Disseminated Candidiasis and Candidemia Caused by Candida palmioleophila in a Green Sea Turtle (Chelonia mydas)

Abstract

Simple Summary A sub-adult green sea turtle was rescued and treated for shell fractures on the carapace and plastron. During the first 2 months, the turtle was kept dry-docked with a placement of an intravenous catheter. Pain management, antibiotic and anthelmintic therapy, fluid therapy, human albumin, force feeding, and wound debridement were provided to manage the shell fractures and to control the infection. After 2 months of care, small budding yeasts were noted on the turtle's blood smears. Blood cultures yielded yeast-like colonies that were later identified as Candida palmioleophila. The patient was then treated with an antifungal agent and the catheter was removed. Approximately 3.5 months later, the carapace and plastron wounds had healed. However, the turtle died at 7.5 months after rescue. The postmortem examination revealed disseminated yeast in joints, bones, brain, and lungs. This study aims to improve the veterinary medical care and, therefore, enhance the conservation of endangered sea turtles by describing a rare report of systemic C. palmioleophila infection. A sub-adult green sea turtle (Chelonia mydas) was rescued and treated for carapace and plastron shell fractures. The turtle was kept dry-docked for the first 2 months with a placement of a long-term jugular central venous catheter (CVC). Pain management, aggressive antibiotic and anthelmintic therapy, fluid therapy, force feeding, and wound debridement were provided to manage the shell fractures and control bacteremia. Human albumin was administered to treat severe hypoalbuminemia. On day 59, small budding yeasts were noted on the blood smears. Candidemia was confirmed by blood culture, as the yeasts were identified as Candida palmioleophila by the molecular multi-locus identification method. The CVC was removed, and the patient was treated with itraconazole. Although the carapace and plastron wounds had epithelized by 5.5 months after the rescue, the turtle died unexpectedly by 7.5 months. The postmortem examination revealed numerous necrogranulomas with intralesional yeasts, morphologically compatible with Candida spp., in joints, bones, brain, and lungs, suggestive of disseminated candidiasis. We describe a rare case of candidemia in the veterinary field. To our knowledge, this is the first report of candidiasis caused by C. palmioleophila in a reptile. The present results should improve veterinary medical care and, therefore, enhance the conservation of endangered sea turtle species.