Development of a Model for Preliminary Diagnosis of Human Granulocytic Anaplasmosis.

Background: Human granulocytic anaplasmosis (HGA) is a vector-borne natural focal disease that is not officially registered in Ukraine. The first 13 cases of HGA in adults in Ukraine were identified in 2007. The purpose of our study was to develop a predictive model of HGA based on clinical and laboratory characteristics to develop a three-level standard case definition of HGA. Materials and Methods: Researchers examined 498 patients with suspected tick-borne infections and carried out a retrospective clinical and epidemiological analysis of 60 cases recruited from Lviv regional infectious disease hospitals. Logistic regression was used to create a model of the probability of the diagnosis of HGA depending on the presence of certain clinical and laboratory factors that, when examined, together may help to confirm a case of HGA. For logistic regression, eight clinical and laboratory factors were selected: history of tick bite, hyperthermia, signs of pharyngitis, changes in chest X-ray picture (enhancement of the pulmonary pattern and enlargement of the lung root boundaries), increased bilirubin (˃21 µmol/L), increased alanine aminotransferase (ALT ˃36 U/L), erythema migrans, and detected Lyme disease. Results: In the presence of all eight factors, the probability of HGA is 95.7%. When the five main signs are absent-signs of pharyngitis, changes in chest X-ray picture, increased bilirubin and ALT, and a history of tick bite-the probability of HGA in the patient dramatically decreases to 6.8%, meaning that HGA might be excluded. Conclusions: Based on the analysis of epidemiological, clinical, and laboratory signs, criteria for establishing a suspected, probable, and confirmed diagnosis of HGA have been developed to improve diagnosis.

Retrospective Study on the Effects of Long-Term Use of Methylprednisolone Acetate on the Blood Work of 25 Cats.

Twenty-five cats at a private animal sanctuary received multiple nonimmunosuppressive doses of parenteral methylprednisolone acetate for at least 3 yr. Complete blood count, chemistry, and T4 results from these cats were examined to look for statistically significant changes. Results found significant changes in triglycerides, amylase, and monocytes. However, these changes remained within the reference interval. All other values showed no significant changes. These results suggest that after 3 yr of chronic parenteral administration of nonimmunosuppressive doses of methylprednisolone acetate, the complete blood count, chemistry, and T4 values in 25 cats were not significantly affected and did not result in abnormal laboratory values.

Esophagitis and Pharyngitis Associated with Avian Infectious Laryngotracheitis in Backyard Chickens: Two Cases.

Infectious laryngotracheitis (ILT) is a contagious viral respiratory disease of great economic importance for the global poultry industry caused by Gallid herpesvirus 1 (GaHV-1). Lesions of the upper digestive tract caused by this virus have not been reported before. Two small flocks of backyard chickens experienced an outbreak of ILT, one in 2006 and the other in 2014. These birds had typical ILT lesions, characterized by a necrohemorrhagic laryngitis and tracheitis but were also affected by a severe erosive and necrotic esophagitis and pharyngitis. On microscopic examination of the esophagus and pharynx, numerous individual epithelial cells were degenerated or necrotic. Syncytial cells were present in the mucosa or sloughed in the overlying inflammatory crust, and some of these cells contained an amphophilic intranuclear viral inclusion. GaHV-1 was detected in tissues, from respiratory and digestive tracts, either by PCR, immunohistochemistry, or both diagnostic assays. This case stresses the importance for veterinarians, owners, and technicians to pay attention to different or atypical clinical manifestations of ILT given its highly contagious nature.

Fatal verminous pharyngitis and esophagitis caused by Streptocara incognita in mute swans (Cygnus olor).

Streptocara spp. infections are reported to cause gastritis, proventriculitis, esophagitis, and pharyngitis in various waterfowls, especially diving ducks. In the present paper, we describe severe fatal diphtheritic pharyngitis and esophagitis caused by Streptocara incognita in three female mute swans (Cygnus olor) in Bosnia and Herzegovina. Prior to death, the swans were showing signs of lethargy, anorexia, and reluctance to move. At necropsy, in all swans severe diphtheritic pharyngitis and esophagitis with deep, dark red hemorrhagic ulcerations were observed. Numerous thin, white, up to 1-cm-long nematodes, identified as S. incognita, were observed embedded in the pharyngeal and esophageal mucosa under the diphtheritic membranes. Histopathology revealed severe fibrinonecrotic inflammation with numerous cross-sections of the parasites. To the authors' knowledge, this is the first report of severe, fatal streptocariasis in mute swans.

Necrotic pharyngitis associated with Mycoplasma bovis infections in American bison (Bison bison).

Mycoplasma bovis has emerged as a significant and costly infectious disease problem in bison, generally presenting as severe, caseonecrotic pneumonia. Three diagnostic cases in which M. bovis is associated with necrotic pharyngitis in bison are described in the current study. The bacterium was isolated from lesions of the pharynx or lung of 3 American bison (Bison bison), at 2 different locations in the upper Midwestern United States, with severe, necrotic pharyngeal abscesses. Chronic caseonecrotic inflammation typical of M. bovis infection in bovines was observed microscopically in the pharynxes of affected bison. A mixed population of bacteria was recovered from the pharyngeal lesions, and Trueperella pyogenes, a frequent secondary pathogen in ruminant respiratory disease, was consistently isolated from the affected animals. Distinctive histopathological features of the pharyngeal lesions favor causation by M. bovis, although a role for T. pyogenes in the clinical presentation cannot be excluded. Veterinarians and producers working with bison should be aware that M. bovis may be associated with pharyngitis in bison.

Gastroesophageal reflux and laryngeal dysfunction in a dog.

CASE DESCRIPTION: A 7-year-old neutered male Saint Bernard was evaluated because of a 6-month history of coughing, gagging, change in phonation, excessive panting, and chronic intermittent vomiting and diarrhea. CLINICAL FINDINGS: Physical examination revealed no remarkable findings other than panting. Total thyroxine concentration and results of a CBC, serum biochemistry analysis, urinalysis, and thoracic radiography were within reference limits. A laryngeal examination revealed edema, erythema, and ulceration of the larynx and pharynx, with normal laryngeal movement. Results of bronchoscopy and cytologic examination of bronchoalveolar lavage fluid were diagnostic only for distal tracheitis. Esophagoscopy and an esophagography revealed esophagitis consistent with gastroesophageal reflux. Gastroduodenoscopy and histologic examination of biopsy specimens revealed Helicobacter colonization and lymphocytic or plasmacytic enteritis. TREATMENT AND OUTCOME: Following treatment for gastroesophageal reflux and suspected Helicobacter infection with combination antacid and antimicrobial treatment, the dog's respiratory signs resolved but vomiting continued. Gastroduodenoscopy revealed complete resolution of the previous laryngitis, pharyngitis, and esophagitis. Treatment for the lymphocytic or plasmacytic enteritis was initiated with prednisone (1 mg/kg [0.45 mg/lb], p.o., q 12 h) and a novel protein diet. The previous treatment was also continued. Complete resolution of clinical signs was maintained 4 months after initiation of appropriate treatment. CLINICAL RELEVANCE: Laryngeal dysfunction induced by gastroesophageal reflux as occurred in the patient described in this report is a previously undocumented association in the veterinary literature. This association could be a potential consideration in dogs with concurrent respiratory and gastrointestinal signs. The present report may provide a basis for further studies investigating this association.

Endoscopic assessment of airway inflammation in horses.

BACKGROUND: Comprehensive endoscopic scoring of the upper and lower airways for inflammation has not been critically assessed among a large population of horses. The relationship between upper and lower airways described in humans by the "one airway, one disease" concept might also apply to horses. HYPOTHESIS/OBJECTIVES: To evaluate if an association exists between endoscopic inflammatory scores and mucus scores of upper and lower airways and to investigate if endoscopic findings correlate with the lower airway inflammation measured by bronchoalveolar lavage (BAL) cytology. METHODS: Prospective field study. Pharyngitis, pharyngeal mucus, tracheal mucus, tracheal septum thickness, and bronchial mucus were scored using new and previously described scoring systems on a convenience sample of 128 horses with and without lung inflammation. Based on BAL fluid cytology, horses were categorized as having normal, moderate, or severe inflammation of the lower airways. RESULTS: All 5 endoscopy scores showed excellent interobserver agreement. Tracheal mucus (P < .001), tracheal septum thickness (P = .036), and bronchial mucus (P = .037) were significantly increased in horses with severe inflammation BALs and were correlated among themselves but not with upper airways scores. BAL neutrophils percentage was correlated with tracheal mucus (r(s) = 0.41, P < .001), bronchial mucus (r(s) = 0.27, P = .003), and had a weak negative correlation with pharyngitis (r(s) = -0.25, P = .004). CONCLUSIONS AND CLINICAL IMPORTANCE: Lower airway endoscopy scores are reflective of lower airway inflammation; however, upper and lower airways are independent in terms of severity of inflammation. Therefore, observing upper airway inflammation is not an indication to test for lower airway inflammation.

Disorders of the pharynx.

Pharyngeal disorders are complex and difficult to treat. Disorders that lead to anatomic derangement, such as trauma and neoplasia, can significantly affect the function of this organ. Pharyngeal dysfunction can manifest as dysphagia, persistent palatal displacement, or exercise intolerance. Secondary complications are serious and life threatening and include aspiration pneumonia, weight loss, and death. Pharyngeal disorders that are only recognizable during strenuous exercise are difficult to diagnose and are treated with limited success, even though they are responsible for significant economic losses with performance animals.

Detection of antibodies to a disease-associated herpesvirus of the green turtle, Chelonia mydas.

Lung-eye-trachea disease-associated herpesvirus (LETV) is linked with morbidity and mortality in mariculture-reared green turtles, but its prevalence among and impact on wild marine turtle populations is unknown. An enzyme-linked immunosorbent assay (ELISA) was developed for detection of anti-LETV antibodies and could distinguish LETV-exposed green turtles from those with antibodies to fibropapillomatosis-associated herpesvirus (FPHV). Plasma from two captive-reared green turtles immunized with inactivated LETV served as positive controls. Plasma from 42 healthy captive-reared green turtles and plasma from 30 captive-reared green turtles with experimentally induced fibropapillomatosis (FP) and anti-FPHV antibodies had low ELISA values on LETV antigen. A survey of 19 wild green turtles with and 27 without FP (with and without anti-FPHV antibodies, respectively) identified individuals with antibodies to LETV regardless of their FP status. The seroprevalence of LETV infection was 13%. The presence of antibodies to LETV in plasma samples was confirmed by Western blot and immunohistochemical analyses. These results are the first to suggest that wild Florida green turtles are exposed to LETV or to an antigenically closely related herpesvirus(es) other than FPHV and that FPHV and LETV infections are most likely independent events. This is the first ELISA developed to detect antibodies for a specific herpesvirus infection of marine turtles. The specificity of this ELISA for LETV (ability to distinguish LETV from FPHV) makes it valuable for detecting exposure to this specific herpesvirus and enhances our ability to conduct seroepidemiological studies of these disease-associated agents in marine turtles.

Persistent right aortic arch in a yearling horse.

A 14-month-old filly with chronic pharyngitis was diagnosed with incomplete esophageal constriction and megaesophagus due to a persistent right aortic arch. This report is unusual because clinical signs of respiratory dysfunction secondary to chronic regurgitation occurred prior to the recognition of dysphagia.

Temporary suppression of cell-mediated immunity in standardbred horses with decreased athletic capacity.

Eighty Standardbred horses, originating from 5 training campuses, with decreased athletic performance in association with symptoms such as intermittent fever and mild pharyngitis were examined. As control animals, 10 horses from a stable with normally performing horses were used. Virus isolation and clinico-chemical and serological tests were performed. Lymphocyte proliferation tests were carried out to evaluate the capacity of the cell-mediated immunity. In addition, a bioassay for equine type I interferon, as a marker for early viral infections, was established. No specific microbe could be linked to these symptoms, but there was a temporary suppression of the cell-mediated immunity, which might be explained by the serological evidence of an EHV-2 and/or rhinovirus infection.

Upper-airway obstruction and prolonged recovery from anesthesia following intranasal clotrimazole administration.

A 16-month-old Labrador retriever was presented for evaluation and treatment of nasal aspergillosis. Intranasal clotrimazole was administered to treat the condition. The dog was anesthetized on two occasions to facilitate drug administration. Following the first treatment, the dog developed mild pharyngitis but no other complications. Inflammation and edema of the pharynx resulted in upper-airway obstruction following the second treatment. Pentobarbital sedation was used to maintain the endotracheal tube until the obstruction was relieved. Recovery following sedation was extremely prolonged. This case illustrates two adverse drug reactions: severe pharyngitis and edema (probably a result of the vehicles present in the clotrimazole formulation) and prolonged recovery (possibly the result of microsomal enzyme inhibition by the clotrimazole).

[Veterinary dentistry (11). Feline gingivitis-stomatitis-pharyngitis complex. Chronic/recurrent stomatitis in cats]. / Veterinaire tandheelkunde (11). Het feliene gingivitis-stomatitis-faryngitis complex. Chronische/recidiverende mondslijmvliesontstekingen kat.

This is the fourth article in a series on veterinary dentistry in cats. This article describes the clinical signs, possible investigations, and differential diagnosis of the gingivitis-stomatitis pharyngitis complex (GSP complex), a complex and frequently occurring disease. Strategies for the treatment of feline chronic stomatitis complex, which is frequently idiopathic, are presented.

FIV vaccine studies. II. Clinical findings, hematological changes and kinetics of blood lymphocyte subsets.

Five groups of cats were vaccinated with different recombinant feline immunodeficiency virus (FIV) SU vaccines expressed either in Escherichia coli or in the Baculovirus system. In Part I of this series, we described the humoral immune response and outcome of intraperitoneal FIV challenge exposure. Additionally, all cats were monitored for clinical and hematological changes and the course of blood lymphocyte subsets. These results are described in this present paper. A great increase of antibodies was found after vaccination with different recombinant FIV antigens, which did not protect the cats from intraperitoneal FIV challenge infection. This observation was paralleled by an increase of eosinophils during vaccination which was even more pronounced after challenge infection. After FIV challenge, infection lymphadenopathy, gingivitis, pharyngitis, changes in total leukocytes and neutrophils and a decrease in the CD4+:CD8+ ratio were found in cats of all groups and were considered as a sign of the FIV infection taking place, independent of vaccination. The following observations suggest that in these cats a TH2-like immune response was elicited: the high counts of eosinophils, the nature of antigen and adjuvant (aluminium hydroxide) and the high amounts of antigens used for immunization. Clearly, this type of immune response did not protect the animals from intraperitoneal FIV challenge infection.

Granulomatous inflammation of the oropharyngeal cavity as a possible cause for unexpected high mortality in a Fischer 344 rat carcinogenicity study.

An unexpected, high, test-substance-unrelated mortality has been found predominantly in female Fischer 344 rats of a 2-year gavage carcinogenicity study, which is still in the active phase. Most of the dead animals (53%) had an impacted food or bedding bolus in the oropharyngeal cavity. Histologic evaluation of this area revealed a calcified, granulomatous inflammation of the sero-mucinous glands (60%), frequently accompanied by papillary projections (50%) into the lumen. Additionally, decentral islet formation of the tracheal cartilage was evident in all animals examined. We assume that the partial blockage of the oropharyngeal lumina was the cause of death, because other possible factors were ruled out. To detect a possible strain-related predisposition, Fischer 344 and Sprague Dawley rats that had been used for technician gavage training were studied. Granulomas and papillary projections, as well as the decentral islet formation in the tracheal cartilage, however, were found in gavaged Fischer 344 but not Sprague Dawley rats. We consider the high mortality to be related to three factors: a predisposition of the Fischer 344 rat strain, an unphysiological pH of the solvent (pH 10), and chronic irritation due to an inflexible, metallic gavage tube.

Feline gingivitis-stomatitis-pharyngitis.

Inflammatory conditions of the feline mouth are commonly encountered in small animal practice. Although the majority can be attributed to dental disease and a small percentage are due to autoimmune diseases, the eosinophilic granuloma complex, neoplasia, and other miscellaneous syndromes, many cases appear to be due to a gingivitis-stomatitis-pharyngitis complex, which is likely multifactorial in origin. Viruses, bacterial infection, diet, dental disease, oral conformation, genetic predisposition, hypersensitivities, immunoinsufficiencies, and other defects in oral defense mechanisms may all be contributory. The complexities of this syndrome have made it one of the most challenging diagnostic and therapeutic problems in feline medicine.

Acute and chronic faucitis of domestic cats. A feline calicivirus-induced disease.

The lesions of acute feline calicivirus infection are of a transient vesiculo-ulcerative nature and involve, to varying degrees, the palate, tongue, gingiva, lips, nasal philtrum, and oral fauces. Chronic ulceroproliferative faucitis is a specific but uncommon sequelae to persistent feline calicivirus oral carriage.