MAXILLARY AND ETHMOID SINUSITIS WITH ORBITAL AND INTRACRANIAL EXTENSION IN AN INFANT ORANGUTAN (PONGO-PYGMAEUS)

Aggressive medical and surgical therapy were employed in a 9-mo-old, p arent-raised, male, hybrid orangutan (Pongo pygmaeus) that developed b ilateral proptosis and pronounced periorbital swellings. Culture of as pirates from the swollen areas initially yielded pure growth of Escher ichia coli. Streptococcus group D was recovered following 11 days of a ntibiotic therapy and worsening of clinical signs. Diagnoses of bilate ral ethmoiditis, left maxillary sinusitis, and bilateral extraconal in traorbital infection with intracranial extension into the anterior fos sa were suggested by computerized tomography (CT) scan. Bifrontal cran iotomy, ethmoidectomy, and maxillary sinus drainage were performed. A chronic proliferative inflammatory process was present in histologic s amples taken from the surgical sites and four different species of aer obic bacteria were isolated. Postsurgical improvement in all areas fol lowing 6 wk of vigorous antibiotic therapy was confirmed by follow-up CT scan. The infant was successfully returned to its parents after 4 m o of separation. The recovery of numerous enteric bacterial species at culture suggests that inoculation of respiratory passages by fecal fl ora was the inciting factor of this infection.