Nora Nogradi1, Sharon J Spier, Balazs Toth, Betsy Vaughan. 1. William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.
Abstract
OBJECTIVE: To describe the clinical course and outcome in horses in which Corynebacterium pseudotuberculosis infections were associated with musculoskeletal disease and lameness. DESIGN: Retrospective case series. ANIMALS: 35 horses. PROCEDURES: Clinical and clinicopathologic data were collected from horses diagnosed with lameness associated with C pseudotuberculosis infection between 1999 and 2009. RESULTS: 32 (91.4%) horses had grade 4/5 lameness. Three (8.6%) horses had grade 5/5 lameness. Abscesses were diagnosed by clinical or ultrasonographic examination. Abscesses were located in the axillary or triceps region in 25 (71.4%) horses, the stifle region in 2 (5.7%), and the popliteal lymph node in 1 (2.9%). Diffuse lymphangitis was seen in 4 (11.4%) horses, osteomyelitis in 2 (5.7%) horses, and septic arthritis in 2 (5.7%) horses. Horses commonly had clinicopathologic abnormalities characterized by neutrophilia (96.4%), anemia (67.8%), hypoalbuminemia (66.6%), or hyperfibrinogenemia (42.8%). Treatment included surgical drainage of the abscess in 21 (60%) horses, performed under ultrasonography in 20 horses; anti-inflammatory medications in 34 (97.1 %) horses; and antimicrobials in 30 (85.7%) horses. CONCLUSIONS AND CLINICAL RELEVANCE: C pseudotuberculosis infection of the limbs in horses typically results in severe lameness but may have a favorable prognosis. The diagnosis may be challenging, and results of blood work consistent with inflammation are nonspecific, but anemia, hyperglobulinemia, and increased synergistic hemolysis inhibition titers are common. Ultrasonography may localize the lesions and facilitate surgical drainage to alleviate lameness. When C pseudotuberculosis musculoskeletal infection results in osteomyelitis or septic arthritis, the prognosis for survival is poor.
OBJECTIVE: To describe the clinical course and outcome in horses in which Corynebacterium pseudotuberculosis infections were associated with musculoskeletal disease and lameness. DESIGN: Retrospective case series. ANIMALS: 35 horses. PROCEDURES: Clinical and clinicopathologic data were collected from horses diagnosed with lameness associated with C pseudotuberculosis infection between 1999 and 2009. RESULTS: 32 (91.4%) horses had grade 4/5 lameness. Three (8.6%) horses had grade 5/5 lameness. Abscesses were diagnosed by clinical or ultrasonographic examination. Abscesses were located in the axillary or triceps region in 25 (71.4%) horses, the stifle region in 2 (5.7%), and the popliteal lymph node in 1 (2.9%). Diffuse lymphangitis was seen in 4 (11.4%) horses, osteomyelitis in 2 (5.7%) horses, and septic arthritis in 2 (5.7%) horses. Horses commonly had clinicopathologic abnormalities characterized by neutrophilia (96.4%), anemia (67.8%), hypoalbuminemia (66.6%), or hyperfibrinogenemia (42.8%). Treatment included surgical drainage of the abscess in 21 (60%) horses, performed under ultrasonography in 20 horses; anti-inflammatory medications in 34 (97.1 %) horses; and antimicrobials in 30 (85.7%) horses. CONCLUSIONS AND CLINICAL RELEVANCE: C pseudotuberculosis infection of the limbs in horses typically results in severe lameness but may have a favorable prognosis. The diagnosis may be challenging, and results of blood work consistent with inflammation are nonspecific, but anemia, hyperglobulinemia, and increased synergistic hemolysis inhibition titers are common. Ultrasonography may localize the lesions and facilitate surgical drainage to alleviate lameness. When C pseudotuberculosis musculoskeletal infection results in osteomyelitis or septic arthritis, the prognosis for survival is poor.