Pythiosis with atypical location in the soft palate in a horse in Southern Brazil

Rossato, Cristina Krauspenhar; Fiss, Letícia; Sperotto, V.R.; Cardona, R.O.C.; Silva, R.B.

doi:10.1590/1678-4162-9568

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…A similar case was observed in a horse with severe breathing difficulties caused by pythiosis in Rio Grande do Sul. In this case, the disease affected the soft palate and caused nasopharyngeal obliteration, which resulted in breathing difficulties [12].…”

Section: Discussionmentioning

confidence: 91%

Cranioesophageal Pythiosis in a Horse

Schmith

Lemos

Rondon

et al. 2020

Acta Scientiae. Vet.

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Background: Pythiosis is a chronic inflammatory disease that is caused by oomycete Pythium insidiosum. This illness affects several species including humans and horses. Equine is the most affected species, having no predisposition for breed, gender, or age. It is usually shown in cutaneous and subcutaneous forms, and the lesions, which grow quickly and are hard to treat, are located mainly in the extremities. The diagnosis is made via epidemiology, clinical signs, and macroscopic and microscopic aspects of the lesion. This study describes a case of cranioesophageal pythiosis in a horse, examining the epidemiological, clinical and pathological characteristics.Case: A 12-year-old male quarter horse, weighing 515 kg was taken to the Veterinary Hospital at the University Center of Espírito Santo (UNESC). The horse had an increase in volume in the cranioesophageal region, coughing, difficulty breathing, and a runny nose. On clinical examination, the horse showed an enlargement in the submandibular and retropharyngeal lymph nodes, subcutaneous edema in the larynx region, and a temperature of 38.2ºC. According to the owner, cough was recurrent and had lasted about 12 months even after treatment with different kinds of antimicrobials. On radiographic exam, there was a marked decrease in the tracheal lumen and increased soft tissue radiopacity in the region adjacent to the narrowing. The animal was taken to surgery to remove the mass, but he died because of complications during surgery. The animal’s owner did not allow necropsy, but a fragment of the mass in the cranioesophageal was removed and sent for histological examination. The fragment was fixed in 10% formalin and processed using routine histological analysis. Macroscopically, the mass was light yellowish and ulcerated, and it measured 7.0 × 5.0 × 5.0 cm. In the middle of the ulcerated areas, there were yellow and firm granular structures that were consistent with kunkers. Histologically, extending from the tracheal adventitia to the thyroid, there was a large number of lymphocytes, macrophages, neutrophils, eosinophils, and multinucleated cells (foreign body type) and a well-defined focus of coagulative necrosis, which was surrounded by a thin border of macrophages. Within the necrotic areas, there were negative images of tubuliform hyphae. Grocott’s silver methanamine staining showed hyphae that had irregular branches, rare septa, smooth and parallel walls, and was impregnated by silver. Histological sections of the mass were subjected to immunohistochemistry. Hyphae were positive for Pythium insidiosum.Discussion: The diagnosis of pythiosis was based on macroscopic, histological findings and positive immunostaining for Pythium insidiosum. This report shows the unusual location of the disease in the horse, which made the clinical diagnosis of the disease complex. Extracutaneous forms of pythiosis in horses are less frequent than cutaneous forms. The etiopathogenesis of these forms is still unclear, but it has been suggested that previous lesions in the intestinal mucosa caused by plant material or pathogens may be predisposing factors for the appearance of the enteric form of the disease. It was not possible to observe if the animal’s other organs were affected because a necropsy could not be performed. The agent probably penetrated the esophageal epithelium and spread throughout the trachea and thyroid, but its origin cannot be determined. The radiographic findings in this study are compatible with neoplasms. However, inflammatory processes such as those caused by pythiosis should be included in the differential diagnosis of horses with swelling in the cranial portion of the esophagus.

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Section: Discussionmentioning

confidence: 91%

Cranioesophageal Pythiosis in a Horse

Schmith

Lemos

Rondon

et al. 2020

Acta Scientiae. Vet.

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“…Clinical manifestations of pythiosis can be classified into cutaneous/subcutaneous, ocular, vascular, gastrointestinal, pulmonary, prostatic, and disseminated/systemic pythiosis (Table 3). Clinical characteristics of cutaneous/subcutaneous pythiosis included ulcerative granulomatous lesion, cellulitis, and subcutaneous lumps, which can be observed at various anatomical parts, such as the head and neck (covering face, periorbital area, nose, lip, and oral cavity), body (i.e., chest and abdomen), perineum (including genitalia and anus), and limb (underneath the muscle and joint could be affected) [82,[90][91][92][93][94][95][96][97][98][99][100][101]]. An ocular lesion was limited within an eye globe.…”

Section: Clinical Features Of Pythiosis In Humans and Animalsmentioning

confidence: 99%

Global Distribution and Clinical Features of Pythiosis in Humans and Animals

Yolanda

Krajaejun

2022

JoF

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Pythiosis is a difficult-to-treat infectious disease caused by Pythium insidiosum. The condition is unfamiliar among healthcare workers. Manifestation of pythiosis is similar to other fungal infections, leading to misdiagnosis and delayed treatment. The geographical extent of pythiosis at a global scale is unclear. This study aimed to analyze the clinical information recorded in the scientific literature to comprehensively project epidemiological characteristics, clinical features, and future trends of pythiosis. From 1980 to 2021, 4203 cases of pythiosis in humans (n = 771; 18.3%) and animals (primarily horse, dog, and cow; n = 3432; 81.7%), with an average of 103 cases/year, were recruited. Pythiosis case reports significantly increased in the last decade. Pythiosis spanned 23 tropical, subtropical, and temperate countries worldwide. Some patients acquired pythiosis from a trip to an endemic country. Strikingly, 94.3% of human cases were in India and Thailand, while 79.2% of affected animals were in the U.S.A. and Brazil. Clinical features of pythiosis varied. Vascular and ocular pythiosis were only observed in humans, whereas cutaneous/subcutaneous and gastrointestinal infections were predominant in animals. Mortality depended on host species and clinical forms: for example, none in patients with ocular pythiosis, 0.7% in cows with a cutaneous lesion, 26.8% in humans with vascular disease, 86.4% in dogs with gastrointestinal pathology, and 100% in several animals with disseminated infection. In summary, this study reports up-to-date epidemiological and clinical features of pythiosis in humans and animals. It increases awareness of this life-threatening disease, as the illness or outbreak can exist in any country, not limited to the endemic areas.

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“…Pythiosis is a life-threatening infectious disease [1][2][3][4][5][6][7] that has been increasingly reported in humans [8][9][10][11][12][13], horses [14][15][16][17][18][19], dogs [20][21][22][23], cats [24][25][26][27], camels [28,29], and some other animals [30][31][32][33][34] living in tropical and subtropical areas worldwide. The causative agent is the oomycete microorganism Pythium insidiosum, which inhabits water and moist soil [35][36][37][38][39][40].…”

Section: Introductionmentioning

confidence: 99%

History and Perspective of Immunotherapy for Pythiosis

Yolanda

Krajaejun

2021

Vaccines

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The fungus-like microorganism Pythium insidiosum causes pythiosis, a life-threatening infectious disease increasingly reported worldwide. Antimicrobial drugs are ineffective. Radical surgery is an essential treatment. Pythiosis can resume post-surgically. Immunotherapy using P. insidiosum antigens (PIA) has emerged as an alternative treatment. This review aims at providing up-to-date information of the immunotherapeutic PIA, with the focus on its history, preparation, clinical application, outcome, mechanism, and recent advances, in order to promote the proper use and future development of this treatment modality. P. insidiosum crude extract is the primary source of immunotherapeutic antigens. Based on 967 documented human and animal (mainly horses) pythiosis cases, PIA immunotherapy reduced disease morbidity and mortality. Concerning clinical outcomes, 19.4% of PIA-immunized human patients succumbed to vascular pythiosis instead of 41.0% in unimmunized cases. PIA immunotherapy may not provide an advantage in a local P. insidiosum infection of the eye. Both PIA-immunized and unimmunized horses with pythiosis showed a similar survival rate of ~70%; however, demands for surgical intervention were much lesser in the immunized cases (22.8% vs. 75.2%). The proposed PIA action involves switching the non-protective T-helper-2 to protective T-helper-1 mediated immunity. By exploring the available P. insidiosum genome data, synthetic peptides, recombinant proteins, and nucleic acids are potential sources of the immunotherapeutic antigens worth investigating. The PIA therapeutic property needs improvement for a better prognosis of pythiosis patients.

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Pythiosis with atypical location in the soft palate in a horse in Southern Brazil

Cited by 6 publications

References 10 publications

Cranioesophageal Pythiosis in a Horse

Cranioesophageal Pythiosis in a Horse

Global Distribution and Clinical Features of Pythiosis in Humans and Animals

History and Perspective of Immunotherapy for Pythiosis

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