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用局部克霉唑和口服碘化钾治疗烟曲霉菌引起的四分之一马母马的霉菌性鼻炎。

Treatment of mycotic rhinitis caused by aspergillus fumigatus in a quarter horse mare using topical clotrimazole and oral potassium iodide.

机构信息

Federal University of Santa Catarina, Curitibanos, SC, Brazil.

School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil.

出版信息

Vet Res Commun. 2024 Nov 22;49(1):28. doi: 10.1007/s11259-024-10570-2.

DOI:10.1007/s11259-024-10570-2
PMID:39576399
Abstract

Fungal rhinitis in horses is rare, although severe, due to the progressive nasal obstruction. Aspergillus is one of the fungi most often involved in these cases. A 7-year-old Quarter Horse mare weighing 325 kg was admitted with a history of recurrent nasal discharge and bleeding, foul smell, reluctance to exercise, and abortion. Laboratory and imaging examinations revealed eosinophilia, scarring and erosion areas in the nasal mucosa, purulent and bloody secretions, and remarkable yellowish plaques. Histopathological examination revealed fungal rhinitis and bacterial culture revealed the presence of β-hemolytic Streptococcus and Staphylococcus sp. Fungal culture and molecular diagnosis confirmed Aspergillus fumigatus as the etiological agent. A tracheostomy was necessary due to the patient's dyspnea. For the treatment, topical application of clotrimazole ointment was carried out in the rostral portion of the nasal cavity once a day and in the caudal portion of the nasal cavity, endoscopic guided every 48 h. In the fifth endoscopy-guided application, a significant improvement was noticed; however, the animal exhibited a hypersensitivity reaction, and the treatment was discontinued. Thus, potassium iodide therapy was initiated (67 mg/kg, PO, SID, 14 days). The patient demonstrated favorable clinical improvement, achieved resolution of the fungal infection, and was discharged after 25 days of hospitalization. Topical clotrimazole demonstrated a probable efficacy as a standalone treatment, although its use had to be prematurely discontinued due to the emergence of a hypersensitivity reaction. The combination of clotrimazole and potassium iodide effectively treated fungal rhinitis in a shorter time than previously reported. This report provides useful guidance for other cases of fungal rhinitis, although further studies are needed.

摘要

马的真菌性鼻炎很少见,但由于进行性鼻阻塞,病情可能很严重。曲霉菌是这些病例中最常涉及的真菌之一。一匹 7 岁的夸特马母马,体重 325 公斤,因反复出现鼻分泌物和出血、恶臭、不愿运动和流产而入院。实验室和影像学检查显示嗜酸性粒细胞增多、鼻黏膜有瘢痕和侵蚀区、脓性和血性分泌物,以及明显的黄色斑块。组织病理学检查显示真菌性鼻炎,细菌培养显示β-溶血性链球菌和葡萄球菌属。真菌培养和分子诊断证实烟曲霉菌是致病因子。由于患者呼吸困难,需要进行气管切开术。治疗方法为鼻腔前段每天一次和鼻腔后段每 48 小时一次局部应用克霉唑软膏。在第五次内窥镜引导下应用时,发现明显改善;然而,动物出现过敏反应,停止治疗。因此,开始进行碘化钾治疗(67mg/kg,口服,每天 1 次,共 14 天)。患者表现出良好的临床改善,真菌感染得到解决,住院 25 天后出院。局部克霉唑单独使用可能有效,但由于出现过敏反应,不得不提前停止使用。克霉唑和碘化钾的联合使用在比以前报道的更短的时间内有效地治疗了真菌性鼻炎。本报告为其他真菌性鼻炎病例提供了有用的指导,但仍需要进一步的研究。

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