Hello, my name is Karina Ferneda. I am one of the diagnostic pathologists at Nationwide Laboratories. Today, I would like to present to you an interesting case we received at our lab on this May.

We received a formal fixed right for a leg from a 1 year old male bearded dragon named Sandy. The leg measured 6.5 centimetres in length.

On each of the dorsal and paler aspects was an approximately 1 centimetre long, totally extensive, well demarcated, dark yellow to brown ulcer. The skin around each of the ulcers was thickened. After decalcification, the leg was sectioned and processed for histopathologic examination.

This slide shows one section to give you an overview. Here we can see skin. We can see skeletal muscle and a section of bone.

This is higher power view of the same section. Here you can see the ulcerated area. As you can see, the epidermis has lost cellular nuclear detail.

There are numerous degenerated etherophis intermixed with cellular debris, which is this dark area that we can see here. This is higher power view still from the same area. There is a thick layer of amorphouseosinophiic sorry, sinophilic material containing numerous formal hyphae.

And there are mixed bacterial aggravates. This PASte section shows the detail of the hyphae. As you can see, they are irregularly branching, they are sate with parallel walls.

This is the of the same section. We can see severe granulomatose dermatitis that is composed of numerous granulomas, like this one. Surrounded by marked mixed inflammatory infiltrate.

This is higher power view of one of the granulomas. It has a central core of necrosis and degenerated cells surrounded by numerous macrophages. And you are wanting to get the giant cells.

The dimis between these granulomas is infiltrated by large numbers of heterophis, macrophages, and fewer lymphocytes and plasma cells, and we can see here, for example, one multinucleated giant cell. On this slide, you can see within this granuloma that a nodes are often within the surrounding interstitial inflammation, numerous fungal hyphae, as we can see here. And we can see here a multinucleated China sizes.

This is a nice view of one of the IV. You can clearly see the set, set. Here.

And a multinucleated giant cell. This is another section of the same sample with similar dermatitis. In this section inflammation is also extending deeper into the skeletal muscle, as we can see in this area.

In this picture, we can see Morgannolomas that also contain As we can see here, numerous hyphae. We can see here also the SEPTA. This slide has been stained with PAS which makes it easier to identify the hyphae, not the branching and not the SEPTA.

Bone was also affected by this infection as we can see this section. Including bone marrow. In this area, There are multinucleated giant cells.

Surrounded multiple ivy. The morphologic diagnosis for this case was dermatitis, cellulitis, myositis, and osteomyelitis, granulomatos and necrotizing, severe withational fungal organisms. Among the possible ideologies, Chrysosporeon species are the most likely cause.

Fungal infections of reptiles has been regarded as opportunistic, caused by saprophytic organisms, and it's often associated with inappropriate environmental conditions, poor nutrition or immunosuppression. During the last years, there have been several reports of yellow fungus disease. This is an emerging disease in reptiles where preform species have been identified.

Among them, Chrysosporum anamorph of Naniopsis variety, very difficult name, known as CAMV is the most important clinically and is considered the primary pathogen. Most cases have been identifying reptiles, such as the bird the dragon as in this case. It has also been described in snakes, geckos, lizards, and saltwater crocodiles.

However, other crisis form species have been reported in dogs, in horses, chickens, and humans. In bearded dragons, this fungus cause granulomatose dermatitis that often extends into underlying muscle and bone causing myositis and osteomyelitis as we have just seen. It often progresses to a lethal systemic infection causing granuloma to inflammation in internal organs.

Fungal infections are likely underdiagnosed as they are often difficult to clinically differentiate from bacterial infections that tend to be more common. In this species. The key for the diagnosis is skin biopsy and culture.

We should bear in mind that this fungus is difficult to identify in culture. The main problem being that it may be mistaken for trichophytum and trichosporum. Hence, if you suspect chrysosporum infection and submit samples for culture, always let lab know that you suspect this.

As reptiles became more popular as pets, it is very important to identify fungal disease, not only for their health, but also because some of these species can also affect humans. I hope you found also in this case and enjoy the, the pictures. Thank you very much for your attention.