LCPG Diagnostic exercise 40: Gastric cryptosporidiosis in a Pacific gopher snake

Describe the gross changes:Stomach: The gastric wall is diffusely thickened, rough and reddened, with marked longitudinal rugae.2-Morphologic diagnosis: Gastric hypertrophy and hyperplasia, chronic, diffuse, severe.[also acceptable: proliferative gastritis].3-Etiologic diagnosis: Gastric cryptosporidiosis.Etiology: Cryptosporidium serpentis5-Likely histologic findings:a. Marked hyperplasia of the gastric wall.b. Hypertrophy and hyperplasia of the mucus neck cells that often replace the granular cells of gastric glands.c. Presence of Cryptosporidium sp. [3-7 um diameter, round, pale amphophilic protozoa with basophilic nuclei] lining the mucosal surface, the luminal glandular epithelium, and free within the lumen of the gastric glands.Discussion:Gastric hypertrophy/hyperplasia, although not pathognomonic, is a lesion often associated with Cryptosporidium infection in snakes. C. serpentis is considered to be a snake-specific pathogenic infectious organism, rather than associated with consumption of infected prey or other infected reptiles; however, it has also been isolated from lizards and other reptiles. Clinical signs and lesions primarily concern the stomach and are chronic, as opposed to in mammals, in which the main lesions are intestinal with the primary manifestation being acute diarrhea. In the present case, the parasite was possibly introduced to the collection by a new snake acquisition. The snake in this case had no microscopic signs of immunosuppresion. The diagnosis allowed appropriate health management decisions to be taken for the rest of the reptile collection, and alleviated epizoonotic and public health concerns. The latter particularly because while C. serpentis does not infect humans, other species of Cryptosporium sp. may be of zoonotic potential to staff and public. In addition to these changes in the stomach, this snake also had a microscopic diagnosis of hemosiderosis. The etiology of hemosiderosis in the present case is unknown, although it may result from congestion, hemolysis, overexposure to iron, iron storage abnormalities or starvation. It has also been associated with halofuginone treatment of cryptosporidiosis in snakes (not used in this case).