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Candidiasis
 
Description:

Candida - is a polymorphic yeast, i.e., yeast cells that hyphae and pseudohyphae are produced. It has been shown that Candida needs a transcription repressor to maintain the yeast form. This ability to assume various forms may be related to the pathogenicity of this organism. The yeast form is 3-6 um in diameter, gram positive, and it grows overnight on most fungal media.

The genus Candida includes around 154 species. Among these, six are most frequently isolated. While Candida albicans is the most abundant and significant species, Candida tropicalis, Candida glabrata, Candida parapsilosis, Candida krusei, and Candida lusitaniae are also isolated as causative agents of Candida infections.

In birds Candidiasis is generally, but not always caused by the opportunistic yeast known as Candida albicans. It is quite common in the environment and may be present in small numbers in a normal bird's digestive tract. It may, however, cause illness under certain conditions. Very young birds, especially those on antibiotics, may develop primary candidiasis due to their immature immune systems. Adult birds on long term antibiotics or suffering from malnutrition or other illnesses may develop secondary candidiasis. Antibiotics change the normal digestive tract flora and allow the organism to overgrow. Candida albicans most often affects the crop, although the proventriculus (muscular stomach) and nontriculus (glandular stomach) may be affected as well. Candidiasis has also been found to affect the skin, respiratory tract, central nervous system and all other organs.

Transmission: Yeast are found everywhere in the environment including spoiled food. For this reason, fresh fruits and vegetables should not be left in the bird's cage for long periods of time. In the summer heat and humidity, food can spoil in as little as a few hours.

Poor hygiene can also spread yeast infections. Not sterilizing hand feeding equipment, improper cage cleaning and even not washing our hands can spread the yeast.

Most healthy birds will not be affected. Older birds, neonates, sick birds and stressed birds generally develop yeast infections as secondary infections. These secondary infections put increased stress on their already overtaxed immune system and interfere with the healing process.


Symptoms: Regurgitation, anorexia, and delayed crop emptying may be present with a candida infection of the crop. Some birds develop a swollen or bloated mucus-filled crop. White plaques may be present in the mouth if oral candida is present. These must be differentiated from Vitamin A deficiency, pox, and trichomoniasis (parasite). Feather problems around the crop due to irritation and beak abnormalities due to chronic infection are also very common.

Prevention: Removal of old food from the flights, keep water clean and environmental or nutritional stress are extremely important. Maintain a general level of hygiene when handling and hand rearing neonates will help prevent young birds from contracting the disease. It is also important to remember that unnecessary antibiotic therapy can increase the risk of fungal infections.


Treatment: Nystatin, the most commonly prescribed anti-fungal agent. This yellowish liquid suspension is usually administered by mouth for several 5 days or longer. Nystatin can be mixed directly into the hand-feeding formula but is more effective if given full strength about 1/2 hour before feeding. This will give it time to coat the crop lining and attack the unhealthy Candida organism. Nystatin works by disrupting fungal cell walls. Nystatin is not well absorbed in the gastrointestinal tract. This anti-fungal agent should not be used indiscriminately or as a preventative. Candida may become resistant to Nystatin from continued use, from inadequate or improper dosing regimens. Do not assume that a bird treated with nystatin will be free of Candida. Some resistant yeasts require antifungals other than Nystatin.

Diflucan, one of the newer drugs, has proved to be effective in treating fungal infections. A suspension combining Nystatin and Diflucan has been found to be a safe and effective treatment for Candida. Candida in cockatiels can prove to be extremely difficult to treat. When administered properly Diflucan can clear up Candidiasis within five days.

Ketoconazole (trade name Nizoral) which is dosed orally is sometimes prescribed when Nystatin resistant strains of Candida develop. It is almost insoluble in water, expensive and can be toxic if used improperly. Using Nizoral on a severely ill and physically stressed bird can prove fatal. Nizoral should be used under veterinary supervision, only in physically "healthy" birds, to treat yeast infection, or as a preventative when using antibiotic therapy.

Flucytosine - 250mg/kg PO BID x 21 days

Ketoconazole - 10-30 mg/kg BID x 21 days

Fluconazole - 5mg/kg SID for 7 days

Nystatin - 100,000 units 1ml per 400 gram bird PO BID x 7 days

Diagnosis:

Tentative diagnosis can be made with clinical signs along with the absence of bacterial infection. Samples can also be taken, and cultured in specially prepared culture media. Caution - Candida is a common environmental contaminant.

PCR and sequence assays are essential tool to identify the presence of Candida and identify specific strains.
Sample: When testing individual birds, a cloacal swab and throat culture is recommended. If the sample tests positive and clinical signs are positive, the bird should be placed in quarantine and treatment should begin immediately.

Environmental testing using swabs of aviaries, countertops, fans, air-filters, nest-boxes etc. is extremely effective in determining the presence of candida in the environment. Remember candida is found naturally in certain environments without causing any harm.

Handling: Prior to shipping samples should be stored at 4 C. (refrigerator). Samples must be shipped in a padded envelope or box. Samples may be sent by regular mail, but overnight is recommended.
Limitations:
References:

Candida

ASK THE VET (Candidiasis)

 

 
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