Pyovagina and sepsis due to Streptococcus didelphis in a Virginia opossum

Virginia opossums (Didelphis virginiana) are the only native marsupials in the United States of America and Canada. Females have a reproductive tract consisting of a complex duplex (bifurcated) reproductive system, with 2 ovaries, 2 uteri and uterine tubes, and a vaginal complex composed of 2 lateral vaginae, vaginal sinuses, and a urogenital sinus. Few conditions of the reproductive tract have been described in these marsupials. A 2-y-old, female Virginia opossum was presented because of hematuria and was found dead shortly after admission. The autopsy revealed left lateral vaginal torsion and pyovagina. Streptococcus didelphis was isolated and identified from the lateral vaginal exudate, blood, and liver using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Histologic examination confirmed suppurative and lymphoplasmacytic vaginitis, endometritis, cystitis, pyelonephritis and interstitial nephritis, portal hepatitis with fibrosis, myocarditis, and adrenalitis with intralesional gram-positive cocci. These results suggest ascending S. didelphis infection of the lateral vagina with subsequent torsion, bacterial translocation, bacteremia, and sepsis as the cause of death.