunguis) under human care, presented with three 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 antibiotics were instituted. This treatment strategy did not lead to any clinical improvement and after six months, the lesions progressed to a confluent abscess (5.0 x 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 days 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 as well as review concerns that these bacteria are zoonotic agents and are frequently resistant to conventional antibiotics.