Eosinophilic Granuloma with Splendore-Hoeppli Material Caused by Toxigenic <i>Corynebacterium ulcerans</i> in a Heifer

Abstract

Raised lesions were present on the left nasal vestibule of a 20-month-old Japanese Brown heifer. The largest mass which caused partial nasal obstruction was removed surgically. Corynebacterium ulcerans was identified in the mass. 16S ribosomal RNA and RNA polymerase beta subunit genes were 100% and 98% identical to other C. ulcerans strains. Histologically, multiple foci of eosinophilic granuloma with Splendore-Hoeppli material were seen. Rod-shaped Gram-positive organisms were detected with metachromatic granules, producing diphtheria toxin with 5, 30 and 48 amino acid differences to another C. ulcerans strain, C. diphtheriae or C. pseudotuberculosis, respectively. The toxin is highly cytotoxic and may be responsible for the formation of abundant Splendore-Hoeppli material. The lesion was therefore judged to be an allergic reaction to bacterial antigens or diphtheria toxin.

Histological Study of Bovine Nocardial Eosinophilic Granuloma with Comparison of Splendore-Hoeppli Material

“…Since this allergic disease occurs most commonly in patients with asthma or cystic fibrosis, especially those with coexisting atopy (Chetty 2003, Patterson & Strek 2010, the animals with nocardial eosinophilic granuloma were also considered to have an allergic constitution. Similar eosinophilic granulomas have been caused by C. ulcerans T. Oyama et al (Murakami et al 2014) and M. granulomatis (Riet-Correa et al 1992), and further studies would find other organisms associated with bovine eosinophilic granuloma. Splendore-Hoeppli material is said to consist of tissue debris, fibrin, and immunoglobulin (Hussein 2008, Johnson et al 2010.…”

“…On the other hand, in a case of Trueperella pyogenes infection, neutrophils containing intact bacteria became necrotic and coalesced, and showed transition into sulfur granules. Likewise, in a case of Corynebacterium ulcerans infection, cell death induced by cytotoxic diphtheria toxin was believed responsible for the formation of abundant Splendore-Hoeppli material (Murakami et al 2014). Elongated spicules of Splendore-Hoeppli material were not observed in these cases caused by toxigenic rod-shaped bacteria (Billington et al 1997, Murakami et al 2014, unlike in cases of branching filamentous bacteria.…”

“…In addition, stained sections from previously reported cases of nocardial eosinophilic granuloma (Shibahara et al 2001) and actinomycosis (Murakami et al 2014) were also observed as controls.…”

“…However, small amounts of allergens can cause severe inflammation in both humans and animals, implying difficulties in identifying its etiological agents. In a case of eosinophilic granuloma in the nasal vestibule of a Japanese Brown heifer, abundant Splendore-Hoeppli material surrounded by eosinophils was observed, and Corynebacterium ulcerans producing diphtheria toxin was isolated from the lesion (Murakami et al 2014 caused by Nocardia sp. in the nasal cavities of a Holstein heifer has also been reported (Shibahara et al 2001).…”

“…is histologically characterized by fungal hyphae and neutrophil infiltration, but epithelioid cell granuloma with eosinophil infiltration is formed in allergic bronchopulmonary aspergillosis in humans (Bosken et al 1988). Allergic granuloma may occur in the skin and nasal cavity of cattle (Murakami et al 2014, Riet-Correa et al 1992, Shibahara et al 2001. However, small amounts of allergens can cause severe inflammation in both humans and animals, implying difficulties in identifying its etiological agents.…”