Sd. Dannemiller et al., FLUCONAZOLE THERAPY IN A RHESUS-MONKEY (MACACA-MULATTA) WITH EPIDURALTRICHOSPORON BEIGELII IN A CEPHALIC RECORDING CYLINDER, Laboratory animal science, 45(1), 1995, pp. 31-35
An adult female rhesus monkey with a cephalic recording cylinder surgi
cally implanted over a craniotomy site developed cloudy cylinder fluid
and a white gelatinous plaque on the epidural capsule surface, Result
s of baseline hematologic, serum biochemical, and cerebrospinal fluid
analysis and simian retrovirus panel were unremarkable. Aerobic cultur
e of the cylinder fluid yielded a pure culture of Trichosporon beigeli
i. This organism is a ubiquitous saprophytic fungus that is a potentia
l pathogen, especially in the immunocompromised host. Factors that cou
ld have contributed to the infection included a microenvironment in th
e cylinder that was favorable to fungal growth, and presence of a dura
l psuedocapsule of collagen and granulation tissue in the implant whic
h could have inhibited cellular defense mechanisms. An intravenous for
mulation of fluconazole was selected for direct application into the r
ecording. cylinder on the basis of safety and efficacy. Fluconazole is
a highly water-soluble, metabolically stable bis-triazole antifungal
with excellent cerebrospinal fluid penetration and low toxicity. A 4-w
eek course of treatment eliminated Trichosporon organisms from the cyl
inder. Change to oral administration of fluconazole was made at that t
ime to allow use of cephalic cylinder antibiotics that are incompatibl
e with fluconazole. Further treatment with fluconazole was continued o
rally for 3 more months to prevent fungal recrudescence. Culture of cy
linder fluid was performed periodically for 6 months after resolution,
and results remained negative for T. beigelii. This case is believed
to be the first reported T. beigelii infection in a non-human primate.
Fluconazole was effective in eliminating the infection from the cylin
der and preventing its recurrence.