Fungal dermatitis secondary to a hemipenal plug in a rhinoceros viper (Bitis nasicornis)

A rhinoceros viper presented with recurrent grey, thickened and crusted tissue protruding from the vent, with unilateral thickening and firmness of the left side of the base of the tail. Under anaesthesia, a plug of caseous material was removed from the inverted left hemipene. Fungal culture of the cloaca showed confluent growth of a single species, which could not be definitively identified at that stage. Because of the potential for Ophidiomyces ophidiicola, the causative agent of ophidiomycosis (snake fungal disease), antifungal treatments were initiated on Day 14. This included 30 minutes daily nebulisation with terbinafine dissolved in sterile saline and topical dilute betadine spray and enilconazole spray on the affected area, with infrequent oral terbinafine. Treatment continued until Day 101. The fungus was ultimately identified by a reference laboratory as a species of Fusarium sp. Clinical resolution was confirmed on Day 214. Aggressive treatment was chosen because of the risk that ophidiomycosis can present to a collection of snakes.