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犬感染后闭塞性细支气管炎导致肺纤维化疾病的推测性发展过程及发病后情况

Presumptive Development of Fibrotic Lung Disease From and Post-infectious Bronchiolitis Obliterans in a Dog.

作者信息

Jaffey Jared A, Harmon Mark, Masseau Isabelle, Williams Kurt J, Reinero Carol

机构信息

Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, MO, United States.

Department of Clinical Sciences, Université de Montréal, Saint-Hyacinthe, QC, Canada.

出版信息

Front Vet Sci. 2019 Oct 10;6:352. doi: 10.3389/fvets.2019.00352. eCollection 2019.

Abstract

A 7-month-old Miniature Poodle acquired from a pet store developed cough and subsequently respiratory distress compatible with infection. Partial but incomplete resolution of clinical signs and thoracic radiographic/computed tomographic imaging lesions were noted with use of susceptibility-guided antimicrobials. Additionally, a concern for an infectious nidus led to left cranial lung lobectomy at 9 months of age. Histopathology predominantly revealed polypoid and constrictive bronchiolitis obliterans (i.e., small airway disease). Intermittent antimicrobial administration over the next 5 years failed to blunt progressive clinical signs. At 8 years, necropsy confirmed severe airway-centered interstitial fibrosis. This pattern of fibrosis was strongly suggestive of underlying small airway disease as the trigger. In retrospect, post-infectious bronchiolitis obliterans (PIBO), a syndrome in young children caused by pulmonary infections but not yet recognized in pet dogs, likely initiated a pathway of fibrosis in this dog. In dogs with risk factors for community-acquired pathogens such as , PIBO is a differential diagnosis with development of severe, persistent respiratory signs incompletely responsive to appropriate antimicrobials. Untreated PIBO may lead to airway-centered interstitial fibrosis. Future study is required to determine if targeted therapy of PIBO could alter the course of end-stage pulmonary fibrosis.

摘要

一只从宠物店购得的7个月大的迷你贵宾犬出现咳嗽,随后出现与感染相符的呼吸窘迫症状。使用药敏指导的抗菌药物后,临床症状以及胸部X线/计算机断层扫描影像病变有部分但不完全缓解。此外,由于担心存在感染病灶,该犬在9月龄时接受了左肺上叶切除术。组织病理学检查主要显示为息肉样和缩窄性闭塞性细支气管炎(即小气道疾病)。在接下来的5年里,间歇性使用抗菌药物未能抑制病情的进展。8岁时尸检证实存在严重的以气道为中心的间质纤维化。这种纤维化模式强烈提示潜在的小气道疾病是引发因素。回顾来看,感染后闭塞性细支气管炎(PIBO),一种在幼儿中由肺部感染引起但在宠物狗中尚未被认识的综合征,可能在这只狗身上引发了纤维化进程。在具有社区获得性病原体风险因素的犬中,PIBO是一种鉴别诊断,表现为出现严重、持续的呼吸道症状,对适当的抗菌药物反应不完全。未经治疗的PIBO可能导致以气道为中心的间质纤维化。需要进一步研究以确定针对PIBO的靶向治疗是否能改变终末期肺纤维化的病程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40de/6795681/d83afec3262e/fvets-06-00352-g0001.jpg

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