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   Aspergillus in Parrots  

Kevin Eatwell BVSc (hons) DZooMed (Reptilian) MRCVS
RCVS Recognised specialist in Zoo and Wildlife Medicine
Exotic animal and Wildlife Service
Hospital for Small Animals
Royal (Dick) School of Veterinary Studies
EH25 9RG

Aspergillus is a commonly seen fungal infection in the respiratory tract of birds. This infection is not contagious and is an opportunistic infection. Acute and chronic disease is possible and it is the most frequent fungal infection in birds. Aspergillus is widespread in the environment and proliferates in higher humidity environments. Thus mouldy litter, damp food sources (such as decaying fruit or poor quality seed), poor environmental hygiene or overcrowding can predispose birds to infection. Viral infections such as PBFD can also allow the fungus to take hold. Other causes of immunosuppression (such as chronic stress, malnutrition, prolonged antibiotic use or steroidal therapy) or underlying respiratory disease can lead to Aspergillus infection.

The Aspergillus spores are typically inhaled from the environment and then may cause disease within the respiratory tract. It is important to realise that many birds will be exposed to the fungus but usually will not become ill. Transmission does not occur between birds. Ingestion or skin infection is also possible.

In birds clinical signs typically involve the respiratory tract. Birds can present showing signs of respiratory difficulties and may have noisy breathing. In these cases the fungal infection is within the air sacs and lungs compromising gas exchange. Other birds can present having a change in voice and this is of concern as the infection is on the birds syrinx which can lead to a blockage of the trachea. In some cases Aspergillus may be identified in a bird which was not obviously ill, but was hiding the infection. In some cases mild weight loss is all that is seen. Disease is also possible in the upper respiratory tract of the bird. In birds which are immunocompromised the disease can be quick with many birds dying. These are typically the young birds. In older birds more long standing disease leads to a gradual progression of clinical signs.

Clinical signs alone are insufficient to diagnose the condition. Anaesthesia followed by radiography and endoscopic examination of the tracheal or body cavity is needed to identify the organism. Radiography can show thickened air sacs or overinflation. In some cases subsequent visual inspection with the endoscope is sufficient, but samples can be taken for culture or microscopic examination. Haematology can show elevated white cell counts and antibody testing is available.

Controlling exposure is difficult as Aspergillus is ubiquitous. However keeping the cage clean and using an antifungal disinfectant such as F10 will limit the numbers of spores around. Testing any birds for PBFD is wise, particularly if young birds are involved. Improving the diet and avoiding seed based diets will also reduce the risk. Providing an optimum environment will help to reduce stress effects on the birds.

Treatment is possible but does depend on the severity of the case. Birds that are suffering from respiratory distress due to a blockage in the trachea are emergency cases that require the blockage to be bypassed with an air sac tube. This is placed surgically, while the bird is under anaesthesia, into the side of the bird. Having done this the blockage can be assessed and treated.

Antifungal drugs can be given orally. Typically itraconazole is used for many birds but grey parrots have been shown to be highly sensitive to this drug and terbinafine is used as an alternative. Resistance is possible and newer agents can also be used but do have the disadvantage of higher costs. Topical treatment of lesions is possible with liquid preparations, such as amphotericin B and can be squirted onto lesions via the endoscope.
Nebulisation is also typically performed for these cases. The birds can be placed into a small cage or basket and the nebuliser fixed to the side of the container. A towel can be used to cover the cage and then the unit is switched on. In severe cases the bird will require to be hospitalised and put in an oxygen cage whilst being nebulised. If the infection is in the sinuses then injections may be given directly into these to kill of the fungus.
Surgical treatment is possible depending on the case and surgical removal of a granuloma may be suggested depending on the case.

Treatment is usually ongoing for a number of weeks and in most cases the bird requires repeat examinations to see if the treatment is working.

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