PMC6614951_01
PMC6614951_02
A silicon esophagostomy tube exposed for 77 days in a cat (case 1). (a) The esophagostomy tube prior to removal. Note the multifocal darkly pigmented plaques, primarily within the area of the suture finger trap at the site of tube insertion. (b) The esophagostomy tube after removal. Solid black arrows highlight darkly pigmented plaques, while thinner, lighter colored plaques extend up the insertion tube. The hollow arrow indicates a marker line at the site of interface of the tube and stoma. Note the lack of plaques below the interface line. (c) Close-up photo of the esophagostomy tube after removal of the suture finger trap. Solid black arrows highlight the most prominent plaques. The hollow arrow indicates a marker line at the site of insertion into the stoma.
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fig1
A 2-year female spayed domestic shorthair undergoing treatment for severe chronic rhinitis and bacterial pneumonia had a silicone E-tube (Jorgensen Laboratories, Inc., Loveland, CO) exchanged because of darkly pigmented growth on the tube's luminal surface of 3-4 day duration (Figures 1(a)-1(c)).
Scanning electron microscopy (SEM) images of silicone esophagostomy tubes. (a) The luminal surface of a reference tube. The surface is mostly regular with mild imperfections. The scale bar is equal to 10 mum and the original magnification is 1.44K. Photo credit: John Dunlap. (b) Thick biofilm with crevices covering the luminal surface of a tube exposed for 77 days in a cat (case 1). Dense mats of fungal mycelia are visible. The scale bar is equal to 20 mum and the original magnification is 450x. Photo credit: John Dunlap. (c) Biofilm and multiple large pores in the luminal wall of the intraesophageal portion of a tube exposed for 246 days in a dog (case 2). The scale bar is equal to 10 mum and the original magnification is 1.43K. Photo credit: John Dunlap. (d) Mixed biofilm with bacteria and yeast, as well as a multitude of pores, in the luminal wall of the extraesophageal portion of a tube exposed for 246 days in a dog (case 2). The scale bar is equal to 2 mum and the original magnification is 5.75K. Photo credit: John Dunlap.
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fig2
Scanning electron microscopy findings included a thick biofilm and numerous, variably sized pores within the tube wall, consistent with tube degradation (Figures 2(c) and 2(d)).
PMC6614951_03
Scanning electron microscopy (SEM) images of silicone esophagostomy tubes. (a) The luminal surface of a reference tube. The surface is mostly regular with mild imperfections. The scale bar is equal to 10 mum and the original magnification is 1.44K. Photo credit: John Dunlap. (b) Thick biofilm with crevices covering the luminal surface of a tube exposed for 77 days in a cat (case 1). Dense mats of fungal mycelia are visible. The scale bar is equal to 20 mum and the original magnification is 450x. Photo credit: John Dunlap. (c) Biofilm and multiple large pores in the luminal wall of the intraesophageal portion of a tube exposed for 246 days in a dog (case 2). The scale bar is equal to 10 mum and the original magnification is 1.43K. Photo credit: John Dunlap. (d) Mixed biofilm with bacteria and yeast, as well as a multitude of pores, in the luminal wall of the extraesophageal portion of a tube exposed for 246 days in a dog (case 2). The scale bar is equal to 2 mum and the original magnification is 5.75K. Photo credit: John Dunlap.
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fig2
Scanning electron microscopy findings included a thick biofilm and numerous, variably sized pores within the tube wall, consistent with tube degradation (Figures 2(c) and 2(d)).
PMC6614951_04
1000x magnification of mixed bacteria and budding yeast like cells on Gram stain from a dog (case 3). Photo credit: Bente Flatland.
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fig3
Small, round to ovoid budding yeast with occasional pseudohyphae were observed by light microscopy (Figure 3).
Scanning electron microscopy (SEM) images of polyurethane esophagostomy tubes. (a) The luminal surface of an unused polyurethane tube. The scale bar is equal to 20 mum and the original magnification is 1.42K. Photo credit: John Dunlap. (b) Thick bacterial and yeast-containing biofilm on the luminal surface of a tube exposed for 204 days in a dog (case 3). The visible tube surface has no evidence of pores or cracks. The scale bar is equal to 10 mum and the original magnification is 1.28K. Photo credit: John Dunlap. (c) Thin biofilm on the smooth luminal surface of a tube exposed for 204 days in a dog (case 3). The scale bar is equal to 1 mum and the original magnification is 12.22K. Photo credit: John Dunlap.
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fig4
A thick biofilm of bacteria and yeast was evident on SEM, but the visible areas of the luminal E-tube surface appeared smooth; pores and crevices were not noted (Figure 4).