Presumptive Stenotrophomonas maltophilia Associated Multisystemic Granulomatous Disease in Aquatic Turtles

Stenotrophomonas maltophilia is a gram-negative bacterium that can be routinely identified in the aquatic environment, and has become an emergent, multi-drug resistant life-threatening organism in some circumstances. This bacterium was identified as a presumptive causative agent in cases of polysystemic granulomatous disease in one diamondback terrapin (Malaclemys terrapin) and one mata mata (Chelus fimbriata). Both chelonians presented with lethargy, hyporexia, and multifocal subcutaneous masses diagnosed by physical examination and in one individual on computed tomography (CT). The primary hematologic finding was moderate to severe heterophilic leukocytosis, and both turtles were treated with a combination of supportive care, systemic antibiotics, and/or surgical resection of subcutaneous masses. Medical and surgical management were unsuccessful, and one patient was euthanized and the other found deceased. Necropsies revealed multisystemic granulomas, and cultures identified growth of Stenotrophomonas maltophilia. A post-mortem investigation into possible risk factors identified co-morbidities including shell disease, repeated administration of injectable antibiotics, low environmental temperature, and aquatic pH changes as possible contributing factors. This bacterium appears to be an emerging organism of concern and should be considered as a potential cause of granulomas in aquatic chelonians.