Exotis ISSN 2398-2985

Reptiles

Abscesses

Synonym(s): Infected wound, Granuloma, Fibriscess

Contributor(s): Robert Johnson, Bruce Maclean

Introduction

  • Cause: local collection of inflammatory product consisting of leukocytes, purulent and liquefied tissue enclosed within a capsule. The contents range in consistency from liquid (rare in reptiles) to a more solid pasty material. May be sterile (rarely - foreign body reaction, particularly drug injection sites) or associated with a wide variety of possible etiological agents (bacterial, fungal, parasitic, viral).
  • Many types of bacteria have been described, including Aeromonas spp, Citrobacter spp, Corynebacterium spp, Enterobacter spp, Morganella spp, Neisseria spp, Proteus spp, Pseudomonas spp, Salmonella spp, Serratia spp; and anaerobic species (Bacteroides spp, Fusobacterium spp, Clostridium spp and Peptostreptococcus spp.
  • Mycobacterium and Nocardia spp have been found.
  • Various fungi may be associated with abscesses, eg Candida, Aspergillus, Fusarium spp.
  • Protozoal spp, especially Trichomonas spp, have been associated with subspectacular abscesses.
  • Microsporidia may be associated with abscesses (especially bearded dragons).
  • Signs: dependent on location of the abscess.
  • Diagnosis: history and oral/physical examination; imaging; bacterial culture and sensitivity.
  • Treatment: drain/reduce/resect/remove abscess; antimicrobial therapy.
  • Prognosis: depends on location and extent of the abscess, system involved, etiologic agent and chronicity of the infection.
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Pathogenesis

Etiology

  • Local collection of inflammatory product consisting of leukocytes, purulent and liquefied tissue enclosed within a capsule secondary to tissue damage/infection.
  • The contents are usually solid or pasty material (rarely liquid in reptiles), and difficult to drain.
  • Many types of bacteria have been described, including Aeromonas spp, Citrobacter spp, Corynebacterium spp, Enterobacter spp, Morganella spp, Neisseria spp, Proteus spp, Pseudomonas spp, Salmonella spp, Serratia spp; and anaerobic species (Bacteroides spp, Fusobacterium spp, Clostridium spp and Peptostreptococcus spp.
  • Mixed infections are found in oral abscesses.
  • Can occur in multiple systems and signs vary according to location of the abscess.
  • Subspectacular abscess in snakes will present as a collection of purulent material beneath the spectacle. Infection may originate from the oral cavity and travel via the nasolacrimal duct; from penetrating wounds or bacteremia. Often associated with flagellates Flagellate/ciliate infection (microscopy of purulent material essential).
  • Gastrointestinal abscesses may occur due to migrating ascarid larvae.
  • In pythons, abscesses are common in the intestine at the level of the gall bladder.
  • Aural abscesses in chelonians are discrete spherical abscesses ventral and rostral to the tympanic membrane.
  • In snakes and lizards, stomatitis may lead to abscessation.
  • Abscess may also occur in the caudal cloaca or hemipene region.
  • Trauma from bite wounds may result in abscessation in lizards.
  • Bacteremia may result in abscessation anywhere in the body.

Predisposing factors

General

Specific

  • Inadequate sterilization of feeding equipment, water bowls.
  • Poor tank management and water quality in aquatic chelonians.
  • Group housing (fighting/mating wounds).
  • Hypovitaminosis A.
  • Stress.

Pathophysiology

  • Abscesses usually occur due to bacteremia, a wound or a penetrating foreign body, eg ascarid larvae, plant material.
  • Oral abscesses in snakes are usually secondary to stomatitis which may initially occur due to poor husbandry and the build-up of pathogenic bacteria in the substrate or drinking water.
  • Trauma suffered by snakes during prehension of food may also cause gingival wounds or periodontal damage resulting in infection.
  • A fibrous capsule forms around the purulent material, which is difficult to drain.

Timecourse

  • Abscesses in reptiles usually form slowly and are chronic in nature.
  • The time period from infection to diagnosis is difficult to determine in most cases.

Epidemiology

  • Any reptile can be susceptible to abscessation.
  • If housed in groups, some species may fight and inflict wounds, eg male lizards with rivals or mates.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Huchzermeyer F W & Cooper J E (2000) Fibriscess, not abscess, resulting from a localised inflammatory response to infection in reptiles and birds. Vet Rec 147 (18), 515-517 PubMed.

Other sources of information

  • Chitty J & Raftery A (2013) Soft Tissue Masses. In: Essentials of Tortoise Medicine and Surgery. Wiley-Blackwell, UK. pp 231-234.
  • Jacobson E R (2007) Bacterial Diseases of Reptiles. In: Infectious Diseases and Pathology of Reptiles. Ed: Jacobson E R. Taylor & Francis Group, USA. pp 461-526.
  • Mader D R (2006) Abscesses. In: Reptile Medicine and Surgery. Saunders-Elsevier, USA. pp 715-719.
  • Murray M J (2006) Aural Abscesses. In: Reptile Medicine and Surgery. Ed: Mader D R Saunders-Elsevier, USA. pp 742-746.
  • Pare J A, Sigler L, Rosenthal K L & Mader D R (2006) Microbiology: Fungal and Bacterial Diseases of Reptiles. In: Reptile Medicine and Surgery. Ed: Mader D R. Saunders-Elseveier, USA. pp 217-226.

Organisation(s)

  • Association of Reptile and Amphibian Veterinarians. Website: www.arav.org.


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