Sweeney C R, Habecker P L
Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348, USA.
J Am Vet Med Assoc. 1999 Mar 15;214(6):808-11.
To analyze medical records and identify factors that veterinarians can use to prevent pulmonary aspergillosis in horses or that would enable them to diagnose it as early as possible.
Retrospective study.
29 horses.
Medical records were reviewed for horses with pulmonary aspergillosis diagnosed on the basis of characteristic postmortem findings. Information on history, clinical signs, disease progression, and postmortem findings was obtained.
25 of 29 (86.2%) horses had primary (n = 20) or secondary (5) disease compatible with loss of integrity of the gastrointestinal (GI) tract. The remaining 4 horses had a non-GI tract disorder; only 1 of these 4 had clinical signs associated with the respiratory tract (i.e., pleuropneumonia). Although 22 (75.9%) horses had various signs of respiratory tract disorders, an antemortem diagnosis of Aspergillus pneumonia was made in only 1 horse and was suspected in only 1 other. Fungal organisms were seen histologically in tissues other than the lung in 12 (41.4%) horses.
Horses with enteritis, colitis, typhlitis, or other diseases of the GI tract that result in mucosal compromise, and horses with clinical signs of respiratory tract disease, particularly if the horse's condition is unresponsive to treatment with antimicrobial agents; should be considered at high risk of having pulmonary aspergillosis. Immunosuppression from debilitating disease may also predispose horses to aspergillosis. Because invasive pulmonary aspergillosis can be difficult to diagnose, clinicians should be aware of clinical and epidemiologic settings in which this disease would develop.
