Diseases / List of Fungal / Algal Diseases / Disease description:

Candidiasis in Waterfowl and Bears (with notes on Cranes, Elephants, Lagomorphs and Bonobos):

INFORMATION AVAILABLE

GENERAL INFORMATION

CLINICAL CHARACTERISTICS & PATHOLOGY

INVESTIGATION & DIAGNOSIS

TREATMENT & CONTROL

SUSCEPTIBILITY & TRANSMISSION

ENVIRONMENT & GEOGRAPHY

 

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General and References

Disease Summary

Yeast-like fungal infection, usually of debilitated individuals, often affecting the gastro-intestinal tract.
In Lagomorphs: Candida albicans has been reported to cause a moist dermatitis in domestic rabbits (Oryctolagus cuniculus domesticus). (B606.4.w4)

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Alternative Names (Synonyms)

  • Candida infection
  • Thrush
  • Crop mycosis
  • Moniliasis
  • Sour crop

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Disease Type

 Fungal Infection

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Infectious/Non-Infectious Agent associated with the Disease

Candida albicans, Candida spp. - Yeast-like fungi. (also previously named Oidium albicans, Mycotorula albicans, Monila candida, Monila albicans).

Infective "Taxa"

Non-infective agents

--

Physical agents

-- Indirect / Secondary

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References

Disease Author

Debra Bourne MA VetMB PhD MRCVS (V.w5); Nikki Fox BVSc MRCVS (V.w103); Gracia Vila-Garcia DVM, MSc, MRCVS (V.w67)
Click image for main Reference Section

Referees

Anna Meredith MA VetMB CertLAS DZooMed (Mammalian) MRCVS (V.w128); Richard Saunders BVSc BSc CertZooMed MRCVS (V.w121)

Major References / Reviews

Code and Title List

In Waterfowl:

B11.34.w2, B13.35.w2, B15, B16.19.w1, B18, B36.14.w14, B37.x.w1, B48.17.w17
J1.21.w3
J6.7.w2
J7.30.w2
J8.26.w1

In Cranes:
B197.9.w9, B703.10.w10

In Elephants:

B450.17.w17, B453.7.w7
J354.2.w1
P3.2000b.w1

In Bears:

B10.48.w43, B16.9.w9, B64.26.w5
J4.155.w4
D251.8.w8
P5.29.w5

In Lagomorphs: 

B606.4.w4

In Bonobos & Great Apes
B336.39.w39
J4.157.w8, J23.20.w2
N45.13.w1
R1.18Oct2008.w1

Other References

Code and Title List

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Clinical Characteristics and Pathology

Detailed Clinical and Pathological Characteristics

General

WATERFOWL Candidiasis is generally an opportunistic infection, normally affecting debilitated birds. Most commonly an oral/oesophageal infection, also has been reported in the gizzard, as an ocular infection, as a foot infection and as a venereal infection in geese.

Clinical Characteristics

WATERFOWL
  • Gastro-intestinal (usually oral/oesophageal): Anorexia, loss of condition, listlessness, dehydration, 'yeasty' breath. Soft, white to creamy deposits may be visible in the mouth (B11.34.w2, B16.19.w1, B37.x.w1).
  • Ocular: Nictitating membrane (third eyelid) thickened, irregular, opaque, grey-white and with a granular external surface. Discrete lesions in mild cases, may become confluent in severe cases. Mild conjunctivitis. Occasionally also focal corneal opacity, and rarely intraocular involvement with associated lacrimation, blepharospasm and photophobia (J6.7.w2).
  • Foot: Granulomatous nodule on the plantar surface of one foot, with overlying necrotic skin and associated severe lameness (J8.26.w1).
  • Venereal: Penis/cloacal mucosa swollen and reddened, ulcers or granulomatous lesions on the sides of the penis or in the cloaca. Later distal portion (0.5-2cm) of penis blackened, gangrenous and finally sloughing off to leave a shortened penis (J5.17.w1).
CRANES
  • Candida is occasionally isolated from the mouth or bill, usually following an injury (B197.9.w9) or in a crane which is immunosuppressed. (B703.10.w10)
ELEPHANTS The following conditions have been noted in association with Candida infection in elephants:
BEARS
  • Death without prior clinical signs, at two weeks old (in a cub hand-reared from five days old). (J4.155.w4)
LAGOMORPHS
  • A moist dermatitis can occur due to infection with Candida albicans. The chin and dewlap are the most likely areas to be affected. (B606.4.w4)
BONOBOS
  • Oral candidiasis was seen in two recently imported two-year-old bonobos at Yerkes, USA, with severe stomatitis in one of the bonobos. The bonobos, which were refusing to eat, were emaciated and died due to Klebsiella pneumonia. (J23.20.w2, N45.13.w1)
  • Oral candidiasis was seen in a hand-reared bonobo, with typical signs. Intermittent/recurring over a period of about four weeks. (R1.18Oct.w1)
  • Anorexia, diarrhoea and dehydration were seen in a one-year-old Pan troglodytes - Chimpanzee. (J4.157.w8)
  • Tongue lesions were seen in a Gorilla gorilla - Gorilla. (J26.19.w2)

Incubation

WATERFOWL --
CRANES  
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS --

Mortality / Morbidity

WATERFOWL --
CRANES  
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS
  • Candidiasis waspersent but not considered to be the main cause of death in two two-year-old female bonobos recently imported to Yerkes, USA.  (J23.20.w2)

Pathology

WATERFOWL
  • Gastro-intestinal (usually oral/oesophageal): White to cream, cheesy plaques in the mouth and oesophagus. Inflamed, thickened surrounding mucosa (J7.30.w2, B11.34.w2, B37.x.w1, B48.17.w17). (N.B. Similar lesions occasionally seen affecting the proventriculus, cloaca, respiratory tracts, skin (B37.x.w1).)
  • Gastric: Budding yeast-like organisms (3-4Ám diameter) and masses of pseudohyphae on the surface of the koilin layer and extending into the koilin. Positive staining with Periodic Acid-Schiff (J1.21.w3).
  • Ocular: Pseudomycelial hyphae, blastospores and chlamydospores in the nictitating membrane and (if involved) the cornea and deeper parts of the eye. Superficial erosion of the keratinised layers of the nictitating membrane, the stratum spinosum infiltrated with hyphae and budding blastospores. Also some oedema, spongiosis and early acanthosis. Mild corneal oedema, and cellular infiltration: heterophils and mononuclear cells (J6.7.w2).
  • Foot: Granulomatous mass, mainly granulation tissue, with necrotic fibrous tissue, heterophils and scattered granulomas in the dermis, totally destroyed epidermis. Fungal elements (hyphae and yeasts) detected in necrotic outer dermis, blastosporulated yeasts in granulomas (J8.26.w1).
  • Venereal: Inflammatory foci in penis and cloaca, mild to severe inflammation, with variable numbers of fungal elements; also mixed bacteria. Glands in cloaca blocked with fungi (J5.17.w1).
CRANES  
ELEPHANTS --
BEARS Gross pathology:

In a two week old Ursus maritimus - Polar bear cub:

  • Skin: Single puncture (probably bite) caudal to the left scapula. 
  • Mouth: tongue and corners of the mouth covered with adherent white material.
  • Stomach. Distended. Extending from the greater to the lesser curvature, a 1-inch-wide (2.5 cm) band of ischaemic tissue, with intensely hyperaemic edges and gastric mucosa
  • Bladder: multiple small congested areas of the mucosa.
  • CNS: Over the left tentorium cerebelli, extending for 1 cm over the cerebellum, a piece of white material. In the lateral third and fourth ventricles, similar material filling the ventricles. 

    (J4.155.w4)

Histopathology

In a two week old Ursus maritimus - Polar bear cub:

  • Mouth: Dorsum of the tongue hyperkeratotic and parakeratotic. Septate pseudohyphae were found penetrating the stratum corneum and numerous bacterial colonies were present in the superficial keratin. (J4.155.w4)
  • GIT: Stomach - large infarct, with an intensely congested border containing a massive lymphocyte infiltration. In the submucosa were bacterial rods. (J4.155.w4)
  • CNS: Within the cerebral ventricles, extensive occlusive fibrinopurulent exudate. Choroid plexuses swollen with infiltration of leucocytes and fibrin accumulation. Also ependymitis and adjacent non-purulent encephalitis and congestion of adjacent vessels. In the infiltrate were mainly lymphocytes but also in some areas poylmorphonuclear leucocytes and macrophages. No pathogenic microorganisms were detected. (J4.155.w4)
LAGOMORPHS --
BONOBOS
Gross pathology

In a one-year-old Pan troglodytes - Chimpanzee: (J4.157.w8)

  • GIT: Oesophageal mucosa covered in a yellow-white, tenacious pseudomembrane. (J4.157.w8)

Histopathology

In a one-year-old Pan troglodytes - Chimpanzee: (J4.157.w8)

  • GIT: Superficial oesophagel epithelium necrotic. Adjacetnt to normal epithelium, numerous pseudohyphae and blastospores, and at the interface with the normal epithelium, macrophages and large lymphocytes. (J4.157.w8)

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Human Health Considerations

Humans are susceptible to candidiasis as an infection of the mucous membranes, skin, nails and internal organs (B36.14.w14).

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Susceptibility / Transmission

General information on Susceptibility / Transmission

WATERFOWL
  • Candida albicans is a common organism in the environment and may be present normally in the avian gastro-intestinal tract. Candidiasis is usually seen as a secondary infection.
  • Inappropriate use of antibiotics, disrupting the normal microbial flora, may predispose to candidiasis.
  • Sea ducks (e.g. eiders, long-tailed ducks, scoters) kept on fresh (rather than salt) water appear more susceptible. It may be that the nasal secretions of the active salt glands in these species normally inhibit yeasts; this protection is removed when the salt gland atrophies without access to salt water.
  • In general, young birds are considered more susceptible than adults.

(J7.30.w2, B11.34.w2, B13.35.w2, B15, B16.19.w1B18, B37.x.w1)

CRANES
  • Infection usually follows an injury (B197.9.w9) or is found in a crane which is immunosuppressed. (B703.10.w10)
ELEPHANTS --
BEARS
  • In the two-week-old hand-reared Ursus maritimus - Polar bear, infection was thought to be associated with the administration of prophylactic antibiotics (erythromycin) and possibly also with the milk substitute used. (J4.155.w4)
  • In a young Ursus maritimus - Polar bear cub being hand-reared at Brookfield Zoo, development of thrush was possibly induced by use of antibiotics. (D251.8.w8)
LAGOMORPHS --
BONOBOS
  • Candida albicans infection may occur as a superinfection in great apes being treated with antibiotics. (B23.50.w50)
  • Candidiasis is most likely to be seen in great ape infants receiving antibiotic therapy. (B336.39.w39)
  • Individuals may also be more susceptible if immunosuppressed, or with neoplasia or concurrent infectious disease. (B336.39.w39)

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Disease has been reported in either the wild or in captivity in:

In Waterfowl:
  • Long-tailed duck Clangula hyemalis, Barrow's goldeneye Bucephala islandica, common scoter Melanitta nigra, red-breasted merganser Mergus serrator (J6.7.w2).
  • Domestic geese (J5.17.w1).
  • Geese (B48.17.w17).
  • 'Swans'. (B15)
  • 'Seaducks' in the UK (J7.30.w2).
  • Mute swan Cygnus olor (J8.26.w1)

Cranes

  • Found occasionally in cranes. (B197.9.w9)

In Elephants:

  • A case of Candida albicans infection has been reported in an elephant (species not specified). (B453.7.w7)
  • Candida albicans infection has been detected in an Elephas maximus - Asian Elephant associated with hyperkeratosis of the skin. (P3.2000b.w1)
  • Candida spp. are among the infectious agents commonly found associated with dermatitis in elephants. (B450.17.w17)
  • A Candida sp. yeast was isolated together with bacterial infection from the eye of an Elephas maximus - Asian Elephant with ocular lesions in Sri Lanka. (J354.2.w1)

In Bears:

  • Gastroenteric and encephalitic candidiasis infection has been reported in bears (species not specified). (B10.48.w43)
  • Candida albicans affecting the oral cavity, oesophagus and stomach was reported in a two week old Ursus maritimus - Polar bear cub. The infection appeared after a four day course of prophylactic erythromycin. (B16.9.w9, B64.26.w5, J4.155.w4)
  • Candidiasis was the primary diagnosis in three Kodiak bear (Ursus arctos - Brown bear) cubs of 20 aged four to seven months which died at Rostock Zoo, 1971-1985, and was a secondary finding in a further eight cubs. (P5.29.w5)
  • Thrush developed in a young Ursus maritimus - Polar bear cub being hand-reared at Brookfield Zoo in 1999-2000. (D251.8.w8)

In Lagomorphs:

In Bonobos:

  • Oral candidiasis in a bonobo being hand-reared at Twycross Zoo. (R1.18Oct2008.w1)

Host Species List

WATERFOWL:

CRANES

MAMMALS:

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Disease has been specifically reported in Free-ranging populations of:

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Host Species List

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Environment/Geography

General Information on Environmental Factors/Events and Seasonality

In waterfowl: 
  • No seasonal aspects, except that incidence may be higher in spring and summer due to the presence of juveniles which may be more susceptible. Overcrowding and unsanitary conditions may be predisposing factors.
    (B36.14.w14, B37.x.w1, B48.17.w17).

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Regions / Countries where the Infectious Agent or Disease has been recorded

Worldwide (B36.14.w14).

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Regions / Countries where the Infectious Agent or Disease has been recorded in Free-ranging populations

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General Investigation / Diagnosis

General Information on Investigation / Diagnosis

WATERFOWL
  • Clinical examination for typical lesions in the mouth. Examination of stained smears and scrapes from lesions may reveal 3 - 6Ám oval/rounded, thin-walled budding yeast-like cells and mycelial fragments. Fungal elements in tissues visualized by histology.
  • Lactophenol cotton blue is recommended for staining wet mounts, Diff-Quik or similar, new methylene blue and Gram's stain may all be used for staining dry smears.
  • Samples for Histopathology lesions and underlying tissue.

(J8.26.w1, B11.34.w2, B13.35.w2, B16.19.w1, B48.17.w17).

  • Presence of Candida albicans in the foot lesion was confirmed by growth on Sabouraud agar and its pathogenicity was proven by guinea-pig inoculation (J8.26.w1).
CRANES
  • Presence of Candida . (B197.9.w9)
ELEPHANTS
  • Culture. (J354.2.w1)
  • Histopathological examination of biopsy specimen. (P3.2000b.w1)
BEARS
  • Identification of the characteristic organisms in faecal smears, vomitus or caseous material from the oral cavity. (B16.9.w9, B64.26.w5)
  • Candida albicans cultured from the dorsum of the tongue and from the mucosa of the stomach. (J4.155.w4)
    • Note: the brain was fixed before examination, therefore could not be cultured. No micro-organisms were detected in the CNS under microscopic examination, but a subacute bacterial or Candida infection was suspected. (J4.155.w4)
LAGOMORPHS
BONOBOS
  • In a recently imported infant bonobo with severe stomatitis, the presence of Candida was confirmed from swabs of the mouth. (N45.13.w1)
  • Clinical signs, culture of Candida albicans. (R1.18Oct2008.w1)
Related Techniques
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Similar Diseases (Differential Diagnosis)

WATERFOWL Trichomoniasis (Trichomoniasis (Flagellate Infection)), aspergillosis (Aspergillosis), hypovitaminosis A (Vitamin A Deficiency), avian pox virus (Avian Pox), tuberculosis (Avian Tuberculosis), pseudotuberculosis (Yersiniosis); differentiate oesophageal plaques from lesions of duck plague (Duck Plague) (B13.35.w2, B37.x.w1).
CRANES --
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS --

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Treatment and Control

Specific Medical Treatment

WATERFOWL
  • Ocular (eye) lesions: topical nystatin, applied twice daily (e.g. Panalog ointment, Ciba) (B11.34.w2); amphotericin B in ointment, or injected subconjunctivally (B13.35.w2).
  • Oral and oesophageal: oral nystatin, 100,000 units (1ml) per 300g bodyweight twice daily, orally. N.B. this should not be administered by crop tube as this may miss treatment of proximal lesions and the drug is not absorbed from the digestive tract (B11.34.w2, B37.x.w1); in feed at 220 mg/kg diet may also be used (B16.19.w1). Spraying food once daily with 6% formic acid or three times daily with 2% formic acid may also be useful (J7.30.w2).
  • Foot: (in association with removal of main mass of lesion). Oral ketaconazole: 50 mg first day, 75 mg second day, 100mg (12.5 mg/kg) third and subsequent days. Total 32 days of drug treatment (J8.26.w1).
  • Venereal: topical treatment with combined antifungal agent and antibiotics suspended in liquid paraffin was effective in the outbreak described in geese (J5.17.w1).
CRANES
  • For infection in the mouth or bill, topical Nystatin cream. (B197.9.w9)
  • Itraconazole 5 - 10 mg/kg orally every 12 hours. (B12.56.w14)
ELEPHANTS
  • In a case of hyperkeratosis with associated Candida albicans infection, treatment involved daily baths with an antiseptic/antifungal shampoo (2% chlorhexidine/2% miconazole - Malaseb, Leo Laboratories Ltd.), followed by application of mineral oil. Softening of the hyperkeratotic horns was noted within four weeks, with patches of normal skin appearing by six weeks. Reduced body odour was also noted and a repeat biopsy at eight weeks did not reveal any Candida (or other organisms). (P3.2000b.w1)
  • Mixed bacterial and fungal (including Candida) corneal infections of elephants in Sri Lanka were treated with subconjunctival gentamicin (1.0 to 1.5 mL of 80 mg/mL solution), daily for two weeks or polymyxin/bacitracin eye ointment applied four times daily plus ketoconazole, four drops four times daily of a solution made by dissolving a 200 mg tablet of ketoconazole in 25 mL sterile water), for two months. (J354.2.w1)
BEARS
  • Nystatin suspension, orally, at the standard canid (dog) dose rate. (B16.9.w9, B64.26.w5)
LAGOMORPHS

(B606.4.w4)

BONOBOS
  • Oral Nystatin drops (0.5 mL four times daily, for seven days initially but repeated as necessary). (R1.18Oct2008.w1)
  • Fluconazone is recommended in the treatment of Candida infection in bonobos. (P131.w11)
  • Nystatin, Ketoconazole or fluconazole are appropriate for treatment of Candida albicans infection in great apes. (B23.50.w50)
Related Techniques
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General Nursing and Surgical Techniques

WATERFOWL
  • Treat any underlying problem, as Candida is usually an opportunistic pathogen (B13.35.w2, B11.34.w2).
  • Vitamin A and vitamin B supplementation may be useful (B48.17.w17).
  • Main mass of foot lesion removed (J8.26.w1).
CRANES --
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS --
Related Techniques
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Preventative Measures

Vaccination WATERFOWL Vaccination was apparently useful in the venereal disease in geese (J5.17.w1).
CRANES --
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS --
Prophylactic Treatment

WATERFOWL

--
CRANES  
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS Nystatin can be used prophylactically in individual great apes at risk of this infection. (B336.39.w39)
Related Techniques
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Environmental and Population Control Measures

General Environment Changes, Cleaning and Disinfection

WATERFOWL

Good husbandry, good hygiene and control of other diseases (B11.34.w2, B18, B48.17.w17).
CRANES --
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS --
Population Control Measures WATERFOWL --
CRANES --
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS --
Isolation, Quarantine and Screening WATERFOWL --
CRANES --
ELEPHANTS --
BEARS --
LAGOMORPHS --
BONOBOS --
Related Techniques
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