马特发性出血性膀胱炎(EIHC)是最近描述的马无菌性膀胱炎形式,没有明显的根本原因。此病例报告描述了一名9岁的纯种gel犬,Polakiuria,和血尿。膀胱镜检查显示膀胱粘膜溃疡和出血,弥漫性壁层充血和明显的尿沉。膀胱的组织病理学评估显示慢性活动性溃疡性嗜中性粒细胞,淋巴浆细胞,和嗜酸性粒细胞性膀胱炎.培养后没有细菌或真菌生长,但膀胱粘膜上马疱疹病毒1(EHV-1)的聚合酶链反应(PCR)测试和测序呈阳性。使用广谱抗微生物剂和非甾体抗炎药的保守治疗在14天内完全缓解了临床体征,并显着改善了宏观病变。尽管EHV-1PCR阳性提示病毒病因,马的临床症状,组织学和恢复率与马特发性出血性膀胱炎(EIHC)更为一致。嗜中性粒细胞和淋巴浆细胞性炎症是EIHC的已知特征,但嗜酸性粒细胞浸润以前尚未描述。嗜酸性粒细胞参与的意义尚不确定;然而,它们的存在与真菌有关,病毒,寄生,和其他身体系统中的免疫介导的病因。这是澳大利亚一匹马可能进行EIHC的第一份报告,以及第一例嗜酸性粒细胞浸润,EHV-1检测呈阳性。
Equine idiopathic haemorrhagic cystitis (EIHC) is a recently described form of aseptic cystitis in horses in which there is no discernible underlying cause. This
case report describes a 9-year-old Thoroughbred gelding that presented with stranguria, pollakiuria, and haematuria. Cystoscopy revealed ulceration and haemorrhage of the bladder mucosa, diffuse mural hyperaemia and marked urine sedimentation. Histopathological evaluation of the bladder revealed chronic active ulcerative neutrophilic, lymphoplasmacytic, and eosinophilic cystitis. There was no bacterial or fungal growth upon culture but polymerase chain reaction (PCR) testing and sequencing for equine herpesvirus-1 (EHV-1) on bladder mucosa was positive. Conservative therapy with broad spectrum antimicrobials and non-steroidal anti-inflammatory therapy yielded complete resolution of clinical signs with significant improvement of macroscopic lesions in 14 days. Although a positive EHV-1 PCR suggests a viral cause, the horse\'s clinical signs, histology and recovery rate are more consistent with equine idiopathic haemorrhagic cystitis (EIHC). Neutrophilic and lymphoplasmacytic inflammation is a known feature of EIHC but eosinophilic infiltrates have not been previously described. The significance of the eosinophilic involvement is not certain; however, their presence has been associated with fungal, viral, parasitic, and immune-mediated aetiologies in other body systems. This is the first report of a horse with possible EIHC in Australia, as well as the first
case with eosinophilic infiltrates and testing positive for EHV-1.