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犬念珠菌性腹膜炎:5例报告

Candida peritonitis in dogs: report of 5 cases.

作者信息

Bradford Katy, Meinkoth Jim, McKeirnen Kelci, Love Brenda

机构信息

Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078, USA.

出版信息

Vet Clin Pathol. 2013 Jun;42(2):227-33. doi: 10.1111/vcp.12047.

Abstract

Candida peritonitis is reported in people and is associated with significant morbidity and mortality compared with sterile or bacterial peritonitis. Recognized predisposing risk factors include peritoneal dialysis, hollow viscous organ perforation, abdominal surgery, inflamed intestinal mucosa, antimicrobial administration, and immunosuppression. In this report, we describe 5 cases of dogs with peritonitis complicated by Candida spp; 3 dogs with C albicans, one dog with C albicans and C glabrata, and one dog with C glabrata only. The 3 dogs with C albicans peritonitis presented with duodenal perforation due to NSAID therapy, intestinal resection and anastomosis following postspay-surgery dehiscence, and intestinal foreign body removal. The 2 dogs with C glabrata peritonitis had undergone cholecystectomy due to gall bladder rupture and dehiscence of intestinal biopsy removal sites following exploratory laparatomy. In all cases, initial diagnosis of fungal peritonitis was made via cytologic examination of peritoneal effusions, which revealed marked pyogranulomatous inflammation with numerous 3-8 μm oval, deeply basophilic yeast organisms with thin clear capsules noted within phagocytes and extracellularly. In addition, germ tube formation, hyphae, and pseudohyphae were rarely seen in some of the cases with pure C albicans. Identity of the organisms was determined by culture in all cases and confirmed by PCR in 3 cases. Candida spp. are commensals normally inhabiting the alimentary, the upper respiratory, and the lower urogenital tracts of mammals. They are opportunistic pathogens that can invade and colonize tissue when a patient is immune-compromised or there is disruption of the mucosal barrier. Candida peritonitis should be considered in patients with peritoneal contamination with gastrointestinal or biliary contents.

摘要

念珠菌性腹膜炎在人类中已有报道,与无菌性或细菌性腹膜炎相比,其发病率和死亡率都很高。公认的易感风险因素包括腹膜透析、中空脏器穿孔、腹部手术、肠黏膜炎症、抗菌药物使用和免疫抑制。在本报告中,我们描述了5例并发念珠菌属感染的犬腹膜炎病例;3例白色念珠菌感染犬,1例白色念珠菌和光滑念珠菌混合感染犬,1例仅光滑念珠菌感染犬。3例白色念珠菌性腹膜炎犬分别因非甾体抗炎药治疗导致十二指肠穿孔、绝育手术后切口裂开行肠切除吻合术、肠道异物取出术。2例光滑念珠菌性腹膜炎犬分别因胆囊破裂行胆囊切除术、剖腹探查术后肠活检取出部位裂开。所有病例均通过腹腔积液细胞学检查初步诊断为真菌性腹膜炎,结果显示为显著的脓性肉芽肿性炎症,吞噬细胞内和细胞外可见大量3-8μm椭圆形、嗜碱性深的酵母样菌体,周围有薄而清晰的荚膜。此外,在一些单纯白色念珠菌感染的病例中很少见到芽管形成、菌丝和假菌丝。所有病例均通过培养确定病原体身份,3例通过PCR进一步确诊。念珠菌属通常是哺乳动物消化道、上呼吸道和下泌尿生殖道的共生菌。它们是机会致病菌,当患者免疫功能低下或黏膜屏障遭到破坏时,可侵入组织并定殖。对于有胃肠道或胆汁内容物污染腹腔的患者,应考虑念珠菌性腹膜炎。

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