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2010-2020 年 24 例无脓胸的细菌性脑膜炎或脑膜脑炎犬的临床症状、治疗和转归。

Clinical presentation, treatment, and outcome of 24 dogs with bacterial meningitis or meningoencephalitis without empyema (2010-2020).

机构信息

Royal Veterinary College, North Mymms, UK.

Langford Veterinary Services, University of Bristol, Bristol, UK.

出版信息

J Vet Intern Med. 2023 Jan;37(1):223-229. doi: 10.1111/jvim.16605. Epub 2023 Jan 14.

Abstract

BACKGROUND

Bacterial meningitis (BM) and meningoencephalitis (BMEM) are associated with high case fatality rates and neurologic sequelae in people, but limited data exists on outcome in dogs.

HYPOTHESIS/OBJECTIVES: To report the clinicopathologic features, treatment and outcome of BM/BMEM in dogs, with a focus on clinical presentation, relapse and long-term neurological deficits.

ANIMALS

Twenty-four client-owned dogs diagnosed with BM/BMEM without empyema.

METHODS

Retrospective case series of dogs diagnosed with BM/BMEM from 5 veterinary referral hospitals between January 2010 and August 2020.

RESULTS

Twenty-four dogs were included. Median duration of clinical signs was 2 days (range ≤24 hours to 30 days) and signs recorded included pyrexia (3) and cervical hyperesthesia (10). Neurological deficits were present in 18 dogs including altered mentation (12), ataxia (8), nonambulatory status (8), head tilt (8), and cranial nerve deficits (13). Intracellular bacteria were visualized on cerebrospinal fluid (CSF) analysis in 15/24 dogs, with positive CSF bacteriological culture in 8/21. Otitis media/interna (OMI) was diagnosed in 15/24 dogs, of which 6/15 dogs underwent total ear canal ablation and lateral bulla osteotomy. Twenty dogs survived to hospital discharge. Median duration of antibiotic administrations was 8 weeks (range, 2-16 weeks). Glucocorticoids were administered to 15 dogs. Median follow-up time was 92 days (range, 10-2233 days). Residual neurological deficits were reported in 9 dogs, with a single case of suspected relapse.

CONCLUSIONS AND CLINICAL IMPORTANCE

Clinical signs were variable in dogs with BM/BMEM, the nidus of bacterial infection was often OMI and the majority of dogs made a full recovery with treatment.

摘要

背景

细菌性脑膜炎(BM)和脑膜脑炎(BMEM)可导致人类患者病死率和神经后遗症高,但有关犬只的此类疾病结局数据有限。

假设/目的:报告无积脓的 BM/BMEM 犬的临床病理特征、治疗和结局,重点关注临床症状表现、复发和长期神经缺损。

动物

24 只确诊为 BM/BMEM 且无积脓的患犬。

方法

对 5 家兽医转诊医院 2010 年 1 月至 2020 年 8 月间诊断为 BM/BMEM 的犬进行回顾性病例系列研究。

结果

24 只犬纳入研究。临床症状的中位持续时间为 2 天(范围为≤24 小时至 30 天),记录的症状包括发热(3 例)和颈强直(10 例)。18 只犬存在神经功能缺损,包括精神状态改变(12 例)、共济失调(8 例)、非运动状态(8 例)、头倾斜(8 例)和颅神经缺损(13 例)。15/24 只犬的脑脊液(CSF)分析中可见细胞内细菌,21/24 只犬的 CSF 细菌培养阳性。24 只犬中诊断为中耳炎/内耳炎(OMI)的有 15 只,其中 6 只接受了全耳道消融和侧鼓室切开术。20 只犬存活至出院。抗生素治疗的中位持续时间为 8 周(范围为 2-16 周)。15 只犬接受了糖皮质激素治疗。中位随访时间为 92 天(范围为 10-2233 天)。9 只犬出现残留神经功能缺损,1 例疑似复发。

结论和临床意义

BM/BMEM 犬的临床症状各不相同,细菌感染灶通常为 OMI,大多数犬经治疗后完全康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e67/9889693/0142a780d2e0/JVIM-37-223-g001.jpg

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