Geisen Vera, Mayer Christian, Harrer Julia, Hartmann Katrin, Ulrich Sebastian, Unterer Stefan
Medizinische Kleintierklinik, Zentrum für Klinische Tiermedizin, Ludwig-Maximilians-Universität München.
Institut für Tierpathologie, Zentrum für Klinische Tiermedizin, Ludwig-Maximilians-Universität München.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2020 Oct;48(5):369-375. doi: 10.1055/a-1238-1554. Epub 2020 Oct 21.
A 10-month-old male Rhodesian Ridgeback was presented to the Clinic of Small Animal Medicine, LMU, Germany, with a 6-month history of chronic diarrhea and hematochezia. The dog lived in Germany and had never traveled abroad. Complete blood count and serum biochemistry performed by the referring veterinarian revealed neutrophilia, hyperkalemia, and hyponatremia, with a basal cortisol of 4.3 µg/dl, which excluded hypoadrenocorticism. Since antibiotic treatment had not resulted in any improvement, a 2 week course of prednisolone administration had been initiated, leading to a marked deterioration of intestinal signs and a significant weight loss of 6 kg. At the time of referral, the patient was markedly emaciated, dehydrated, hypovolemic and had a rectal temperature of 39.6 °C. Abdominal ultrasound showed a thickened and irregular colonic wall. On colonoscopy, an irregular colonic mucosa with ulcerations was observed. Histopathologic examination revealed an ulcerative granulomatous colitis, and on Periodic acid-Schiff reaction (PAS) numerous organisms consistent with spp. were identified. infection was confirmed by culture and MALDI-TOF MS. In order to test for an underlying immunodeficiency, immunoglobulin levels in serum were determined. IgM was decreased, while IgG and IgA levels were within the reference interval. Due to deterioration of general condition, grave prognosis and costs of a treatment trial, the patient was euthanized one week later, and necropsy was performed. spp. were detected on histopathologic examination in the lymphnodes, however not in the eyes or the central nervous system. Protothecosis should be considered an differential diagnosis in dogs with chronic diarrhea and ulcerative granulomatous colitis even in dogs living in Germany. Histopathologic examination of colonic biopsies with special stains such as PAS is recommended in every dog with signs of chronic large bowel disease in order to avoid missing this rare infectious disease.
一只10个月大的雄性罗德西亚脊背犬被送至德国慕尼黑大学小动物医学诊所，有6个月慢性腹泻和便血病史。该犬生活在德国，从未出过国。转诊兽医进行的全血细胞计数和血清生化检查显示有中性粒细胞增多、高钾血症和低钠血症，基础皮质醇为4.3 µg/dl，排除了肾上腺皮质功能减退症。由于抗生素治疗未见任何改善，已开始给予泼尼松龙2周疗程，导致肠道症状明显恶化，体重显著减轻6 kg。转诊时，患者明显消瘦、脱水、血容量不足，直肠温度为39.6 °C。腹部超声显示结肠壁增厚且不规则。结肠镜检查发现结肠黏膜不规则并有溃疡。组织病理学检查显示为溃疡性肉芽肿性结肠炎，在过碘酸希夫反应（PAS）中鉴定出许多与 spp.一致的微生物。通过培养和基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）确诊感染。为了检测潜在的免疫缺陷，测定了血清中的免疫球蛋白水平。IgM降低，而IgG和IgA水平在参考区间内。由于一般状况恶化、预后严重以及治疗试验费用高昂，该患者在一周后实施安乐死并进行了尸检。在组织病理学检查中，在淋巴结中检测到了 spp.，但在眼睛或中枢神经系统中未检测到。即使是生活在德国的犬，原虫病也应被视为慢性腹泻和溃疡性肉芽肿性结肠炎犬的鉴别诊断。对于每只出现慢性大肠疾病迹象的犬，建议对结肠活检组织进行PAS等特殊染色的组织病理学检查，以避免漏诊这种罕见的传染病。
