van den Wollenberg L, Butler C M, Houwers D J, de Grootv M W, Panhuijzen H, van Maanen C, van Oldruitenborgh-Oosterbaan M M Sloet
DAP Bodegraven, Zuidzijde 63, 2411 RT Bodegraven, the Netherlands.
Tijdschr Diergeneeskd. 2011 Aug;136(8):565-70.
Equine proliferative enteropathy (EPE) is an emerging infectious enteric disease caused by the obligate intracellular gram-negative bacterium Lawsonia intracellularis. EPE was tentatively diagnosed in six weanling foals, aged between 5 and 7 months. Clinical signs included depression, anorexia, ventral oedema, and weight loss. Plasma biochemistry consistently revealed severe hypoproteinaemia. The ante-mortem diagnosis of EPE was based on clinical signs, hypoproteinaemia (6/6), the detection of moderate-to-high titres of L. intracellularis antibody (6/6), and severe thickening of the small intestinal wall on ultrasonography (2/2), or L. intracellularis detected in faeces by PCR (I/2). The first foal died despite treatment and at post-mortem examination the tentative diagnosis was EPE. Three foals from the same farm, which showed similar clinical symptoms were treated with azithromycin and rifampicin; two survived. Post-mortem examination of the foal that died confirmed the tentative clinical diagnosis of EPE on the basis of the lesions found and the detection of L. intracellularis--DNA in the ileum and jejunum. The fifth foal died despite intensive treatment and the post-mortem examination revealed lymphohistiocytic enteritis, typhlitis, and widespread thrombosis in several organs. The sixth foal recovered completely after treatment. This report confirms the presence of clinical L. intracellularis infection in weanling foals in the Netherlands and shows the difficulty in reaching a definitive ante-mortem diagnosis.
马增生性肠炎（EPE）是一种由专性细胞内革兰氏阴性菌胞内劳森菌引起的新发传染性肠道疾病。在6匹5至7月龄的断奶幼驹中初步诊断出EPE。临床症状包括精神沉郁、厌食、腹部水肿和体重减轻。血浆生化检查始终显示严重低蛋白血症。EPE的生前诊断基于临床症状、低蛋白血症（6/6）、检测到中高滴度的胞内劳森菌抗体（6/6）以及超声检查显示小肠壁严重增厚（2/2），或通过PCR在粪便中检测到胞内劳森菌（1/2）。第一匹幼驹尽管接受了治疗仍死亡，尸检时初步诊断为EPE。同一农场的3匹表现出相似临床症状的幼驹用阿奇霉素和利福平进行治疗；2匹存活。对死亡幼驹的尸检根据发现的病变以及在回肠和空肠中检测到胞内劳森菌DNA，证实了EPE的初步临床诊断。第五匹幼驹尽管接受了强化治疗仍死亡，尸检显示淋巴细胞性组织细胞性肠炎、盲肠炎以及多个器官广泛血栓形成。第六匹幼驹治疗后完全康复。本报告证实了荷兰断奶幼驹中存在临床胞内劳森菌感染，并显示了生前明确诊断的困难。
