Comparison of In-Clinic Diagnostic Testing Methods for Macrorhabdus ornithogaster

Macrorhabdus ornithogaster is an ascomycete yeast often found at the isthmus of the ventriculus and proventriculus of infected birds. Antemortem diagnosis has traditionally involved direct visualization of organisms on wet-mount or gram-stained fecal preparations, cloacal and crop swabs, or by both methods; however, different in-clinic diagnostic techniques have never been compared to establish an optimum test for the identification of M ornithogaster in an avian patient. We compared 5 microscopically evaluated diagnostic testing methods: fecal Gram's stain, direct fecal wet preparation, macro suspension technique, macro suspension with Gram's stain, and macro suspension stained with new methylene blue. Each technique was performed on 96 fecal samples collected during the treatment of M ornithogaster-infected budgerigars with water-soluble amphotericin B. The macro suspension technique produced statistically higher organism counts than the other 4 techniques and was always estimated to have the largest detection probability. We recommend that the macro suspension technique be implemented as the most efficacious diagnostic test for in-clinic assessment of avian patients possibly infected with M ornithogaster.