16 John F. Prescott Ulcerative enteritis produced by Clostridium colinum is an acute disease of game birds (grouse, quail, partridge, and pheasants), young chickens, and turkeys, and sometimes other birds including pigeons and American robins. It occurs worldwide. The disease was originally described in quail and therefore at one time it was called quail disease. Disease caused by this bacterium has only been described in birds. Ulcerative enteritis is caused by C. colinum, a close relative of Clostridium piliforme (Figure 1.1), a Gram-positive anaerobe that forms colonies on routine solid medium incubated at 37 °C in 48 hours. Optimal growth is obtained on tryptose-phosphate agar with 0.2% glucose, 0.5% yeast extract, and 8% horse plasma, but the organism grows well on other rich media conventionally used for anaerobes, such as Columbia or Brucella blood agar. Virtually nothing is known about the basis of virulence of this organism; its genome has not been characterized and the basis of its remarkable virulence is unknown. Disease is most frequent in young birds of all types aged 4–12 weeks, but may occur, albeit uncommonly, in adults. An outbreak may last three weeks, peaking 5–14 days after initial infection. Chickens are often predisposed to infection by prior infection with coccidia, or by immunosuppressive infections such as infectious bursal disease or infectious anemia. The infection is transmitted by ingestion of fecally contaminated water or feed, or is acquired directly from infected birds. It is likely that the spores persist for months or years in contaminated environments that are not disinfected, and still persist, to some degree, in environments that are disinfected. Birds recovered from infection may remain carriers, and are likely an important source of infection, but little is known about the persistence of infection and fecal shedding. Clinically, ulcerative enteritis is characterized by the development of diarrhea, which is initially watery but may become hemorrhagic. Affected birds are dull and depressed, become huddled and exhibit feather ruffling. Birds may become emaciated. Mortality varies from 2–10% in chickens to 100% in highly susceptible species such as quail. The latter may just be found dead without clinically apparent illness being observed. In quail, acute lesions are characterized by marked hemorrhagic enteritis mainly of the duodenum, with punctate multifocal hemorrhages often visible through the serosa. Over time, the punctate hemorrhages develop into ulcers, both in the duodenum and throughout the intestinal tract, including the cecum, although lesions are most common in the small intestine. Early hemorrhagic and ulcerative lesions are characteristically surrounded by a pale yellow halo, and expand and coalesce to form large fibrinous and necrotic plaques (Figure 16.1). The ulcers may perforate through the serosa to produce peritonitis. More chronic lesions typically include large, transmural, white focal areas of necrosis (Figure 16.2). The watery intestinal content is bloody in acute cases. Liver lesions are a hallmark of ulcerative enteritis. They vary considerably, from multifocal hemorrhagic or white on the liver surface to large, yellow, irregular multifocal to coalescing areas of necrosis present both on the liver surface and throughout the parenchyma (Figure 16.3
Disease caused by Clostridium colinum: Ulcerative enteritis of poultry and other Avian species
Introduction
Etiology
Epidemiology
Clinical signs
Gross changes
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