Nebulized Clotrimazole for Avian Aspergillosis

Avian Aspergillosis is the most common fungal disease of the avian respiratory tract with the primary culprit being Aspergillosis fumigatus. This infection can be challenging to treat at times for a number of reasons. The initial diagnosis of distinguishing Aspergillosis can be tricky since this opportunistic infection often presents with non-specific symptoms. Predisposing conditions such as immunocompromised, unsanitary conditions, malnutrition and respiratory irritants can increase susceptibility to Aspergillosis. Once the diagnosis is made, the fungi produce spores that attach to the lung cavity and air sacs (Beernaert, 2010). 

Assuming your avian friend is willing to comply with wearing a face mask for nebulization therapy, inhalation therapy will be ideal for localized treatment to lungs. This helps achieve high lung concentrations of medication while minimizing systemic side effect potential. Treatment with antifungal therapy is often a long duration to ensure complete eradication and avoid re-infection, particularly to eliminate spores. Most recommendations have therapy anywhere between 1-4 months with Clotrimazole 1% given daily over 30 minutes as a great option (Orosz, 1995). Many have seen dramatic improvements over just one week but important to continue for longer duration to ensure eradication of disease. 

Beernaert, L.A. et al. (2010). Aspergillus infections in birds: a review. Avian Pathology, 39 (5), 325-331. 

Beernaert LA, Pasmans F, Van Waeyenberghe L, et al. Avian Aspergillus fumigatus strains resistant to both itraconazole and voriconazole. Antimicrob Agents Chemother. 2009;53(5):2199–2201. doi:10.1128/AAC.01492-08

Orosz, S.E. & Frazier, D.L. (1995) Antifungal agents: a review of their pharmacology and therapeutic indications. Journal of Avian Medicine and Surgery, 9, 8-18.