Toth Balazs, Aleman Monica, Nogradi Nora, Madigan John E
Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.
J Am Vet Med Assoc. 2012 Mar 1;240(5):580-7. doi: 10.2460/javma.240.5.580.
To describe clinical and clinicopathologic findings and outcome of horses with meningitis and meningoencephalomyelitis.
Retrospective case series.
28 horses.
Medical records of horses admitted to the hospital during a 25-year period were reviewed. Horses with a definitive diagnosis of meningitis or meningoencephalomyelitis were included in this study. Information extracted from the medical records included signalment, history, reason for admission, clinical signs, results of clinicopathologic testing and diagnostic procedures, treatment, outcome, and necropsy findings.
22 horses had confirmed infectious disease (19 bacterial, 2 parasitic, and 1 fungal), 4 had suspected infectious disease on the basis of CSF cytologic examination findings, and 2 had noninfectious meningitis or meningoencephalomyelitis. Trauma of the head and vertebral column with disruption of the blood-brain barrier and local ascending or hematogenous spread were the most common routes of infection. Common neurologic signs included abnormal mental status, cranial nerve deficits, vestibular dysfunction, ataxia, tetraparesis, and apparent neck pain. Common hematologic abnormalities included leukocytosis, neutrophilia, lymphopenia, and hyperfibrinogenemia. Cytologic examination of CSF samples revealed moderate to marked suppurative inflammation. Mortality rate was 96.4%. Microbial culture of CSF yielded bacterial growth in 15 of 23 horses (before death [2 horses], after death [11], and both [2]).
Results suggested that meningitis and meningoencephalomyelitis are uncommon disorders in horses. Infectious disease was more common than noninfectious disease. Local trauma, ascending infection, or hematogenous spread of infection were the most common causes of meningitis or meningoencephalomyelitis. Neurologic deficits, neutrophilia, lymphopenia, hyperfibrinogenemia, and CSF with neutrophilic pleocytosis were common findings in affected horses.
描述患有脑膜炎和脑膜脑脊髓炎马匹的临床、临床病理特征及预后情况。
回顾性病例系列研究。
28匹马。
回顾了25年间收治入院马匹的病历。确诊为脑膜炎或脑膜脑脊髓炎的马匹纳入本研究。从病历中提取的信息包括特征、病史、入院原因、临床症状、临床病理检查及诊断程序结果、治疗、预后及尸检结果。
22匹马确诊为传染病（19例细菌感染、2例寄生虫感染、1例真菌感染），4匹马根据脑脊液细胞学检查结果怀疑患有传染病，2匹马患有非感染性脑膜炎或脑膜脑脊髓炎。头部和脊柱创伤导致血脑屏障破坏以及局部上行性或血源性传播是最常见的感染途径。常见的神经症状包括精神状态异常、脑神经功能缺损、前庭功能障碍、共济失调、四肢轻瘫以及明显的颈部疼痛。常见的血液学异常包括白细胞增多、中性粒细胞增多、淋巴细胞减少和纤维蛋白原血症。脑脊液样本的细胞学检查显示中度至重度化脓性炎症。死亡率为96.4%。23匹马中有15匹马的脑脊液微生物培养有细菌生长（死亡前[2匹]、死亡后[11匹]、死亡前后均有[2匹]）。
结果表明，脑膜炎和脑膜脑脊髓炎在马匹中是罕见疾病。传染病比非传染病更常见。局部创伤、上行性感染或血源性感染传播是脑膜炎或脑膜脑脊髓炎最常见的病因。神经功能缺损、中性粒细胞增多、淋巴细胞减少、纤维蛋白原血症以及脑脊液中性粒细胞增多是患病马匹的常见表现。
