Sellon D C, Spaulding K, Breuhaus B A, Katz L, Mealey R
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.
J Am Vet Med Assoc. 2000 Mar 15;216(6):882-7, 864-5. doi: 10.2460/javma.2000.216.882.
Hepatic abscesses were diagnosed in 3 adult horses. Two were < 4 years old and had evidence of concurrent immune-mediated conditions, including aseptic arthritis, immune-mediated thrombocytopenia, and immune-mediated anemia. Predisposing factors for hepatic abscess formation in these horses included prior abdominal surgery, proximal duodenitis/jejunitis, inflammatory bowel disease, and a penetrating foreign body in the large colon. Serum hepatic enzyme activities were within or slightly greater then reference limits in all 3 horses. The most pronounced and consistent abnormalities on CBC and serum biochemical analyses were hyperproteinemia, hyperglobulinemia, and a decreased albumin-to-globulin concentration ratio. Hepatic ultrasonography identified hepatic abscesses in all 3 horses. A variety of bacteria were isolated from these abscesses, including Staphylococus aureus and Bacteroides fragilis. One horse developed septic tibiotarsal arthritis, presumably as a result of intermittent bacteremia. Despite aggressive medical treatment, all horses were euthanatized because of a worsening condition and poor prognosis.
3匹成年马被诊断出患有肝脓肿。其中2匹马年龄小于4岁,并有并发免疫介导疾病的证据,包括无菌性关节炎、免疫介导的血小板减少症和免疫介导的贫血。这些马形成肝脓肿的诱发因素包括既往腹部手术、近端十二指肠/空肠炎、炎症性肠病以及大肠内的穿透性异物。所有3匹马的血清肝酶活性均在参考值范围内或略高于参考值。血常规和血清生化分析中最明显且一致的异常是高蛋白血症、高球蛋白血症以及白蛋白与球蛋白浓度比值降低。肝脏超声检查在所有3匹马中均发现了肝脓肿。从这些脓肿中分离出了多种细菌,包括金黄色葡萄球菌和脆弱拟杆菌。1匹马发展为化脓性跗关节关节炎,可能是间歇性菌血症所致。尽管进行了积极的药物治疗,但由于病情恶化和预后不良,所有马匹均被实施安乐死。