Guttural pouch mycosis in two foals

Abstract

Summary Guttural pouch mycosis (GPM) is a rare disorder in foals and should be considered as a differential in a foal presenting with dysphagia. This manuscript describes the medical management of 2 Thoroughbred foals (age 2 and 4 months) that presented with dysphagia secondary to presumptive mucosal penetration and damage by the fungal hyphae to the glossopharyngeal and hypoglossal nerves, and the pharyngeal branch of the vagus nerve. Successful treatment of the GPM was achieved with the use of systemic itraconazole and topical miconazole. The mycotic lesions resolved, but both foals continued to have residual cranial nerve deficits, which included an acquired left laryngeal paralysis (Foal A), and residual dysfunction of the glossopharyngeal, hypoglossal and vagus nerves resulting in a weak swallow reflux and transient dysphagia (Foal B).

Salpingopharyngeal fistula as a treatment for guttural pouch mycosis in seven horses

“…Medical therapy consists of systemic and topical treatment, neither of which have significant evidence to support their efficacy. Systemically, treatments with thiabendazole , itraconazole and iodide have been described. Topical treatment of GPM with a range of topical medications can be found in the literature, but their efficacy is not well supported .…”

Successful combination treatment of bilateral guttural pouch mycosis with salpingopharyngeal fistulation and potassium iodide

“…While there is no age predisposition to GPM, the disease is infrequently described in foals less than 9 months of age (Chidlow & Slovis, 2017; Millar, 2006). Prolonged antimicrobial treatment has been implicated in the pathogenesis of GPM in foals (Chidlow & Slovis, 2017).…”

“…While there is no age predisposition to GPM, the disease is infrequently described in foals less than 9 months of age (Chidlow & Slovis, 2017; Millar, 2006). Prolonged antimicrobial treatment has been implicated in the pathogenesis of GPM in foals (Chidlow & Slovis, 2017). The colt in this report had received multiple courses of antimicrobial treatment for a suspected respiratory tract infection prior to the onset of neck stiffness; however, it is unknown whether these respiratory signs were as a result of already present GPM or if antimicrobial treatment contributed to the development of GPM.…”

“…Predisposing factors for aspergillosis in horses include prolonged antibiotic administration, immunosuppression, enteritis, endocrinopathies, neoplasia and exposure to environmental moulds (Blue et al, 1987; Guillot et al, 1997; Hattel et al, 1991; Pace et al, 1994; Slocombe & Slauson, 1988). There is no age, breed or sex predisposition for GPM but adult horses are most commonly affected and the disease has only occasionally been reported in foals (Chidlow & Slovis, 2017; Ryan et al, 1992).…”

Extensive and invasive guttural pouch granuloma in a 2‐year‐old gelding

“…). Mostly adult horses are infected, but foals can be affected as well (Chidlow and Slovis ). Typical lesions of guttural pouch mycosis are characterised as clearly demarcated, yellow‐brown, necrotic tissue, which is firmly adhered to the surface of the medial compartment of one of the guttural pouches (Cook ; Markus et al .…”