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新生马驹产气荚膜梭菌感染相关的小肠结肠炎:54例病例(1988 - 1997年)

Enterocolitis associated with Clostridium perfringens infection in neonatal foals: 54 cases (1988-1997).

作者信息

East L M, Savage C J, Traub-Dargatz J L, Dickinson C E, Ellis R P

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523, USA.

出版信息

J Am Vet Med Assoc. 1998 Jun 1;212(11):1751-6.

PMID:9621884
Abstract

OBJECTIVE

To identify clinical signs, physical examination findings, results of diagnostic tests, treatments administered, and clinical outcome of neonatal foals with enterocolitis associated with Clostridium perfringens infection.

DESIGN

Retrospective study.

ANIMALS

54 neonatal foals.

RESULTS

Most foals had acute onset of obtunded mentation, colic, or diarrhea and developed leukopenia, neutropenia, an abnormally high number of band neutrophils, toxic WBC, and hypoproteinemia within 24 hours after admission, despite high serum IgG concentrations (> 800 mg/dl). Abdominocentesis and abdominal radiography of some foals revealed exudative peritonitis and gaseous distention of the small and large intestine, respectively. Cytologic examination of feces revealed spores or gram-positive rods in 8 of 10 foals. The most common genotypes of C perfringens isolates were type A and C, alone or in combination. Treatment did not alter mortality rate for most foals that had a positive culture for C perfringens type C. Of 54 foals, 29 (54%) that had C perfringens-associated enterocolitis died. Foals that had a culture that yielded C perfringens had higher sepsis scores, IgG concentrations, and mortality rates, compared with the overall hospital population of neonatal foals.

CLINICAL IMPLICATIONS

Foals less than 7 days old that have enterocolitis associated with C perfringens infections, especially type C, have a guarded prognosis. Cytologic examination of feces to determine spore counts and detect rods may be a means for early identification of C perfringens infections. Polymerase chain reaction assays to determine genotype are important for designing preventive treatment regimens.

摘要

目的

确定与产气荚膜梭菌感染相关的新生驹小肠结肠炎的临床症状、体格检查结果、诊断性检查结果、所给予的治疗以及临床结局。

设计

回顾性研究。

动物

54匹新生驹。

结果

大多数驹发病急,表现为精神沉郁、腹痛或腹泻,入院后24小时内出现白细胞减少、中性粒细胞减少、杆状核中性粒细胞数量异常增多、毒性白细胞及低蛋白血症,尽管血清IgG浓度较高(>800mg/dl)。部分驹的腹腔穿刺和腹部X线检查分别显示渗出性腹膜炎和小肠及大肠积气。10匹驹中有8匹粪便的细胞学检查发现孢子或革兰氏阳性杆菌。产气荚膜梭菌分离株最常见的基因型为A型和C型,单独或联合存在。对于大多数C型产气荚膜梭菌培养阳性的驹,治疗并未改变死亡率。54匹驹中,29匹(54%)患有产气荚膜梭菌相关性小肠结肠炎死亡。与新生驹的总体住院群体相比,产气荚膜梭菌培养阳性的驹有更高的败血症评分、IgG浓度及死亡率。

临床意义

小于7日龄的驹患有与产气荚膜梭菌感染相关的小肠结肠炎,尤其是C型感染,预后不佳。粪便的细胞学检查以确定孢子计数并检测杆菌可能是早期识别产气荚膜梭菌感染的一种方法。聚合酶链反应检测以确定基因型对于设计预防性治疗方案很重要。

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