MAXILLARY AND ETHMOID SINUSITIS WITH ORBITAL AND INTRACRANIAL EXTENSION IN AN INFANT ORANGUTAN (PONGO PYGMAEUS)

Aggressive medical and surgical therapy were employed in a 9-mo-old, parent-raised, male, hybrid orangutan (Pongo pygmaeus) that developed bilateral proptosis and pronounced peri orbital swellings. Culture of aspirates from the swollen areas initially yielded pure growth of Escheri chia coll Streptococcus group D was recovered following 11 days of antibiotic therapy and worsening of clinical signs. Diagnoses of bilateral ethmoiditis, left maxillary sinusitis, and bilateral extraconal intraorbital infection with intracranial extension into the anterior fossa were suggested by comput erized tomography (CT) scan. Bifrontal craniotomy, ethmoidectomy, and maxillary sinus drainage were performed. A chronic proliferative inflammatory process was present in histologie samples taken from the surgical sites and four different species of aerobic bacteria were isolated. Postsurgical improvement in all areas following 6 wk of vigorous antibiotic therapy was confirmed by follow up CT scan. The infant was successfully returned to its parents after 4 mo of separation. The recovery of numerous enteric bacterial species at culture suggests that inoculation of respiratory passages by fecal flora was the inciting factor of this infection.