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Treatments: Based on clinical findings, Stinky was treated with nebulized gentamycin/saline solution in the hospital. Immediate improvement of respiratory effort and noise was appreciated. Topical Selamectin was applied to ensure complete treatment for external parasites.
The patient was discharged to the rehabilitator to continue gentamycin nebulization and oral doxycycline pending external lab results.
Upon receiving lab results indicating a fungal component to the upper respiratory infection, the patient was started on Terbinafine in addition to the antibiotic treatments. It was not until the terbinafine was started that significant improvement and, eventually resolution, was noted.
Conclusions/Diagnosis: Stinky suffered from severe dermatophytosis resulting in an upper respiratory infection with significant fungal involvement, in addition to the more common skin issues. While the Trichophyton DNA isolated from Stinky’s deep nasal swab could have been a contaminate from more external areas, the volume of trichophyton DNA recovered compared to other bacterial fungal organisms, and the fact that resolution was noted only after the terbinafine was added, both seem to support it as a primary nasal pathogen.
A differential diagnosis of Adenovirus is pending based on a collaborative effort with Dr. David Needle, a veterinary pathologist with the University of New Hampshire studying emerging and zoonotic wildlife diseases.
Follow-up: Stinky improved greatly with home treatments, continued to eat well, and became increasingly active. Upon completing nebulization treatments, he was transitioned to an outdoor enclosure to finish oral antibiotics and antifungals.
Stinky has now fully recovered from both dermatophytosis and upper respiratory infection. He has been released back into the wild.
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