Galgut Bradley I, Janardhan Kyathanahalli S, Grondin Tanya M, Harkin Kenneth R, Wight-Carter Mary T
Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
Vet Clin Pathol. 2010 Sep;39(3):386-90. doi: 10.1111/j.1939-165X.2010.00246.x. Epub 2010 Aug 2.
A 9-year-old female spayed Shetland Sheepdog was presented to the Kansas State University Veterinary Medical Teaching Hospital for evaluation following a 3-week history of left rear limb lameness that had progressed to generalized ataxia. Multifocal or diffuse brain lesions were suspected based on physical examination findings. Cerebrospinal fluid (CSF) contained 52 nucleated cells/μL composed of mixed inflammatory cells. Treatment with prednisone and cyclosporine was initiated based on a presumptive diagnosis of granulomatous meningoencephalitis. Thirteen days later the dog was nonambulatory and mentally obtunded. Repeat CSF analysis revealed 298 nucleated cells/μL with 61% eosinophils. Rare protozoal tachyzoites consistent with Neospora caninum, Toxoplasma gondii, or Sarcocystis spp. were found extracellularly and within macrophages and an eosinophil. Despite cessation of prednisone and cyclosporine therapy and provision of supportive care, the dog died 6 days later. Examination of brain tissue sections revealed multifocally extensive, necrotizing, histiocytic, and lymphoplasmacytic meningoencephalitis with numerous protozoal zoites and cysts. Immunohistochemical analysis of brain tissue using a monoclonal antibody specific for N. caninum confirmed the diagnosis of neosporosis. Similar but less severe lesions were noted in the spinal cord, although organisms were not found. This case emphasizes the value of repeated CSF analysis when therapy is ineffective and the importance of excluding infectious causes of meningoencephalitis before commencement of immunosuppressive therapy.
一只9岁已绝育的设得兰牧羊犬因左后肢跛行3周且已发展为全身性共济失调，被送至堪萨斯州立大学兽医学院教学医院进行评估。根据体格检查结果怀疑存在多灶性或弥漫性脑病变。脑脊液（CSF）中含有52个有核细胞/μL，由混合性炎性细胞组成。基于肉芽肿性脑膜脑炎的推测性诊断，开始使用泼尼松和环孢素进行治疗。13天后，这只狗无法行走且精神迟钝。重复脑脊液分析显示有298个有核细胞/μL，其中61%为嗜酸性粒细胞。在细胞外以及巨噬细胞和嗜酸性粒细胞内发现了罕见的与犬新孢子虫、弓形虫或肉孢子虫属一致的原虫速殖子。尽管停止了泼尼松和环孢素治疗并提供了支持性护理，但这只狗6天后死亡。脑组织切片检查显示多灶性广泛的坏死性组织细胞性和淋巴浆细胞性脑膜脑炎，伴有大量原虫虫体和囊肿。使用针对犬新孢子虫的单克隆抗体对脑组织进行免疫组织化学分析，确诊为新孢子虫病。在脊髓中也发现了类似但不太严重的病变，尽管未发现病原体。该病例强调了在治疗无效时重复进行脑脊液分析的价值，以及在开始免疫抑制治疗前排除脑膜脑炎感染原因的重要性。
