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Topic:Neurological Diseases

Neurological diseases in horses encompass a range of disorders affecting the central and peripheral nervous systems. These conditions can arise from various etiologies, including infectious agents, genetic predispositions, trauma, or metabolic imbalances. Common neurological diseases in horses include equine protozoal myeloencephalitis (EPM), equine herpesvirus myeloencephalopathy (EHM), and cervical vertebral stenotic myelopathy (CVSM), also known as wobbler syndrome. Clinical signs associated with these diseases may include ataxia, weakness, altered gait, and changes in behavior or mental status. Diagnosis typically involves a combination of clinical evaluation, imaging techniques, and laboratory testing. This page compiles peer-reviewed research studies and scholarly articles that investigate the pathophysiology, diagnostic approaches, and treatment options for neurological diseases in equine populations.
West Nile Virus: An Update Focusing on Southern Europe.
Microorganisms    December 18, 2024   Volume 12, Issue 12 2623 doi: 10.3390/microorganisms12122623
Carrasco L, Utrilla MJ, Fuentes-Romero B, Fernandez-Novo A, Martin-Maldonado B.West Nile Virus (WNV) is a zoonotic, vector-borne pathogen affecting humans and animals, particularly in Europe. The virus is primarily transmitted through mosquitoes that infect birds, which serve as the main reservoirs. Humans and horses are incidental hosts. This review focuses on the epidemiology of WNV in southern Europe, particularly its increasing prevalence. Methods included an extensive literature review and analysis of recent outbreaks. WNV is largely asymptomatic in humans, but a small percentage can develop West Nile neuroinvasive disease (WNND), leading to severe neurological symp...
Effectiveness of Equine-Assisted Activities and Therapies for Children with Autism Spectrum Disorder: An Update.
Children (Basel, Switzerland)    December 8, 2024   Volume 11, Issue 12 1494 doi: 10.3390/children11121494
Zoccante L, Sabaini S, Bonatti SM, Rigotti E, Lintas C, Marconi M, Zaffanello M.Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition requiring personalised therapeutic approaches. This study evaluated the effectiveness of Equine-Assisted Activities and Therapies (EAATs) in 86 children with varying ASD severity levels (levels 1-3). Methods: Vineland Adaptive Behaviour Scales and the Parenting Stress Index were used. Between May 2022 and October 2023, participants completed 20 weekly sessions of 45 min each, tailored to their individual needs. Results: Children with level 3 ASD demonstrated greater challenges in communication (level 1: 67.1 ± 29.0 vs. l...
Skeletal Muscle Biopsy.
The Veterinary clinics of North America. Equine practice    November 28, 2024   Volume 41, Issue 1 31-45 doi: 10.1016/j.cveq.2024.10.003
Valberg SJ, Porter A.Muscle biopsy is often required to provide a definitive diagnosis for neuromuscular disorders and can be performed using open surgical or percutaneous needle biopsy techniques. Fresh samples that are subsequently frozen in the laboratory are preferred by laboratories engaged in research, whereas formalin-fixed muscle is processed by diagnostic laboratories with specialized tinctorial and immunohistochemical techniques. Interpretation by an experienced histopathologist, combined with the signalment, history, and clinical input, is essential for establishing a diagnosis. This article outlines be...
Pneumocephalus due to temporohyoid osteoarthropathy in a 16-year-old Friesian mare.
Journal of equine veterinary science    October 26, 2024   Volume 143 105210 doi: 10.1016/j.jevs.2024.105210
Witt P, Stas EKL, Hardeman LC, van Proosdij ER, Weerts EAWS, Lloyd-Edwards RA, Veraa S, Kranenburg LC, van den Boom R.A sixteen-year-old Friesian mare was admitted to the university clinic with the following clinical signs: anorexia, weight loss, fever, bilateral nasal discharge, unilateral facial paralysis and a non-healing corneal lesion. Endoscopic examination of the upper airways showed thickening of the proximal portion of the right stylohyoid bone. Computed tomography imaging showed pneumocephalus due to grade 3 unilateral temporohyoid osteoarthropathy (THO) with fracture of the petrous temporal bone. The horse did not improve following medical treatment. Surgical intervention was declined by the owner ...
Urinary incontinence and sabulous cystitis in mares: report of five cases.
Brazilian journal of veterinary medicine    October 21, 2024   Volume 46 e005024 doi: 10.29374/2527-2179.bjvm005024
de Melo UP, Ferreira C.This report describes five cases of urinary incontinence in Quarter Horse mares associated with the development of sabulous cystitis. The animals in this study had a history of persistent urinary incontinence for eight months, with clinical signs of continuous dribbling urine during rest and movement. The initial treatment with antibiotics and anti-inflammatory drugs was ineffective. Clinical examination revealed severe scalding in the perineal region and on the medial aspect of the hind limbs, along with neurological signs such as ataxia, hind limb paresis, and diminished perineal reflexes. T...
Outbreak of Western Equine Encephalitis Virus Infection Associated with Neurological Disease in Horses Following a Nearly 40-Year Intermission Period in Argentina.
Viruses    October 10, 2024   Volume 16, Issue 10 1594 doi: 10.3390/v16101594
Vissani MA, Alamos F, Tordoya MS, Minatel L, Schammas JM, Dus Santos MJ, Trono K, Barrandeguy ME, Balasuriya UBR, Carossino M.Western equine encephalitis virus (WEEV) is a mosquito-borne arbovirus (genus , family ) that has re-emerged in South America in late 2023, causing severe disease in both horses and humans after a nearly 40-year intermission period. We here describe the virological, serological, pathological, and molecular features of WEEV infection in horses during the 2023-2024 outbreak in Argentina. WEEV-infected horses developed neurological signs with mild to severe encephalitis associated with minimal to abundant WEEV-infected cells, as demonstrated by WEEV-specific in situ hybridization. The distributio...
Attenuation of the neuropathogenic equine herpesvirus type 1 strain Ab4p in hamsters by a single amino acid mutation (D752N) in viral DNA polymerase ORF30.
The Journal of veterinary medical science    October 9, 2024   Volume 86, Issue 12 1273-1278 doi: 10.1292/jvms.24-0338
Nishimura F, Fukushi N, Sakai H, Fukushi H.Equine herpesvirus type 1 (EHV-1) causes abortion, respiratory infection, and neurological diseases (equine herpesvirus myeloencephalopathy) in horses. A single nucleotide polymorphism (SNP) associated with a single amino acid in the DNA polymerase gene (ORF30, in which D752 is neuropathogenic and N752 is non-neuropathogenic) of EHV-1 has been associated with neuropathogenicity in horses. We constructed an EHV-1 Ab4p ORF30 N752 mutant and a repair virus to examine the effect of a D752N mutation on the neuropathogenicity of the virus in Syrian hamsters. The N752 mutation did not affect viral gr...
Effect of repetitive transcranial magnetic stimulation on trigeminal-mediated headshaking in 17 horses.
Journal of veterinary internal medicine    September 12, 2024   Volume 38, Issue 5 2758-2765 doi: 10.1111/jvim.17194
Franzen V, Gruber NA, Klußmann S, Schoster A, May A.Trigeminal-mediated headshaking is a neuropathic facial pain condition in horses. No treatment has been entirely successful. Repetitive transcranial magnetic stimulation (rTMS) is used in human medicine as a treatment for various neuropathic pain conditions, and good results have been achieved in cases of trigeminal neuralgia. Objective: Apply rTMS to horses with trigeminal-mediated headshaking (TMHS) and to evaluate tolerability, application of the setting, and success rate. Methods: Seventeen horses with nonseasonal signs of TMHS. Methods: Other underlying causes of headshaking were ruled ou...
Acute myeloid leukemia-M1 in a horse with neurologic signs and necrotizing enterocolitis. Lee J, Mordoh S, Mirza M, Carossino M, Del Piero F.An 18-y-old American Saddlebred mare was admitted with fever and acute onset of neurologic signs including grade 3 of 5 ataxia, difficulty in prehension, and dull mentation. Because of financial restraints, desired testing could not be performed; the horse's condition declined despite supportive treatment, and euthanasia was elected. Postmortem examination revealed petechiae and ecchymoses in the meninges and neuroparenchyma of the encephalon. Blast-like neoplastic round cells were identified within the vasculature and areas of hemorrhage in the neuroparenchyma, the intestinal submucosa, and o...
Equine-assisted therapy in quality of life and functioning of people with active epilepsy: A feasibility study.
Epilepsy & behavior reports    August 22, 2024   Volume 28 100707 doi: 10.1016/j.ebr.2024.100707
de Andrade Santos FO, Souza-Santos C, Passos AA, Nunes de Santana Campos R, Martins-Filho PR, Arida RM, Teixeira-Machado L.People with active epilepsy, which is often associated with specific neurological conditions, endure significant impairments in quality of life (QoL) and functioning, particularly those in middle-income countries. Physical intervention plays an essential role in addressing these challenges. This study investigated the impact of equine-assisted therapy (EAT) on QoL, functional independence, sleep quality, antiseizure medications, and frequency of seizures among people with epilepsy (PWE), with or without additional neurological conditions. Fourteen participants aged 4-34 years old diagnosed wi...
Lipofuscin accumulates in ganglionic neurons in chronic equine dysautonomia. Tan Yi Shean L, Milne EM, Shaw DJ, Maxwell S, Del-Pozo J.Lipofuscin is a complex mixture of highly oxidized, cross-linked macromolecules that accumulates in neurons with age and some neurodegenerative diseases. Equine dysautonomia (ED) is a polyneuropathy that mainly affects autonomic and enteric nervous systems, resulting in alimentary tract dysfunction. Our main aim was to determine whether neuronal lipofuscin increased with increasing duration of ED. We investigated the prevalence of lipofuscin in cranial cervical ganglia of horses with acute (AED), subacute (SED), and chronic ED (CED), young controls (of similar age to ED cases), and aged contro...
Management of paracondylar process fracture in three horses.
Equine veterinary journal    July 18, 2024   Volume 56, Issue 6 1193-1200 doi: 10.1111/evj.14202
Beldeanu S, Tay MCA, Daniel C, Dosi MCM, Hahn CN, James O, Townsend NB, Liuti T, Schwarz T, Parkinson NJ.Fractures of the paracondylar process of the occipital bone may cause headshaking, neck pain and neurologic deficits. The condition is being recognised more frequently with increasing availability of computed tomography. However, to date only limited information is available as to presentation, treatment, surgical approach and outcome. Objective: To describe the clinical signs, imaging findings, treatment, surgical approach and outcome in three horses diagnosed with paracondylar process fracture. Methods: Retrospective case series. Methods: Clinical records and diagnostic images of affected ca...
Use of a poll-mounted accelerometer for quantification and characterisation of equine trigeminal-mediated headshaking.
Equine veterinary journal    July 17, 2024   Volume 57, Issue 3 645-653 doi: 10.1111/evj.14132
Pickles KJ, Marlin DJ, Williams JM, Roberts VLH.Equine trigeminal-mediated (TGM) headshaking (HS) is a neuropathic facial pain syndrome characterised by varying intensity and frequencies of head movements and signs of nasal irritation. An accurate method for quantification and/or characterisation of HS severity is lacking. Objective: To develop and validate an objective measure of TGMHS. Methods: Prospective case control study. Methods: Horses presenting for investigation of HS were recruited alongside those presenting for forelimb lameness (LAME) and pre-purchase examination as well as healthy controls (CONTROL). Head movement data were co...
Congenital variants of the ventral laminae of the sixth and seventh cervical vertebrae are not associated with clinical signs or other radiological abnormalities of the cervicothoracic region in Warmblood horses.
Equine veterinary journal    June 28, 2024   doi: 10.1111/evj.14127
Dyson S, Phillips K, Zheng S, Aleman M.There is controversy about the clinical relevance of congenital variants of the ventral laminae of the sixth (C6) and seventh (C7) cervical vertebrae and their relationship with other radiological abnormalities. Objective: To document the prevalence of congenital variants of C6 and C7 and that of other radiological abnormalities from C6 to the second thoracic vertebra (T2). Methods: Cross-sectional. Methods: The study included Warmblood horses ≥3 years of age undergoing clinical assessment at two referral institutions: 127 control horses and 96 cases (neurologic, neck pain or stiffness, or...
Divergent strains of EHV-1 in Swedish outbreaks during 2012 to 2021.
BMC veterinary research    June 22, 2024   Volume 20, Issue 1 270 doi: 10.1186/s12917-024-04096-7
Öhrmalm J, Cholleti H, Theelke AK, Berg M, Gröndahl G.Equid alphaherpesvirus 1 (EHV-1) is a ubiquitous and significant viral pathogen in horses worldwide, causing a range of conditions, including fever, respiratory disease, abortion in pregnant mares and the severe neurological disease called equine herpes myeloencephalopathy (EHM). Despite that EHV-1 is a notifiable animal disease in Sweden, there is limited knowledge about the circulating strains. This study aimed to analyze the genetic diversity of EHV-1 strains in equine samples from different Swedish outbreaks by partial genome sequencing. Genotyping based on three selected open reading fram...
Unmasking the ongoing challenge of equid herpesvirus- 1 (EHV-1): A comprehensive review.
Microbial pathogenesis    June 17, 2024   Volume 193 106755 doi: 10.1016/j.micpath.2024.106755
Afify AF, Hassanien RT, El Naggar RF, Rohaim MA, Munir M.Equid herpesviruses (EHVs) are a group of highly impactful viral pathogens that affect horses, presenting a substantial risk to the global equine industry. Among these, equid herpesvirus-1 (EHV-1) primarily causes respiratory infections. However, its ability to spread to distant organs can lead to severe consequences such as abortion and neurological diseases. These viruses can enter a dormant phase, with minimal activity, and later reactivate to trigger active infections at any time. Recently, there has been a notable rise in the prevalence of a particularly devastating strains of EHV-1 known...
West Nile Virus Seroprevalence in Wild Birds and Equines in Madrid Province, Spain.
Veterinary sciences    June 7, 2024   Volume 11, Issue 6 259 doi: 10.3390/vetsci11060259
Williams RAJ, Criollo Valencia HA, López Márquez I, González González F, Llorente F, Jiménez-Clavero MÁ, Busquets N, Mateo Barrientos M....West Nile virus (WNV) is a re-emerging flavivirus, primarily circulating among avian hosts and mosquito vectors, causing periodic outbreaks in humans and horses, often leading to neuroinvasive disease and mortality. Spain has reported several outbreaks, most notably in 2020 with seventy-seven human cases and eight fatalities. WNV has been serologically detected in horses in the Community of Madrid, but to our knowledge, it has never been reported from wild birds in this region. To estimate the seroprevalence of WNV in wild birds and horses in the Community of Madrid, 159 wild birds at a wildli...
Primary phenotypic features associated with caudal neck pathology in warmblood horses.
Journal of veterinary internal medicine    June 3, 2024   doi: 10.1111/jvim.17125
Dyson S, Zheng S, Aleman M.Detailed descriptions of clinical signs associated with radiological findings of the caudal cervical vertebral column are not available. Objective: Describe the clinical features associated with neck pain or stiffness, neck-related thoracic limb lameness, proprioceptive ataxia consistent with a cervicothoracic spinal cord or nerve lesion, and their frequency of occurrence compared with control horses. Methods: A total of 223 Warmblood horses. Methods: Case-control study. Controls and cases were recruited prospectively. All horses underwent predetermined lameness and neurologic examinations. Th...
A fresh look at the SarcoFluor antibody test for the detection of specific antibodies to Sarcocystis neurona for the diagnosis of equine protozoal myeloencephalitis.
Veterinary parasitology    June 3, 2024   Volume 330 110219 doi: 10.1016/j.vetpar.2024.110219
Pandit PS, Smith WA, Finno CJ, Aleman M, Conrad PA, Packham A, Plancarte M, Woolard K, Marsh A, Pusterla N.Equine protozoal myeloencephalitis (EPM) is a challenging disease to diagnose in horses with neurological signs. To optimize contemporary diagnostic testing, including the use of serum:CSF antibody ratios, the SarcoFluor antibody test for Sarcocystis neurona requires revalidation. The SarcoFluor, a previously validated immunofluorescent antibody test (IFAT) for the detection of antibodies specific to S. neurona in serum and cerebrospinal fluid (CSF) of naturally infected horses was analyzed using recent data and considering a serum:CSF antibody ratio threshold. Utilization of serum and CSF pho...
A possible cause and therapy for equine grass sickness.
Toxicon : official journal of the International Society on Toxinology    May 29, 2024   Volume 245 107790 doi: 10.1016/j.toxicon.2024.107790
Montecucco C, Bano L.No abstract available
Neck pain but not neurologic disease occurs more frequently in horses with transposition of the ventral lamina from C6 to C7.
Journal of the American Veterinary Medical Association    May 29, 2024   1-7 doi: 10.2460/javma.24.04.0230
Henderson CS, Story MR, Nout-Lomas YS.To determine reasons for horses to have neck radiographs performed, the incidence of transposition of the ventral lamina of C6 onto C7 (TC67), and the final diagnoses for all horses. Our hypotheses were to find a similar incidence of TC67, as has been previously reported, and an increased incidence of neck pain and dysfunction in horses with TC67. Methods: 135 horses. Methods: Retrospective observational study. Medical records of 135 horses with cervical vertebral column radiographs between 2020 and 2022 were assessed. Patient signalment, reasons for radiographs, radiographic findings, and dia...
Bilateral stringhalt associated with Hypochaeris radicata in Uruguayan horses.
Toxicon : official journal of the International Society on Toxinology    May 29, 2024   Volume 245 107780 doi: 10.1016/j.toxicon.2024.107780
Machado M, Camacho AL, Coubrough C, R R Queiroz-Machado C, Custodio C, Barros CSL, Riet-Correa F, Menchaca A.We reported thirteen cases of bilateral stringhalt associated with Hypochaeris radicata that occurred in horses in Uruguay during a severe drought in the summer of 2023. All horses were affected chronically and progressively by bilateral hyperflexion of hindlimbs. In two severely affected horses, the main histological lesions included neuronal chromatolysis and axonal spheroids in the ventral gray horn in the lumbar and sacral spinal cord and axonal degeneration and digestion chambers in ventral roots fibers and long peripheral nerves. We suggest that in addition to injuries to peripheral nerv...
Impact of the host immune response on the development of equine herpesvirus myeloencephalopathy in horses.
The Journal of general virology    May 20, 2024   Volume 105, Issue 5 doi: 10.1099/jgv.0.001987
Giessler KS, Goehring LS, Jacob SI, Davis A, Esser MM, Lee Y, Zarski LM, Weber PSD, Hussey GS.Herpesviruses establish a well-adapted balance with their host's immune system. Despite this co-evolutionary balance, infections can lead to severe disease including neurological disorders in their natural host. In horses, equine herpesvirus 1 (EHV-1) causes respiratory disease, abortions, neonatal foal death and myeloencephalopathy (EHM) in ~10 % of acute infections worldwide. Many aspects of EHM pathogenesis and protection from EHM are still poorly understood. However, it has been shown that the incidence of EHM increases to >70 % in female horses >20 years of age. In this study we use...
Long-term performance of show-jumping horses and relationship with severity of ataxia and complications associated with myeloencephalopathy caused by equine herpes virus-1.
Journal of veterinary internal medicine    April 12, 2024   Volume 38, Issue 3 1799-1807 doi: 10.1111/jvim.17070
de la Cuesta-Torrado M, Velloso Alvarez A, Neira-Egea P, Cuervo-Arango J.Equine herpesvirus myeloencephalopathy (EHM) has severe impact on the sport horse population. Objective: Study the influence of EHM on the likelihood of affected horses to return to their previous performance and investigate the association of clinical variables with prognosis. Methods: Twenty-six horses positive for equine herpesvirus type 1 (EHV-1) were admitted to a veterinary teaching hospital (VTH) during a natural EHM outbreak at an international jumping event. Methods: Data collected from the VTH, the International Equestrian Federation, and surveys completed by the riders and horse own...
Review of cellular therapies provides new insights into the potential treatment of diverse neurologic diseases in horses and dogs.
Journal of the American Veterinary Medical Association    March 8, 2024   1-10 doi: 10.2460/javma.23.12.0709
Colbath AC, Goodrich L, Frye C, Dow S.Neurological diseases and injuries in veterinary patients (horses, dogs, and cats) are complex, and effective treatment options are limited. Neuronal loss, damage to nerve conduction pathways, and inflammation and scarring associated with spinal cord injury pose major challenges in managing many neurological diseases. Furthermore, most of these neuropathologies lack definitive pharmacological treatments, driving interest and research into novel interventions. Our objective is to provide a narrative review of the current literature surrounding cellular therapies including neuronal and glial ste...
Heme oxygenase-1 is an equid alphaherpesvirus 8 replication restriction host protein and suppresses viral replication via the PKCβ/ERK1/ERK2 and NO/cGMP/PKG pathway.
Microbiology spectrum    March 5, 2024   Volume 12, Issue 4 e0322023 doi: 10.1128/spectrum.03220-23
Wang T, Li S, Hu X, Geng Y, Chen L, Liu W, Zhao J, Tian W, Wang C, Li Y, Li L.Equid alphaherpesvirus 8 (EqHV-8) is one of the most economically important viruses that is known to cause severe respiratory disease, abortion, and neurological syndromes in equines. However, no effective vaccines or therapeutic agents are available to control EqHV-8 infection. Heme oxygenase-1 (HO-1) is an antioxidant defense enzyme that displays significant cytoprotective effects against different viral infections. However, the literature on the function of HO-1 during EqHV-8 infection is little. We explored the effects of HO-1 on EqHV-8 infection and revealed its potential mechanisms. Our ...
Identification of neuropathogenic Varicellovirus equidalpha1 as a potential cause of respiratory disease outbreaks among horses in North Xinjiang, China, from 2021-2023.
BMC veterinary research    February 27, 2024   Volume 20, Issue 1 77 doi: 10.1186/s12917-024-03925-z
Tong P, Yang E, Liu B, Tian S, Suo Y, Pan J, Dang Y, Palidan N, Jia C, Kuang L, Xie J.Varicellovirus equidalpha1 (formerly Equid alphaherpesvirus 1, EqAHV-1) is among the most important viruses responsible for respiratory disease outbreaks among horses throughout the world. No reports to date have detailed the association between EqAHV-1 and respiratory disease among horses in China. This study described one such outbreak among a population of horses in north Xinjiang that occurred from April 2021 - May 2023. Results: qPCR revealed that EqAHV-1 was detectable in all samples and this virus was identified as a possible source of respiratory disease, although a limited subset of t...
Measurement of 8-hydroxy-2′-deoxyguanosine in serum and cerebrospinal fluid of horses with neuroaxonal degeneration and other causes of proprioceptive ataxia.
Journal of veterinary internal medicine    January 11, 2024   Volume 38, Issue 2 1207-1213 doi: 10.1111/jvim.16988
Palmisano M, Kulp J, Bender S, Stefanovski D, Robinson M, Johnson A.Eight-hydroxy-2'-deoxyguanosine (8-OHdG), a biomarker of oxidative damage evaluated in human neurodegenerative disease, has potential to correlate with postmortem diagnosis of neuroaxonal dystrophy/degenerative myeloencephalopathy (NAD/DM) in horses. Objective: We hypothesized that 8-OHdG will be higher in CSF and serum from NAD/DM horses compared with horses with other neurologic diseases (CVSM, EPM) and a control group of neurologically normal horses. We also hypothesized that 8-OHdG will be higher in CSF compared with serum from NAD/DM horses. Methods: Fifty client-owned horses with postmor...
Seroprevalence and risk factors for Neospora spp. infection in equine in Egypt.
Scientific reports    November 19, 2023   Volume 13, Issue 1 20242 doi: 10.1038/s41598-023-47601-y
Alshammari A, Gattan HS, Marzok M, Selim A.Neospora infections in equine are associated with reproductive disorders and neurological diseases. Nevertheless, Egypt has no epidemiological information on this parasite in equine. This study determined the prevalence of Neospora spp. infection in 325 equines from three Egyptian governorates located at Northern Egypt using cELISA. The prevalence of antibodies against Neospora spp. was 19% (95% CI: 14.09-25.05) in horse, 34.1% (95%CI: 24.92-44.69) in donkey and 26.7% (95% CI: 15.97-41.04) in mule. In comparison to horse, donkey had a considerably higher chance of contracting Neospora spp. in...
Streptococcus zooepidemicus Meningitis in an HIV-Positive Horse Breeder Patient: A Case Study and Literature Review.
Infectious disease reports    September 7, 2023   Volume 15, Issue 5 527-534 doi: 10.3390/idr15050052
subsp. is a rare etiologic agent of bacterial meningitis in humans. The disease is a zoonotic infection and is transmitted through close contact with domestic animals, mainly horses. Only 37 cases of meningitis have been reported in the literature until July 2023. The aim of this study is to present a rare clinical case of -related meningitis in a human immunodeficiency virus (HIV)-positive patient and analyze the literature. We present a 23-year-old horse breeder patient with advanced immunosuppression due to acquired immunodeficiency syndrome (AIDS) and meningitis, admitted at the Clinic...