title: Self-Injurious Behavior Secondary to Cytomegalovirus-Induced Neuropathy in an SIV-Infected Rhesus Macaque (Macaca mulatta).
abstract: A 3.5-y-old, female rhesus macaque (Macaca mulatta) inoculated with SIVmac239 presented 8 mo later for inappetence and facial bruising. Physical examination revealed a superficial skin abrasion below the left eye, bruising below the left brow, and epistaxis of the left nostril. There were no significant findings on CBC, serum chemistry, urinalysis, or radiographs. Differential diagnoses included infectious etiologies, self-injurious behavior, immune-mediated dermatitis, and neoplasia. Lack of response to antibiotic and analgesic therapy and observations of the macaque made it apparent that the skin lesions were self-inflicted. The excoriations rapidly progressed to extend over the nose, and the left palpebrae became edematous. Euthanasia was elected because the macaque appeared to be experiencing continued discomfort despite analgesic therapy. Histopathologic examination revealed systemic cytomegalovirus (CMV) infection involving the facial nerves, periocular nerves, meninges, and perimesenteric lymph nodes. CMV is a common infection in macaques, with adult seroprevalence close to 100% in most colonies. Infection in immunocompetent animals is usually asymptomatic but can cause significant clinical disease in immunodeficient hosts. CMV is associated with a painful peripheral neuropathy in human AIDS patients, and analgesic treatment is often unsatisfactory. Peripheral neuropathy secondary to CMV should be considered as an underlying cause of self-injurious behavior in SIV-infected macaques. Macaques affected by other diseases and disorders may also be at risk for development of painful peripheral neuropathies.
authors.affiliation: Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Clemmons
authors.affiliation: Division of Pathology, Yerkes National Primate Research Center, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Gumber
authors.affiliation: Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Strobert
authors.affiliation: Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.
authors.forename: Mollie A
authors.initials: MA
authors.lastname: Bloomsmith
authors.affiliation: Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA. sherrie.jean@emory.edu.
authors.forename: Sherrie M
authors.initials: SM
authors.lastname: Jean
mesh_terms: D000818:Animals; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D008253:Macaca mulatta; D010523:Peripheral Nervous System Diseases / Q000150:complications*; D016728:Self-Injurious Behavior / Q000209:etiology*; D016097:Simian Acquired Immunodeficiency Syndrome / Q000150:complications*