Câmara Antonio Carlos Lopes, de Sousa Davi Emanuel Ribeiro, de Mâcedo Isabel Luana, Soares Karoline Lacerda, Borges José Renato Junqueira, Martins Carlos Frederico, de Mesquita Adriano Queiroz, Dutra Valéria, de Castro Márcio Botelho
Large Animal Veterinary Teaching Hospital, College of Agronomy and Veterinary Medicine, University of Brasília, Brasilia 70910-900, DF, Brazil.
Veterinary Pathology Laboratory, College of Agronomy and Veterinary Medicine, University of Brasília, Brasilia 70910-900, DF, Brazil.
Vet Sci. 2023 Jun 16;10(6):398. doi: 10.3390/vetsci10060398.
This paper aims to report clinical, laboratory and pathological features in a case of suppurative meningoencephalitis by from the direct extension of chronic otitis in a Gir cow. The cow was recumbent during physical examination, and neurological examination revealed depression, absence of left eyelid and auricular motor reflex, and hypotonic tongue. Hematology revealed hemoconcentration, leukocytosis by neutrophilia, and hyperfibrinogenemia. Cerebrospinal fluid was slightly turbid, and presented polymorphonuclear pleocytosis, and hyperproteinorrachia. Grossly, the skull floor showed a purulent green-yellow exudate that drained from the left inner ear to the cisterna magna. There was diffuse congestion of the telencephalon, and meninges showed severe hyperemia, moderate thickening, and opacity with the deposition of fibrinosuppurative material ventrally, extending to the cerebellum and brainstem. The left cerebellar hemisphere showed an approximately 1.5 cm in diameter liquefaction area surrounded by a hemorrhagic halo. Histologically, cerebellar, mesencephalic, thalamic, and brain base meninges were intensely thickened and showed severe suppurative inflammation and fibrin deposition. Small multifocal suppurative areas were observed in the cerebellum and brainstem, characterized by a necrotic core, a number of neutrophils, and Gram-negative intralesional bacillary myriads. Pure cultures of were obtained and identified in the suppurative CNS lesions, meninges, and inner ear samples. This report highlights an uncommon clinical evolution of secondary suppurative meningoencephalitis, probably triggered by recurrent parasitic otitis in an adult Gir cow. Veterinarians, practitioners, and farmers must be aware of the risk of CNS infections after unresolved media and inner otitis, especially in cattle breeds more prone to developing parasitic otitis, such as the Gir and Indubrasil breeds.
本文旨在报告一例吉尔牛因慢性中耳炎直接蔓延导致化脓性脑膜脑炎的临床、实验室和病理特征。体格检查时该牛呈侧卧姿势，神经学检查发现其精神沉郁，左侧眼睑和耳廓运动反射消失，舌肌张力减退。血液学检查显示血液浓缩、中性粒细胞增多引起的白细胞增多和高纤维蛋白原血症。脑脊液略显浑浊，出现多形核白细胞增多和蛋白含量增高。大体观察，颅底可见从左耳向内耳至小脑延髓池引流的脓性黄绿色渗出物。端脑弥漫性充血，脑膜重度充血、中度增厚且不透明，腹侧有纤维蛋白脓性物质沉积，延伸至小脑和脑干。左侧小脑半球有一个直径约1.5厘米的液化区，周围有出血晕。组织学检查显示，小脑、中脑、丘脑和脑底部脑膜明显增厚，呈现严重的化脓性炎症和纤维蛋白沉积。在小脑和脑干观察到小的多灶性化脓区域，其特征为坏死核心、大量中性粒细胞和病灶内革兰氏阴性杆菌簇。在化脓性中枢神经系统病变、脑膜和内耳样本中获得并鉴定出了纯培养物。本报告强调了继发性化脓性脑膜脑炎一种不常见的临床演变过程，可能由成年吉尔牛反复发生的寄生虫性中耳炎引发。兽医、从业者和养殖户必须意识到中耳和内耳炎未愈后发生中枢神经系统感染的风险，尤其是在更易发生寄生虫性中耳炎的牛品种中，如吉尔牛和印杜巴西牛品种。
