Nakamura Reid K, Fenty Renee K, Bianco Domenico
Advanced Veterinary Care Center, 15926 Hawthorne Blvd, Lawndale, CA 90260.
J Vet Emerg Crit Care (San Antonio). 2013 Nov-Dec;23(6):652-6. doi: 10.1111/vec.12120.
To describe a case of immune-mediated thrombocytopenia (IMT) after massive Africanized bee envenomation in a dog.
While boarding at a kennel, a dog was stung by approximately 300 Africanized bees. During initial veterinary examination, the dog was deemed to be in shock, characterized by collapse, with hypotension, bradycardia, and hypoglycemia. In addition, severe diffuse erythema and edema were noted over the entire body. Supportive care, including IV crystalloid and colloid fluids, dextrose, fresh frozen plasma, oxygen therapy, broad spectrum antimicrobials, dexamethasone, and diphenhydramine was initiated. The dog's condition stabilized over the next 2 days. Forty-eight hours after admission the dog developed hematemesis and hematochezia, and severe thrombocytopenia was identified. Extensive diagnostic investigation revealed no likely trigger other than the Africianized bee exposure, and a diagnosis of IMT was made. Following a red blood cell transfusion and immunosuppressive doses of dexamethasone and gastroprotectant therapy, the dog's condition stabilized, and the platelet count returned to normal after 7 days from initiation of therapy.
IMT is a possible sequelae of massive Africanized bee envenomation in the dog.
描述一例犬被大量非洲化蜜蜂蜇伤后发生免疫介导性血小板减少症(IMT)的病例。
一只犬在寄养 kennel 期间被约300只非洲化蜜蜂蜇伤。在初次兽医检查时,该犬被判定处于休克状态,表现为虚脱,伴有低血压、心动过缓及低血糖。此外,全身可见严重的弥漫性红斑和水肿。开始给予支持性治疗,包括静脉输注晶体液和胶体液、葡萄糖、新鲜冷冻血浆、氧气疗法、广谱抗菌药物、地塞米松和苯海拉明。该犬的病情在接下来的2天内稳定下来。入院48小时后,该犬出现呕血和便血,并确诊为严重血小板减少症。广泛的诊断性检查未发现除接触非洲化蜜蜂外的其他可能诱因,遂诊断为IMT。在输注红细胞、给予免疫抑制剂量的地塞米松及胃保护剂治疗后,该犬的病情稳定,治疗开始7天后血小板计数恢复正常。
IMT 是犬被大量非洲化蜜蜂蜇伤后可能出现的后遗症。