Timm Katrin, Welle Monika, Friedel Ute, Gunn-Moore Danièlle, Peterhans Sophie
vetderm.ch, Ennetseeklinik für Kleintiere AG, Rothusstrasse 2, 6331, Hünenberg, Switzerland.
Institute of Animal Pathology, Dermfocus, Vetsuisse Faculty, University of Bern, Länggass-Strasse 122, 3001, Bern, Switzerland.
Vet Dermatol. 2019 Jun;30(3):262-e80. doi: 10.1111/vde.12739. Epub 2019 Mar 18.
Cutaneous disseminated mycobacteriosis is rare in dogs. To the best of the authors' knowledge, the slowly growing mycobacterial species Mycobacterium nebraskense has not been described before in this species.
Description of clinical features, laboratory analyses and treatment regimen of this unusual case.
A 9-year-old female-spayed West Highland white terrier dog presented with progressive nodules and ulcerations on both sides of the thorax and the rostral aspect of the chest.
Investigations involved histopathological examination of skin biopsies (including special stains for fungi, bacteria and mycobacteria), standard and mycobacterial culture (including susceptibility testing), 16S/23S rRNA sequencing and BLAST similarity searching.
Ziehl-Neelsen staining of decontaminated biopsy material revealed acid-fast bacteria morphologically consistent with mycobacteria. Treatment with clarithromycin and marbofloxacin achieved partial resolution. A change in the treatment regimen to pradofloxacin and azithromycin resulted in rapid deterioration of skin lesions. Final healing occurred with the addition of prednisolone at an anti-inflammatory dose. The results of mycobacterial culture and susceptibility testing were received 10 and 12 months, respectively, after the first presentation of the dog. Therapy was stopped after 16 months without recurrence of skin lesions.
This case is noteworthy for the description of a new mycobacterial species contributing to disseminated panniculitis in a dog and for the difficulties experienced in the lengthy empirical treatment of slowly growing nontuberculous mycobacterial infections. The addition of prednisolone to induce complete healing raises the question of whether the mycobacterial infection was primary or whether it occurred secondarily to an ongoing sterile panniculitis.
皮肤播散性分枝杆菌病在犬类中较为罕见。据作者所知,生长缓慢的分枝杆菌物种内布拉斯加分枝杆菌此前尚未在该物种中被描述过。
描述这一罕见病例的临床特征、实验室分析及治疗方案。
一只9岁已绝育的雌性西部高地白梗犬,胸部两侧及胸前部出现进行性结节和溃疡。
调查包括皮肤活检的组织病理学检查(包括真菌、细菌和分枝杆菌的特殊染色)、标准培养和分枝杆菌培养(包括药敏试验)、16S/23S rRNA测序及BLAST相似性搜索。
经去污处理的活检材料进行萋-尼染色显示抗酸菌,其形态与分枝杆菌一致。克拉霉素和马波沙星治疗取得部分缓解。治疗方案改为普拉德氟沙星和阿奇霉素后,皮肤病变迅速恶化。添加抗炎剂量的泼尼松龙后最终实现愈合。在该犬首次就诊后10个月和12个月分别获得分枝杆菌培养和药敏试验结果。16个月后停止治疗,皮肤病变未复发。
该病例值得关注,一是描述了一种导致犬播散性脂膜炎的新分枝杆菌物种,二是在对生长缓慢的非结核分枝杆菌感染进行长期经验性治疗时遇到困难。添加泼尼松龙实现完全愈合引发了一个问题,即分枝杆菌感染是原发性的,还是继发于正在进行的无菌性脂膜炎。