Infectious Resp Disease 2

Question 1

What are some non-viral infections of the respiratory system?

Answer 1

Bacterial, fungal, parasitic, pleural pneumonia, infiltrative and Misc Diseases

Question 2

What are some bacterial respiratory diseases?

Answer 2

Streptococcus equi, equi
Streptococcus Equi zooepidemicus
Streptococcus Dysgalactiae
Streptococcus pneumoniae
Rhodococcus equi
Mycoplasma
Secondary Bacterial Infections

Question 3

What are some characteristics of Streptococcus Equi Equi?

Answer 3

Gram Positive, Chain Forming, B hemolytic Streptococcus
-B hemolytic - completely lyse RBC on blood plate
-Facultative anaerobe

Question 4

What is the pathogenesis of Streptococcus equi equi?

Answer 4

-Nasal or oral route, aerosolized or fomite
-Bacteria adhere, colonize URT epithelium
-Invade epithelium, lamina propia and lump
-Evades neutrophil and replicate lymph nodes
-SPread through lymphatics (bastard)
-Immune repsonse (purpa)

Question 5

Who is at risk for Streptococcus equi equi?

Answer 5

All horses - old, young and naive worst - occurring in crowded population with new horses

Question 6

How is Streptococcus Equi Equi transferred?

Answer 6

Oral and nasal, carrier in guttural pouch

Question 7

What is classic strangles?

Answer 7

Fever, nasal discharge, swollen lymph nodes (palpate 2-3d), abscesses primary source environmental contamination (don’t survive in environment long)

Question 8

What is the immune mediated form of Streptococcus equi equi like?

Answer 8

Forms immune complex, leukocytoclastic vasculitis, purpura hemorrhagica (kidney, heart and liver effected by vasculitis), autoimmune thrombocytopenia and anemia, agalactia

Question 9

What is bastard stangels?

Answer 9

Dissemination and abscess formation in other viscera - weight loss, low fever, elevated WBC and fibrinogen

Question 10

What is atypical strangles?

Answer 10

Subclinical disease, mild and delf limiting, due to bacterial load and pathogenesis, prior exposure

Question 11

How do you diagnose Streptococcus equi equi?

Answer 11

Bacterial Culture or PCR (nasopharyngeal, abscess swab nasal or guttural pouch washes or abscess aspirate)

Serology: Serum - SeM protein

Question 12

What type of management strategy should be utilized with Streptococcus Equi Equi?

Answer 12

Horse with obvious disease - not antibiotic or NSAID - want it to come to a head and drain (hot packs help)

At rick horse - temp daily, febrile start penicillin asap

Unaffected - separate from affected and minimize contact with fomites

Recovering horses remain in isolation - clean and well ventilated environment, culture and scope guttural pouch

Monitor several month post outbreak - some become carriers

Question 13

Is there a vaccine for Streptococcus equi equi?

Answer 13

Yes! Im and IN (careful - do last), not the most protective

Question 14

What kind of pathogen is strep equi zooepidemicus?

Answer 14

Normal Flora
Opportunistic
Viral Respiratory infection
Young foal develop disease

Question 15

How can you diagnose bacterial disease of Respiratory Tract?

Answer 15

TTW - gram stain, cytology, culture and sensitivity

Question 16

What fungus commonly causes fungal pneumonia in lower airway of horeses?

Answer 16

Aspergillus Fusarium - gut or inhaled

Question 17

What drugs can you use to treat a fungal pneumonia?

Answer 17

Amphotericin B, Fluconazole, Miconazole

Question 18

What type of parasites like to cause respiratory disease?

Answer 18

Lung Worm - young horses with donkey - eosinophilia TTW - Ivermectin

Peracarids - migrate larvae - Ivermectin, moxidectin, fenbendazole

Question 19

What are some causes of pleural effusion?

Answer 19

-Secondary to pulmonary lymphatic blockage by pneumonic educate

-Secondary thoracic neoplasia

-Penetrating wound/trauma and secondary contamination tissue damage

Question 20

What is pleuritis?

Answer 20

Inflammation of pleural membrane
-Thoroughbred and standardbred racehorses

Question 21

What is a common HX for horse with pleuritis?

Answer 21

Stress, transport, recent viral infection, strenuous exercise, general anesthesia

Question 22

What are the clinical signs of pleuropneumonia?

Answer 22

Depression, inappetence, acute weight loss
-Fever, tachycardia, dyspnea, grunt, mucopurulent discharge, ventral edema, scant dry feces
-Reluctant to move, base wide, abduction forelimbs - paretal pleura well endowed with pain receptor, plural pain, look like colic or laminitis or myocisits, reluctant to lie down

Question 23

What is a critical part of your exam when looking for pleuropneumonia?

Answer 23

Thoracic exam - auscultation and percussion

Question 24

What does clinical pathology look like for pleuropneumonia?

Answer 24

CBC: Acute Hemoconentration - leukopenia with left shift, azotemia

CBC: Chronic (4-7 d) - anemia chronic disease, leukocytosis with neutrophilia, hyperfibrinogenemia

Chem: Chronic - azotemia, hypoalbuminemia, hypergammaglobulinemia

Question 25

What type of diagnostics should be performed if pleural pneumonia is suspected?

Answer 25

TTW - submit gram stain, cytology, culture sensitivity, PCR Rads- look for pleural fluid line Ultrasound - method of choice - drain chest 1st - see comet tails and fibrin and consolidated lung Thoracocentesis - diagnostic and therapeutic - drain (ICS 7-8 R, ICS 6-7 left) - cytology, culture, sensitivity (aerobic and anaerobic), glucose and PH

Question 26

How do you treat pleuropneumonia?

Answer 26

Antibiotics - broad (penicillin, aminoglycoside, metronidazole) systemic and aerosolized NSAID, Pentoxyfilline, DMSO Laminitis prophylaxis - ice boot Fluid and nutritional support Thoracoscopy if severe with a rib resection

Question 27

What is the prognosis for pleuropneumonia?

Answer 27

Related to chronicity and extent disease -Acute with minimal effusion - good -Chronic with consolidated lung, effusion and fibrin - bad -bad breath, discharge, mixed infection, anaerobes, poor response = bad

Question 28

What are some infiltrative Diseases of RT?

Answer 28

Granulomatous Disease- Silicosis, hairy vetch toxicosis, fungal, bacterial, coccidia, parasitic Equine multinodular pulmonary fibrosis - EHV5 - steroids and poor prognosis MEEDS: multisytemic eosinophilic epitheliotropic disease - eosinophilic infiltrate lung- resp, weight loss, skin lesion, eosinophilia in blood - treat steroid

Question 29

What is a common form of neoplasia here?

Answer 29

Granular cell tumor - interstitial and intrairway invasion -Sign RAO and obstructive disease -Visualize tumor with endoscope (main stem bronchi?) Lymphosarcoma

Question 30

What are some other misc disease that can cause reparatory signs?

Answer 30

Aspiration Pneumonia: laryngeal function and frowing Foreign Body - young, brambles, TTW tubing, endoscopic diagnosis and retrieval Noxious Smoke

Question 31

What causes pneumothorax and what are clinical signs?

Answer 31

Causes: penetrating wound, dissecting SQ emphysema, bullae or rupture bronchi, necrotic Signs: restlessness to anxiousness, tachypnea, tachycardia, flared nostril, asymmetric thoracic movement, cyanosis

Question 32

How do you diagnose a pneumothorax?

Answer 32

Auscultation and percussion Ultrasound and Rads

Question 33

How do you treat a pneumothorax?

Answer 33

Nasal Oxygen, re-inflate chest

Question 34

What are some clinical sings of pulmonary edema?

Answer 34

Harsh lung sounds, tracheal fluid, respiratory distress

Question 35

How do you treat pulmonary edema?

Answer 35

evaluate cardia cunciton, furosamide, nasal oxygen, steroids, bronchofilators, hetastarch