Saulez Montague N, Cebra Christopher K, Heidel Jerry R, Walker Robert D, Singh Ruby, Bird Karyn E
Hagyard Equine Medical Institute, McGee Medical Center, 4250 Iron Works Pike, Lexington, KY 40511-8412, USA.
J Am Vet Med Assoc. 2005 Jan 15;226(2):246-8, 220. doi: 10.2460/javma.2005.226.246.
A 17-year-old gelding was evaluated because of dysuria, inappetence, and weight loss. Cystoscopy revealed severe mucosal ecchymoses with luminal hemorrhage and accumulations of crystalloid sludge. Analysis of a urine sample revealed isosthenuria, an alkaline pH, pyuria, hematuria, bacteriuria, and numerous calcium carbonate crystals. Histologic examination of bladder mucosa biopsy specimens revealed severe neutrophilic infiltration with mineralization. A diagnosis of encrusted cystitis exacerbated by sabulous urolithiasis was made. A Corynebacterium sp susceptible to penicillin, sulfonamide, and enrofloxacin was cultured from the urine and the bladder mucosa biopsy specimens. The horse was treated with penicillin G potassium, IV, for 5 days, followed by trimethoprim-sulfamethoxazole for 4 weeks. Bladder lavage was performed daily for the first 3 days with a balanced electrolyte solution and dimethyl sulfoxide in an attempt to aid expulsion of necrotic debris and crystalline sludge from the bladder. Molecular phylogenetic analysis based on the 16S rDNA gene sequence was used to identify the isolate and determine its phylogenetic position. Results indicated that the isolate was closely related to Corynebacterium matruchotii. To our knowledge, encrusted cystitis secondary to C matruchotii has not been previously identified in a horse.
一匹17岁的去势公马因排尿困难、食欲不振和体重减轻而接受评估。膀胱镜检查显示严重的黏膜瘀斑伴管腔出血和晶体样沉淀物积聚。尿液样本分析显示等渗尿、碱性pH值、脓尿、血尿、菌尿以及大量碳酸钙晶体。膀胱黏膜活检标本的组织学检查显示严重的嗜中性粒细胞浸润伴矿化。诊断为沙性尿路结石加重的结痂性膀胱炎。从尿液和膀胱黏膜活检标本中培养出一株对青霉素、磺胺类药物和恩诺沙星敏感的棒状杆菌。该马先用青霉素G钾静脉注射治疗5天,随后用甲氧苄啶-磺胺甲恶唑治疗4周。头3天每天用平衡电解质溶液和二甲亚砜进行膀胱灌洗,试图帮助排出膀胱内的坏死碎片和晶体样沉淀物。基于16S rDNA基因序列的分子系统发育分析用于鉴定分离株并确定其系统发育位置。结果表明该分离株与马氏棒状杆菌密切相关。据我们所知,此前尚未在马中鉴定出继发于马氏棒状杆菌的结痂性膀胱炎。