Editorial Type:
Article Category: Brief Report
 | 
Online Publication Date: Jul 08, 2021

Septic Arthritis and Granulomatous Osteomyelitis in a Bearded Dragon (Pogona vitticeps) Caused by Mycobacterium sp.

,
,
,
,
, and
Page Range: 184 – 188
DOI: 10.5818/JHMS-S-20-00009
Save
Download PDF

Abstract

A 3-yr-old female bearded dragon (Pogona vitticeps) was presented to the Exotic Pet and Wildlife Veterinary Teaching Hospital at the National Autonomous University of Mexico with a 3-day history of right hindlimb swelling. Radiographs revealed lysis of the right stifle and tarsal bone. Fine-needle aspiration from the stifle revealed large numbers of macrophages and giant cells, and Ziehl-Neelsen stain revealed intracytoplasmic acid-fast bacilli-like bacteria. Standard aerobic culture was performed, with negative results. Pain management was provided with meloxicam (0.2 mg/kg PO q24h) and tramadol (11 mg/kg PO q12h); the owner declined antimicrobial therapy. Three weeks later, radiographs revealed the progression of the lytic lesions to the distal femur, proximal tibia, and tarsal bones. One month later, the patient presented for left hindlimb swelling. Follow-up radiographs revealed a total loss of the right stifle and the tibiotarsal and tarsometatarsal joints, as well as new lytic lesions at the left stifle and tibiotarsal joints. Based on the grave prognosis, the lizard was euthanized. At necropsy, granuloma-like lesions were found at the stifles and the coxofemoral, tibiotarsal, and tarsometatarsal joints. Imprints made from these lesions revealed acid-fast bacilli. No other gross lesions were identified. Microscopic review of the tissues revealed severe granulomatous osteomyelitis and myositis, as well as a severe histiocytic and heterophilic hepatitis with acid-fast intrahistiocytic bacilli. Polymerase chain reaction results confirmed these bacteria as nontuberculous mycobacteria. To the authors' knowledge, this is the first postmortem report of septic arthritis associated with Mycobacterium spp. in a bearded dragon; only two other cases have been reported, both without postmortem findings.

  • Download PDF
Figure 1.
Figure 1.

(a) Macroscopic image of the right hindlimb. Note the soft tissue swelling at the tarsometatarsal joint and right stifle. (b) Postmortem examination. Granuloma-like lesions (arrowheads) of the right tarsometatarsal joint. The phalanges (P) have been marked for anatomic purposes.


Figure 2.
Figure 2.

(a) Survey radiograph of the right hindlimb of a bearded dragon with lytic lesions in the stifle and tarsus. Note the subtle lack of cortical definition in the tarsal region (asterisk). (b) Follow-up survey radiographs of the right hindlimb 13 wk later. Note the progression of the lytic lesions from the stifle and tarsus.


Figure 3.
Figure 3.

(a) Diff-Quik™ stain of the fine needle joint aspirate ×10. Presence of multiple macrophages, Langhans giant cells (asterisks) and basophilic material compatible with minerals. (b) Ziehl-Neelsen stain of the fine-needle joint aspirate ×100. Acid-fast bacilli-like bacteria (arrows) inside the macrophage's cytoplasm. (c) Hematoxylin and eosin stain from the right hindlimb ×40. Increased number of inflammatory cells (histiocytes) and multinucleated giant cells (asterisks). (d) Ziehl-Neelsen stain of right hindlimb ×100. Intralesional acid-fast bacilli-like bacteria (arrows). (e) Hematoxylin and eosin stain from the liver ×40. Liver section with a histiocytic granuloma (arrowheads) and fatty degeneration of hepatocytes (V). (f) Ziehl-Neelsen stain of the liver ×100. Liver parenchyma with multiple vacuoles (V) and acid-fast bacilli-like bacteria (arrows) inside the hepatocyte's cytoplasm.