背景:在中东的一个种马农场中,阿拉伯小马驹在许多季节中都报告了上呼吸道疾病。注意到受影响的小马驹有粘液脓性鼻腔分泌物,咳嗽,发烧和呼吸急促。所有受影响的小马驹都经过了大环内酯和利福平的经验性治疗,由转诊的兽医没有改进。在内窥镜检查中,所有受影响的小马驹均有明显的喉袋脓胸(GPE)。
目的:(1)记录一个幼龄阿拉伯马驹家族中先前未报道的喉袋脓胸(GPE)的表现;(2)记录脓胸的细胞学和微生物组成;(3)确定与GPE的存在显着相关的临床体征,作为需要喉袋(GP)内窥镜检查的预测因子;(4)证明通过机械GP灌洗和基于证据的抗菌药物使用成功解决了已确定的综合征,在这种小马驹的人群中,改善抗生素管理和呼吸系统疾病的单一健康方法。
方法:临床体征的评估和评分,对14只受影响的小马驹和10只年龄匹配的对照组进行了上气道内窥镜检查和胸部超声检查,其次是比较气管和喉袋痰培养和细胞学评估。进行治疗性GP灌洗并监测对治疗的反应。
结果:GPE,颅底分布的超声检查病变和机会性病原体感染提示GPE的原发性病变,并将GP排出物吸入肺部。GP灌洗解决了所有病例的脓胸和相关的临床症状。
结论:气管和喉袋抽吸物的细胞学检查显示嗜中性粒细胞渗出液带有脂质吞噬细胞,暗示吞没了牛奶。细菌学显示马链球菌的患病率很高。动物流行病与其他机会性病原体混合。马链球菌。在任何情况下,equi都不是孤立的。
Upper respiratory disease was reported over many seasons in Arabian foals on a single stud farm in the Middle East. Affected foals were noted to have mucopurulent nasal discharge, cough, fever and tachypnea. All affected foals had been empirically treated with a macrolide and rifampicin, by the referring veterinarian without improvement. On endoscopic examination, all affected foals had significant guttural pouch empyema (GPE).
(1) To document a previously unreported presentation of guttural pouch empyema (GPE) in a family of juvenile Arabian foals; (2) To document the cytological and microbial composition of the empyema; (3) To identify clinical signs significantly correlated with the presence of GPE, as predictors for the need for guttural pouch (GP) endoscopy; (4) To demonstrate successful resolution of the identified syndrome with mechanical GP lavage and evidence based antimicrobial use, improving antibiotic stewardship and the one-health approach to respiratory disease in this demographic of foals.
Evaluation and scoring of clinical signs, upper airway endoscopy and thoracic ultrasound were performed in 14 affected foals and 10 age-matched controls, followed by comparative tracheal and guttural pouch sputum culture and cytological evaluation. Therapeutic GP lavage was performed and response to therapy monitored.
GPE, cranioventrally distributed ultrasonographic lesions and opportunistic pathogen infection suggested a primary lesion of GPE with aspiration of GP discharge into the lungs. GP lavage resolved the empyema and associated clinical signs in all cases.
Cytological examination of tracheal and guttural pouch aspirates revealed a neutrophilic exudate with lipid-laden phagocytes, suggestive of engulfed milk. Bacteriology revealed a high prevalence of Streptococcus equi ssp. zooepidemicus admixed with other opportunistic pathogens. Streptococcus equi ssp. equi was not isolated in any case.