Abstract An adult male Linne's two‐toed sloth presented for evaluation of right unilateral nasal discharge of 2 weeks’ duration. Examination showed expansion of the right naris with brown mucoid discharge. Radiographs showed loss of detail of the right nasal sinus consistent with soft tissue or fluid accumulation. Nasal flush and subsequent histopathology of retrieved material showed a large fibrinous inflammatory coagulum containing intralesional bacteria and pigmented fungi. Bacterial cultures isolated a variety of organisms considered opportunistic pathogens. Panfungal PCR and sequencing identified Scedosporium apiospermum , a ubiquitous, ascomycetous fungus, recognised as causing serious infections in people and other animals. A short course of enrofloxacin with a prolonged course of antifungal therapy, including topical clotrimazole application and systemic terbinafine and voriconazole, resulted in the resolution of symptoms. Therapy was continued until discharge, resolved, and panfungal PCR was negative. This sloth has remained asymptomatic for more than 2 years post treatment.
Michael Wenninger (Mon,) studied this question.