Diarrhea Associated with Enterococcus Faecium in an Adult Cat

A 10.5-year-old Himalayan queen was brought to a vet- erinarian with a 7-day history of intermittent vomiting and diarrhea. The queen had given birth 2 months earlier, and the kittens also had diarrhea. The owner reported no previ- ous medical problem. The physical examination was other- wise normal; oral antibiotics were prescribed and the cat was released without further intervention. The cat was found dead the next morning and was brought to the diagnostic laboratory of the Faculted e Me ´decine Veterinaire de l'Universitede Montreal for necropsy. The body was in a relatively poor condition, and mild autolysis was present. The intestinal contents were loose and no blood was ob- served; the intestinal mucosa appeared normal on gross ex- amination. The only other changes noted were mild hydro- pericardium along with pulmonary congestion and edema. Samples of brain, heart, lung, liver, spleen, kidney, trachea, esophagus, thyroid, bone marrow, stomach, and intestine (duodenum; anterior, mid-, and posterior jejunum; ileum; ce- cum; colon) were fixed in 10% buffered formalin and rou- tinely processed for histopathology. A section of ileum was sent for aerobic culture on sheep blood and MacConkey agars. Microscopic examination revealed the presence of numer- ous gram-positive cocci closely associated with the apical portion of the duodenal and jejunal villous enterocytes (Fig. 1). The bacteria were seen either adhering to the brush bor- der or a few micrometers away from the mucosal surface. The latter pattern was interpreted as postmortem separation because mild-to-moderate autolysis was present. Except for postmortem alterations, no changes were noted in villous enterocyte morphology, and the villi were of normal shape and length. Inflammation was minimal, with only occasional crypts dilated by a few neutrophils. The lungs had diffuse moderate congestion and alveolar edema; a few colonies of gram-positive cocci were observed in alveoli without inflam- matory cells or necrosis. The other viscera did not have sig- nificant changes. Aerobic culture of the ileum yielded large quantities of alpha-hemolytic gram-positive cocci on blood agar. The iso- late was catalase negative, was able to grow in the presence of 6.5% NaCl, and was not resistant to 0.01% tetrazolium chloride or 0.04% tellurite. Acid production was observed From the Laboratoire de Pathologie Veterinaire, M.A.P.A.Q., C.P. 3500, St-Hyacinthe, Quebec J2S 7X9, Canada (Helie), and the De ´- partement de Pathologie et Microbiologie, Faculted e Me