Genitourinary and Pulmonary Multidrug Resistant Mycobacterium tuberculosis Infection in an Asian Elephant (Elephas maximus)

A female Asian elephant (Elephas maximus) developed vaginal and trunk discharge. Cultures were positive for pan-susceptible Mycobacterium tuberculosis. Isoniazid and pyrazinamide were given rectally and monitored by serum levels. After being trained at 10 mo to accept oral dosing, treatment was chan...

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Bibliographic Details
Published in:Journal of zoo and wildlife medicine 2011-12, Vol.42 (4), p.709-712
Main Authors: Dumonceaux, Genevieve A, Leger, Judy St, Olsen, John H, Burton, Michael S, Ashkin, David, Maslow, Joel N
Format: Article
Language:English
Subjects:
Animals
Antitubercular Agents - administration & dosage
Antitubercular Agents - pharmacology
Antitubercular Agents - therapeutic use
Antituberculars
CASE SERIES/REPORTS
elephant
Elephantidae
Elephants
Elephas maximus
Female
Female Urogenital Diseases - microbiology
Female Urogenital Diseases - veterinary
Infections
Lymph node tuberculosis
Lymph nodes
Multidrug resistant tuberculosis
Mycobacterium tuberculosis
Pulmonary tuberculosis
tuberculosis
Tuberculosis, Multidrug-Resistant - microbiology
Tuberculosis, Multidrug-Resistant - veterinary
Tuberculosis, Pulmonary - microbiology
Tuberculosis, Pulmonary - veterinary
Wildlife
Zoos
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Summary:A female Asian elephant (Elephas maximus) developed vaginal and trunk discharge. Cultures were positive for pan-susceptible Mycobacterium tuberculosis. Isoniazid and pyrazinamide were given rectally and monitored by serum levels. After being trained at 10 mo to accept oral dosing, treatment was changed and rifampin was added. Oral medications were administered for another 10 mo. A year after completion of therapy, the vaginal discharge increased and cultures yielded M. tuberculosis, resistant to isoniazid and rifampin. Treatment with oral ethambutol, pyrazinamide, and enrofloxacin and intramuscular amikacin was initiated. Although follow-up cultures became negative, adverse reactions to medications precluded treatment completion. Due to public health concerns related to multidrug resistant M. tuberculosis (MDR-TB), the elephant was euthanized. Postmortem smears from the lung, peribronchial, and abdominal lymph nodes yielded acid-fast bacteria, although cultures were negative. This case highlights important considerations in the treatment of M. tuberculosis in animals and the need for a consistent approach to diagnosis, treatment, and follow-up.
ISSN:1042-7260
1937-2825
DOI:10.1638/2011-0040.1