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Melo UP, Ferreira C, Barreto SWM. Pulmonary aspergillosis in a horse: a case report. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2024; 46:e004723. [PMID: 38282831 PMCID: PMC10811723 DOI: 10.29374/2527-2179.bjvm004723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Respiratory diseases considerably affect equine athletes, being the second most common cause of poor performance. Among these diseases, fungal pneumonia in horses, caused specifically by Aspergillus spp., is relatively rare but potentially fatal. Fungal pneumonia typically affects horses exposed to fungal elements due to environmental factors, immunosuppression, or previous debilitating illnesses. Treatment is complex, with minimal success due to late diagnosis and serious concomitant underlying diseases. The choice of medication depends on the site of infection, the fungal species involved, and financial considerations. This report describes a case of pulmonary aspergillosis diagnosed in a 10-year-old castrated Quarter Horse. Transtracheal lavage revealed fungal elements characteristic of Aspergillus fumigatus. Treatment with dexamethasone, bromhexine hydrochloride, and itraconazole led to a successful recovery. The diagnosis of equine aspergillosis is challenging because its clinical signs overlap with other respiratory diseases. Fungal infections like aspergillosis are gaining attention in the equine health scene. Early and accurate diagnosis is crucial to avoid unnecessary use of antibiotics and prevent antimicrobial resistance. Furthermore, veterinarians and horse handlers must be aware of the risks of spreading aspergillosis to humans, emphasizing preventative measures and respiratory protection.
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Affiliation(s)
| | - Cíntia Ferreira
- Veterinarian, DSc. Centro Universitário Mauricio de Nassau. Natal, RN, Brazil.
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Trápaga MR, Poester VR, Mousquer MA, de Souza RP, Rafael LA, Bonel J, Melo AM, Reis AG, de Faria RO, Stevens DA, Nogueira CEW, Xavier MO. Systemic aspergillosis associated with acute enterocolitis in foals. J Mycol Med 2023; 33:101433. [PMID: 37708695 DOI: 10.1016/j.mycmed.2023.101433] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/12/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
Aspergillosis is an uncommon disease in horses, but it can be fatal. We report two cases of systemic aspergillosis in foals that occurred in a short period in the same region of southern Brazil. In addition, a literature review of similar cases was also performed. Risk factors were attributed to an immunodepression by primary enterocolitis and corticosteroid treatment, the damage in the epithelium, and multiple antibacterial treatments, which allowed local fungal proliferation, tissue invasion and spread of infection, leading to death. Since the antemortem diagnosis of aspergillosis in foals is difficult, our report alerts equine veterinarians regarding the importance of suspecting and investigating fungal co-infections in complicated cases of enterocolitis.
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Affiliation(s)
- Mariana Rodrigues Trápaga
- Laboratory of Mycology, Faculty of Medicine, Federal University of Rio Grande, 96200-400 Rio Grande, RS, Brazil; Post-graduate Program in Health Sciences, Federal University of Rio Grande 96200-400 Rio Grande, RS, Brazil
| | - Vanice Rodrigues Poester
- Laboratory of Mycology, Faculty of Medicine, Federal University of Rio Grande, 96200-400 Rio Grande, RS, Brazil; Post-graduate Program in Health Sciences, Federal University of Rio Grande 96200-400 Rio Grande, RS, Brazil
| | - Mariana Andrade Mousquer
- Hospital of Veterinary Clinics, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Rafaela Pinto de Souza
- Hospital of Veterinary Clinics, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Leandro Américo Rafael
- Hospital of Veterinary Clinics, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Josiane Bonel
- Hospital of Veterinary Clinics, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Angelita Gomes Reis
- Hospital of Veterinary Clinics, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Renata Osorio de Faria
- Hospital of Veterinary Clinics, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - David A Stevens
- California Institute for Medical Research, San Jose, California, United States; Division of Infectious Diseases and Geographic Medicine, Stanford University Medical School, Stanford, California, United States
| | | | - Melissa Orzechowski Xavier
- Laboratory of Mycology, Faculty of Medicine, Federal University of Rio Grande, 96200-400 Rio Grande, RS, Brazil; Post-graduate Program in Health Sciences, Federal University of Rio Grande 96200-400 Rio Grande, RS, Brazil.
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Sierra-Rodriguez T, Groover ES, Lascola KM, Mora-Pereira M, Lee YH, Duran SH, Ravis WR, Spangler E, Hathcock T, Wooldridge AA. Clinical Feasibility and Airway Deposition of Nebulized Voriconazole in Healthy Horses. J Equine Vet Sci 2020; 94:103246. [PMID: 33077094 DOI: 10.1016/j.jevs.2020.103246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/05/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
Voriconazole (VRC) is a potential treatment for pneumomycosis in horses. The objectives of this study were to determine if the delivery of Vfend using a Flexineb nebulizer produced clinically significant [VRC] in lower airways. The hypothesis was that [VRC] after delivery by nebulization would be greater in the pulmonary epithelial lining fluid than plasma. A secondary objective was to determine [VRC] in upper airways through the collection of nasopharyngeal wash (NPW) samples. Voriconazole solution [Vfend-6.25 mg/mL, 100 (n = 2), 200 (n = 3), 500 (n = 1) mg] was nebulized once in 6 healthy geldings. Clinical responses, duration of nebulization, and [VRC] at various time points (up to 8 hours) in plasma, bronchoalveolar lavage fluid (BALF) supernatant and cell pellet, and NPW samples were recorded. Voriconazole (Vfend-6.25 mg/mL, 200 mg) was nebulized in 5 additional, healthy geldings, and [VRC] was measured in NPW samples pre- and postnebulization at time points up to 8 hours. The antifungal activity of BALF and NPW samples was determined using agar disk diffusion. Concentrations of voriconazole were below detection in plasma, BALF supernatant, and cell pellets for all time points and doses except the BALF cell pellet (0.4 μg/g) immediately after nebulization of 500 mg. For 5 horses, administered 200 mg of Vfend, mean [VCR] in NPW at the end of nebulization and 1, 6, and 8 hours postnebulization were: 30.8 ± 29, 1.0 ± 0.84, 0.2 ± 0.19, and 0.34 ± 0.67 μg/mL, respectively. Only NPW samples obtained immediately postnebulization showed antifungal activity. A nebulized Vfend solution is not recommended for the treatment of pneumomycosis in horses.
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Affiliation(s)
- Tamara Sierra-Rodriguez
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Erin S Groover
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Kara M Lascola
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Mariano Mora-Pereira
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Yann H Lee
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL
| | - Sue H Duran
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - William R Ravis
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL
| | - Elizabeth Spangler
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Terri Hathcock
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Anne A Wooldridge
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL.
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Busato E, Meirelles J, Castro M, Abreu A, Sousa R, Brum J, Dornbusch P. Aspergilose sistêmica em um cavalo - relato de caso. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-10600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O presente trabalho relata o caso de aspergilose sistêmica em um cavalo da raça Quarto de Milha. O animal apresentava quadro de emagrecimento progressivo e alopecia. Os parâmetros avaliados durante o exame clínico encontravam-se de acordo com os valores normais para a espécie. No hemograma verificou-se leucocitose por neutrofilia, sem desvio à esquerda, proteínas plasmáticas totais elevadas e aumento do fibrinogênio, indicando um processo inflamatório acompanhado de desidratação. Os exames bioquímicos séricos demonstraram aumento no valor da ureia. Apesar dos exames realizados e da terapia instituída com antibióticos de amplo espectro e suporte nutricional, após 51 dias de internamento o quadro clínico evoluiu para caquexia e decúbito permanente do paciente, o qual foi submetido à eutanásia seguida de necropsia. Com base nos achados nos exames necroscópico e histopatológico, diagnosticou-se infecção sistêmica por Aspergillus sp., acometendo pulmões, fígado, rins, peritônio parietal e encéfalo. Dentre os fatores predisponentes à relatada infecção fúngica sistêmica, destaca-se o status imunológico debilitado do paciente, possivelmente proporcionado por tratamentos prolongados com antibióticos e anti-inflamatórios esteroidais. O presente trabalho relata o primeiro caso descrito de arpergilose sistêmica no Brasil. O diagnóstico definitivo só foi possível após necropsia e histopatologia, visto que os sinais clínicos inespecíficos não foram determinantes para o diagnóstico em vida.
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Affiliation(s)
| | | | | | | | | | - J.S. Brum
- Universidade Federal do Paraná, Brazil
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Brilhante RSN, Bittencourt PV, Lima RAC, Castelo-Branco D, Oliveira JS, Pinheiro A, Cordeiro R, Camargo ZP, Sidrim JJC, Rocha MFG. Coccidioidomycosis and Histoplasmosis in Equines: An Overview to Support the Accurate Diagnosis. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.02.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Headley SA, de Carvalho PH, Cunha Filho LFC, Yamamura AAM, Okano W. Equine pulmonary aspergillosis with encephalitic, myocardial, and renal dissemination. Mycopathologia 2014; 177:129-35. [PMID: 24458918 DOI: 10.1007/s11046-013-9726-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Accepted: 12/24/2013] [Indexed: 01/28/2023]
Abstract
The cause of the death of a 16-month-old Brasileiro-de-Hipismo filly and a 3-year-old male Paint Horse with clinical manifestations of anemia and apathy from southern Brazil was investigated. These horses were maintained at the same stable; received hay as part of their diet and were submitted for routine necropsy evaluations. Significant gross findings included several nodules randomly distributed throughout the pulmonary lobes of both horses, and the kidneys, myocardium, and the frontal lobes of the cerebrum of the filly. Histopathological evaluation revealed pyogranulomatous bronchopneumonia in both horses; granulomatous interstitial nephritis, myocarditis, and encephalitis were observed in the filly. All lesions contained vasculitis and thrombosis associated with myriads of intralesional, branching, septate fungi consistent with Aspergillus spp.; intralesional fungi were more easily identified by the Grocott methenamine silver stain. Mycological culture of fresh pulmonary sections from both horses and the brain of the filly revealed pure growths of A. fumigatus. These findings confirmed the participation of A. fumigatus in the etiopathogenesis of the lesions observed in the lungs of both horses, and the cerebrum, myocardium and kidneys of the filly and might represent the first description of A. fumigatus-induced encephalitis in horses. Additionally, we believe that infection occurred during the ingestion of contaminated hay or by inhalation of spores within contaminated bedding that resulted in transient nasal mycosis, which progressed to pyogranulomatous bronchopneumonia in both horses with embolic encephalitic, myocardial, and renal dissemination of A. fumigatus occurring only in the filly.
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Affiliation(s)
- Selwyn Arlington Headley
- Laboratory of Veterinary Pathology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, PR 445 km 380, Campus Universitário, PO Box 10.011, 860571-970, Londrina, Paraná, Brazil,
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