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Ethmoidal Infection with Aspergillus spp. in 3 Horses: Successful Treatment by Transendoscopic Removal of Mycotic Plaques Alone or in Combination with Systemic Itraconazole
Author(s) -
Theelen M.J.P.,
Siegers E.W.,
Ensink J.M.
Publication year - 2015
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12486_15
Subject(s) - medicine , horse , itraconazole , surgery , aspergillosis , nasal cavity , aspergillus fumigatus , endoscopy , debulking , dermatology , cancer , biology , antifungal , paleontology , immunology , ovarian cancer
Reasons for performing study Ethmoidal infection with Aspergillus spp. is rarely reported in horses. Three horses suffering from unilateral infection with Aspergillus spp. of the ethmoid with varying underlying conditions are described. Study design Case series. Methods Diagnosis was made by endoscopy of the ethmoid (presence of white mycotic plaques on a layer of thick yellow mucus) and confirmed by fungal culture ( A . fumigatus ) and/or cytology. Clinical details and outcome were obtained from the medical records and by contacting owners. Results Horse 1 and 2 had a progressive ethmoid haematoma ( PEH ) and had been treated for over 5 months with repeated formalin injections (one horse after initial surgical debulking of the PEH that also invaded the maxillary and sphenopalatine sinuses) before the infection with Aspergillus was diagnosed. The third horse, presented with poor performance and nasal discharge, had congenitally abnormal anatomy of the right dorsal nasal passage and right ethmoids. In the 2 horses with PEH the mycotic plaques were removed transendoscopically successfully. After 6 weeks the infection was no longer present at endoscopy in both horses (follow‐up endoscopy: Horse 1 no relapse >16 months and Horse 2 no relapse >7 months). In the third horse, it was not possible to remove all mycotic plaques, therefore systemic treatment with itraconazole (3 mg/kg bwt q. 12 h for 8 weeks orally) was started. After 8 weeks, the clinical signs had resolved and endoscopy showed that the A spergillus infection had cleared (follow‐up: no relapse >14 months). No side effects were seen with systemic itraconazole treatment. Conclusions In horses with underlying ethmoidal conditions, secondary infection with A spergillus spp. may occur. Transendoscopic removal of the mycotic plaques alone may be successful and if this approach is not feasible or unsuccessful, systemic treatment with itraconazole can be considered. Ethical animal research: Research ethics committee oversight not currently required by this conference: retrospective study of clinical records. Owners gave informed consent for their horses' inclusion in the study. Source of funding: Utrecht University. Competing interests: None declared.