Pathogenesis in horses refers to the biological mechanisms that lead to the development and progression of diseases within equine species. This process involves a complex interaction between the horse's immune system, genetic predispositions, environmental factors, and infectious agents such as bacteria, viruses, or parasites. Understanding pathogenesis is essential for identifying how diseases manifest and progress in horses, which can inform diagnostic and therapeutic strategies. Research in this area often focuses on specific diseases, examining factors such as pathogen entry, immune response, tissue damage, and recovery processes. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, contributing factors, and implications of pathogenesis in equine health.
Turk MA, Breeze RG, Gallina AM.The pathologic features of bronchiolitis were studied in horses and ponies from 30 minutes to 27 days after an oral dose of 3-methylindole (3MI). From 30 minutes to 3 hours, lesions were limited to nonciliated bronchiolar epithelial (Clara) cells, which lost apical caps and cytoplasmic granules and had dilated smooth endoplasmic reticulum (SER). At 12 hours, necrotic Clara cells were exfoliated; degeneration and necrosis were evident, in bronchiolar ciliated cells. Rare epithelial cells with hyperplastic SER appeared on the denuded basal lamina at 24 hours. Inflammatory cells, epithelia, fibro...
Camp CJ, Leid HW.Extracts of Onchocerca cervicalis, an equine parasite, were incubated with radiolabeled equine neutrophils and neutrophil migration was assessed for factors derived from the parasite itself or for host-derived factors after incubation of these same parasite extracts with equine serum. No stimulus for cell migration was observed in saline extracts of adult worms, uterine microfilariae, or skin microfilariae at any dosage tested. However, after incubation of saline extracts with fresh normal equine sera a marked stimulus for neutrophil migration was observed. Ablation of this biologic activity w...
Campbell TM, Studdert MJ, Blackney MH.Some kinetic data on the inactivation of equine herpesvirus type 1 (EHV1) and equine rhinovirus type 1 (ERhV1) by betapropiolactone (BPL) and ultraviolet (UV) irradiation are reported. 0.25% BPL at 37 degrees C for 1 h reduced the titre of EHV1 by greater than 10(3 . 4) and of ERhV1 by greater than 10(4 . 1) TCID50/ml. UV irradiation (334 microW/cm2) produced similar reductions in titre after 2 min. These data were used as a basis for inactivating EHV1 and ERhV1 by the combined action of BPL and UV irradiation. Viruses were exposed to 0.1% BPL for 1 h at 4 degrees C with constant stirring, fol...
Derksen FJ, Robinson NE, Slocombe RF.In awake sensitized ponies, we studied the effect of aerosol ovalbumin challenge on ventilation, pulmonary mechanics, lung volume, and gas exchange before and after vagal blockade. We also challenged the left lung and measured respiratory rate (f) and right and left respiratory system resistance (RrsR, RrsL) before and after both left and bilateral vagal section. Bilateral ovalbumin aerosol challenge increased f, minute ventilation (VE), total respiratory system resistance (Rrs), and minimal volume, decreased dynamic compliance, total lung capacity, and arterial oxygen tension, and was without...
Clarke LL, Garner HE, Hatfield D.Acute laminitis-hypertension was produced by carbohydrate overloading of the gastrointestinal tract in 12 adult horses. Obel grade 3 (OG3) lameness developed 40 hours (+/- 3.5, SEM) after overfeeding. At OG3 lameness, mean plasma volume was significantly decreased (P less than 0.005) when compared with base-line values. Before OG3 lameness, transient decreases in serum phosphorus and calcium were recorded. Mild hyponatremia also developed before OG3 lameness and persisted. After establishment of OG3 lameness, persistent hypokalemia and increased plasma aldosterone concentration occurred coinci...
Fricker C, Riek W, Hugelshofer J.The digital arteries of 10 horses suffering from navicular disease, and 7 horses from a control group, were examined angiographically. The horses from the disease group showed complete or partial occlusion of the digital arteries in all cases. In the control group of 7 healthy horses, isolated vessel obstructions were also found but these were limited to narrowing of part of an artery only. Histological investigations showed that total occlusion of a vessel involved an organised thrombus but that partial occlusion generally involved changes to the vascular wall, similar to those caused by enda...
Miller RI, Campbell RS.During a clinical study of equine phycomycosis in tropical northern Australia 3 specific forms of phycomycosis were identified. Of 266 cases diagnosed in 5 different laboratories, hyphomycosis caused by Hyphomyces destruens was responsible for 76.7%, basidiobolomycosis caused by Basidiobolus haptosporus for 18.0%, and entomophthoramycosis caused by Conidiobolus coronatus for 5.3%. Most cases of hyphomycosis were observed between March and July, that is after the monsoonal wet summer, but were calculated from clinical histories to originate in the wet season between November and May. Basidiobol...
Shively MA, Banks KL, Greenlee A, Klevjer-Anderson P.Equine infectious anemia is a chronic disease of horses caused by a nononcogenic retrovirus. Studies were undertaken to determine the types of cells involved in the in vitro lymphoproliferative response to viral antigens and the dynamics of this reaction. It was observed that reactive lymphocytes were present at unpredictable times in the peripheral blood of infected horses. This reaction was shown to be specific for the interaction of equine infectious anemia virus and T lymphocytes. Enriched B-lymphocyte populations did not divide when exposed to equine infectious anemia virus. Macrophages w...
McIlwraith CW.Current concepts of pathogenesis, diagnosis, and treatment of equine degenerative joint disease are presented on the basis of recently acquired experimental and clinical knowledge. A number of concepts of pathogenesis need modification and the rationale of some of the newer treatments requires definition. Synovitis and other soft tissue changes are important components of the pathogenesis in addition to direct trauma to the articular cartilage. Loss of glycosaminoglycans constitutes an important biochemical "lesion" in the articular cartilage, making it weak and susceptible to trauma. Recognit...
Sprouse R, Garner H, Eyestone W.The occurrence of the Local Shwartzman Reaction (LSR) in equine species has not previously been reported. The molecular mechanism appears identical to that reported for the rabbit and other species. The immunopathologic and histopathologic similarities of the experimentally induced LSR in horses and ponies to that of the hoof-laminae (an extension of the skin) lesion in naturally-occurring and/or carbohydrate induced laminitis may offer insight into the pathogenesis of this complex disease.
Burrows R, Denyer M.The antigenic relationships between the haemagglutinins of five A/equine-1 viruses and between six A/equine-2 viruses were examined using post-infection ferret and immunized pony sera. Similar results were obtained with sera from both species for the A/equine-1 viruses and these confirmed minor antigenic differences between the prototype A/Prague 1/56 virus and viruses isolated in England in 1973 and 1977. Considerable antigenic differences were found between five of the A/equine-2 viruses, using ferret sera, but these differences were less evident using pony sera. The response of ponies to th...
Acland HM, Allen PZ, Kenney RM.Twenty-three of 24 mares were infected experimentally with contagious equine metritis organisms by intrauterine inoculation, and killed 2-116 days later. From mares killed within 14 days after infection the organism could be recovered from many sites in the uterus, and most sites in the cervix, a few sites in the vagina and oviduct and from one clitoral sinus. At this time the endometrial folds were swollen and there were 10-20 ml of fluid in the uterus. In mares killed after 14 days, the organism was recovered from the ovarian surface (1 mare), oviduct (4 mares), uterus (2 mares) and the clit...
Dixon JB, Jenkins P, Allan D.Culture of murine lymph node cells together with living protoscolices of Echinococcus granulosus is described. The presence of the parasite induced potent blastic transformation in lymphocytes of unimmunized mice as indicated by tritiated thymidine incorporation. The response was markedly reduced by killing the parasite immediately prior to culture. No blastogenic activity was detectable in supernatants from living parasites cultured alone. Protoscolices from artificially infected syngeneic mice were effective stimuli, as were protoscolices from naturally infected horse and sheep. Stimulation ...
Baskerville A.Related to its potential vulnerability the respiratory tract has a very complex and effective defence apparatus. The interaction between these defence mechanisms and certain characteristics of aetiological agents results in a pattern in which initial infections by these agents tend to occur at specific sites in the tract. Infections in which the primary portal of entry is in the upper respiratory tract include Bordetella bronchiseptica and Haemophilus spp in pigs; Pasteurella spp in cattle, sheep, pigs; Mycoplasma spp in cattle, sheep, pigs and poultry; equine herpesvirus 1 in horses; infectio...
Hagler WM, Behlow RF.An outbreak of salivary syndrome in horses in North Carolina was investigated. Rhizoctonia leguminicola was the predominant fungus isolated from toxic red clover hay. The fungus was less prevalent in the hay after 10 months of storage, and the hay had also decreased in biological activity after 10 months. Toxic hay caused extreme salivation, piloerection, respiratory distress, and increased frequency of defecation when fed to guinea pigs, and purified extracts of toxic hay and pure slaframine elicited these same responses when injected intraperitoneally into guinea pigs. The freshly acquired h...
Schein E, Rehbein G, Voigt WP, Zweygarth E.The vertebrate development of Babesia equi from infected Hyalomma marginatum in Morocco was investigated in vitro and in vivo. It was demonstrated that the sporozoites of B. equi initiate a phase of exo-erythrocytic schizogony in lymphocytes both in vitro and in vivo. On the other hand, sporozoites did not invade erythrocytes in vitro. The complete vertebrate life cycle of B. equi was simulated in vitro, from the invasion of lymphocytes by sporozoites, to the development of macro- and microschizonts, the invasion of erythrocytes by merozoites, and the subsequent intra-erythrocytic schizogony. ...
Sentsui H, Kono Y.The serologic relationships between 6 strains of equine infectious anemia (EIA) viruses were investigated by hemagglutination-inhibition (HI) tests. Cross HI tests, using sera from horses in the early stage of infection, revealed that all strains were inhibited only by homologous strain antisera and that HI antibody was always detectable before virus-neutralizing antibody. In the later stages of infection, both homologous and heterologous HI antibodies were detected in a sera of most of the horses, and the order of appearance of heterologous HI antibodies was random in 2 horses inoculated with...
Svalastoga E.Microangiographical investigations of the navicular bone in horses with navicular disease show, compared to similar investigations of normal navicular bones, that, in general, the vascular pattern is preserved but the vessels are dilated with "pooling" of the contrast medium subchondrally under facies flexoria. Similar changes may be observed in cases of human arthrosis. The present investigation therefore supports the view that navicular disease is a disease which resembles arthrosis.
Iqbal J, Purewal AS, Edington N.The aim of this study was to investigate the role of immediate early gene (gene63) in the pathogenesis of equine herpesvirus 1 (EHV-1) acute and latent infections in equine and murine models. EHV-1 gene63 mutant virus (g63mut) along with EHV-1 (Ab4) was used for intracerebral and intranasal infection of 3 and 17-day-old mice. Both viruses were recovered at the same frequency from tissues after infection. Two Welsh ponies were infected via the intranasal route with each of the viruses. Acute infection was monitored by virus isolation from nasal swabs and peripheral blood leukocytes. Six weeks p...
Don-van't Slot HP, van der Kolk JH.Severe-Combined-Immunodeficiency-Disease (SCID) is discussed with special reference to its pathogenesis, clinical symptoms, pathology, and diagnosis. The disorder has been observed in the USA, Canada, Great Britain, and Australia and is characterized by an autosomal recessive mode of inheritance. The clinical features of the disease seen in Arab foals under 46 days of age are intermittent fever, (adenoviral) pneumonia, and weight loss sometimes associated with diarrhoea. From 1998 on, the SCID gene can be detected in the Netherlands by means of DNA analysis.
Rosser EJ.Although there are numerous dermatoses in the horse in which the formation of crusts occurs, there are two relatively common and important infectious crusting dermatoses, namely, dermatophytosis and dermatophilosis. This article reviews the current concepts regarding the etiology and pathogenesis of each disease, as well as the more common clinical presentations, methods of diagnosis, and treatment.
Allen AL.Postmortem radiography can be a valuable supplement to traditional necropsy. This article provides examples where postmortem radiographs have been useful in diagnosing and documenting lesions in animals, and have helped demonstrate important principles of the pathology and the pathogenesis of lesions identified at necropsy. This article also discusses additional circumstances where the application of postmortem radiography might be worthwhile.
Marr KA, Lees P, Page CP, Cunningham FM.The leukotrienes (LT) LTD4 and LTB4 have been shown to cause bronchoconstriction and neutrophil accumulation, respectively, in horse lungs. Such changes are characteristic of the equine allergic respiratory disease, chronic obstructive pulmonary disease (COPD). To further investigate the role of these putative mediators in the pathogenesis of equine COPD the effect of a 5-lipoxygenase inhibitor, fenleuton, on antigen-induced changes in horses with this condition has been examined. Six horses with COPD underwent a series of four antigen challenges, one month apart, with placebo pre-treatment on...
Szczerba-Turek A, Siemionek J, Wasowicz K, Szweda W, Raś A, Platt-Samoraj A.BPV-1 is now recognized as a main etiological agent of equine sarcoids. The etiopathogenesis of the equine sarcoids is equivocal and is not yet fully understood. The aim of the present study was to analyse a partial sequence of the L1 gene of BPV associated with equine sarcoids in Polish horses. After clinical diagnosis, 40 skin lesions obtained from 29 horses were collected. The amplicons of a fragment of BPV L1 DNA were detected using PCR with MY09/MY11 primers in 31 specimens. All of them were recognized as BPV-1. Phylogenetic analysis has allowed the amplicons of partial L1 gene to be divi...
Mair TS, Pearson GR.A 3 1/2-year-old bay gelding of the cob type showed nervous signs and coughing associated with breaking-in and exercise. At post-mortem examination, heavy melanin pigmentation of the meninges of the hind brain and the medulla was identified and, on histological examination, melanin-containing cells were found within connective tissue extending into the medulla. The lesion was considered to be a melanotic hamartoma.
Holbrook TC, Gilliam LL, Stein FP, Morgan SE, Avery AL, Confer AW, Panciera RJ.Caley Pea (Lathyrus hirsutus) is potentially toxic to horses, but large case series are not reported. Objective: To describe the clinical signs of horses intoxicated with Lathyrus hirsutus and speculate on the neuroanatomical lesion localization and pathogenesis based upon the observed clinical signs. Methods: Twenty-two of 25 horses ranging in age from 6 to 34 months were affected. Five affected horses were presented to the OSUCHVS for evaluation and treatment after having been attended at the ranch by a local veterinarian (ALA). An additional horse that had been euthanized was also presented...
Karamendin K, Abishov A, Kydyrmanov A, Akhmetzhanova M.In 2011, there was an outbreak of a disease with mass abortions among horses in southeastern Kazakhstan. The AK-2011 strain was isolated from an aborted fetus and subsequently identified as equid alphaherpesvirus 1. Here, we describe the nearly complete genome sequence of the AK-2011 strain, attenuated for vaccine development.
Malekinejad H, Alizadeh-Tabrizi N, Ostadi A, Fink-Gremmels J.The pathogenesis of equine grass sickness (EGS) has not fully understood. A better understanding of the exact pathogenesis of diseases can help to make an accurate diagnosis. Previous studies reported some pathological damage of neuronal cells in EGS patients. In this study, primarily cytotoxicity of serum from three clinically EGS-diagnosed horses on PC12 Tet-off (PTO) cells was assessed. Subsequently, the apoptotic tests including cytochrome C release, caspase-3/7 activity measurement and DNA fragmentation assay were conducted to clarify the apoptotic effect of serum from EGS patients. Addit...
Bergman HJ, de Kruif A, van Dessel S.A review is given of treatment for 'problem' mares that do not become pregnant. To determine the best therapy, it is necessary to understand the defence mechanisms of the uterus and the pathogenesis of not getting in foal. A thorough clinical examination is absolutely necessary to come to a correct diagnosis. This examination will be explained in a practical way. In the second article the different therapies for treating problem mares are discussed. The therapeutic possibilities vary widely. They can be classified in: anatomical corrections, anti-infectious therapy, and treatment to enhance th...
Musselman EE, LoGuidice RJ.A necropsy diagnosis of hypoplastic left ventricular syndrome was made in a day-old foal. The cardiac abnormalities included mitral and aortic valve atresia, patent ductus arteriosus, and a secundum atrial septal defect. The left ventricle was hypoplastic and nonfunctional. The brief survival of the foal was a consequence of left-to-right shunting through the atrial septal defect and right-to-left shunting through the patent ductus. The information is presented to demonstrate the existence of the syndrome as a congenital defect in the horse and to clarify the necropsy findings for the practiti...
Frank N, Sojka JE, Latour MA.To evaluate selected concentrations of blood lipids and lipase activities in euthyroid and hypothyroid horses deprived of feed for 96 hours. Methods: 4 healthy adult mares and 4 thyroidectomized adult mares. Methods: Horses were deprived of feed for 96 hours. Blood samples were collected at 24-hour intervals and analyzed to determine concentrations of non-esterified fatty acid (NEFA), triglyceride (TG), total cholesterol (TC), and very-low-density lipoprotein (VLDL) as well as composition of VLDL. Plasma lipase activities were measured after feed was withheld for 96 hours and 12 days after res...
Götz HJ.A case of diprosopus in a foal is described. This is only the second report of such a deformity in the equine species. Hereditary pathology and pathogenesis are discussed.
Marsella R.Autoimmune dermatopathies are not common in horses. These autoimmune diseases can be idiopathic or triggered by an antigen such as drugs, vaccines, or neoplasia. The most common one is pemphigus foliaceus, which manifests as a pustular, crusting eruption. Other more common pustular diseases should be ruled out before considering pemphigus. Vasculitis is relatively common in horses and can be triggered by a variety of antigenic stimulations. Systemic lupus and true idiopathic autoimmune vasculitis are very rare in horses. Every effort should be made to reach a final diagnosis, as the prognosis ...
Marsella R.Allergy to insects is the most common skin allergy in horses. Pruritus in affected patients can be extreme. Face, ears, mane, and tail area are commonly affected areas. Diagnosis of insect bite hypersensitivity (IBH) is clinical and is based on history, clinical signs, and response to repellents. Allergy tests are not to be used for diagnostic purposes. Currently, there is no specific treatment for IBH other than insect avoidance, treatment of secondary infections, and symptomatic relief of pruritus. Many allergic horses become also sensitized to pollens. For these patients, allergen specific ...
Johns I.This article discusses the reported paraneoplastic syndromes (PNSs) in horses, including the possible pathogenesis, diagnostic methods, and any treatment options. The more commonly reported PNSs in horses include cancer anorexia and cachexia, fever and increased acute phase protein concentrations, and hypercalcemia and monoclonal gammopathy. As these conditions can often be more commonly diagnosed in non-neoplastic conditions, the diagnosis of a PNS and the accompanying neoplasia can be challenging. As signs of a PNS may precede signs of the underlying neoplasia, it is important that the clini...
Hollis AR.Squamous cell carcinomas are a very common tumor type in horses, and are found in a variety of dermatologic and non-dermatologic locations. Metastasis is common, even at the first presentation of the disease, and a full staging workup is therefore strongly recommended to direct treatment and assist with prognostication. Wide surgical excision remains the treatment of choice in most cases, but recurrence is common, and adjunctive therapy may be indicated to improve the long-term prognosis.
Campos AS, Franco AC, Godinho FM, Huff R, Candido DS, da Cruz Cardoso J, Hua X, Claro IM, Morais P, Franceschina C, de Lima Bermann T, Dos Santos FM....Western equine encephalitis virus (WEEV) is a mosquitoborne virus that reemerged in December 2023 in Argentina and Uruguay, causing a major outbreak. We investigated the outbreak using epidemiologic, entomological, and genomic analyses, focusing on WEEV circulation near the Argentina‒Uruguay border in Rio Grande do Sul state, Brazil. During November 2023‒April 2024, the outbreak in Argentina and Uruguay resulted in 217 human cases, 12 of which were fatal, and 2,548 equine cases. We determined cases on the basis of laboratory and clinical epidemiologic criteria. We characterized 3 fatal equ...
Hain-Saunders N, Knight DR, Bruce M, Riley TV.Recent increases in community-associated Clostridioides difficile infections have highlighted the importance of monitoring toxigenic C. difficile from animal and environmental sources. We provide the complete circularized genomes of two toxigenic C. difficile strains isolated from feral horse faeces. Genome N64 (sequence type 964) consists of a single chromosome of 4,078,791 bp, while genome H251 (sequence type 963) comprises one chromosome (4,304,722 bp) and three plasmids (150,942 bp, 11,534 bp, and 9,074 bp).
François AC, Renaud B, Kruse CJ, Marcillaud-Pitel C, Votion DM.Anne-Christine François, Benoît Renaud, Caroline-Julia Kruse, Christel Marcillaud-Pitel and Dominique-Marie Votion of the Atypical Myopathy Alert Group discuss insights from 20 years of research and surveillance on equine atypical myopathy.
Finno CJ.In the field of equine muscle disorders, many conditions have a genetic basis. Therefore, genetic testing is an important part of the diagnostic evaluation. Validated genetic tests are currently available for 5 equine muscle disorders: hyperkalemic periodic paralysis, malignant hyperthermia, glycogen branching enzyme disease, type 1 polysaccharide storage myopathy, and myosin heavy chain myopathy. These diseases should be tested for in the appropriate breeds with clinical signs of disease or as part of breeding management. Genetic testing in veterinary medicine is not regulated, and therefore,...
Rossdale PD, Jeffcott LB, Leadon DP.The development and design of a project in collaborative research which originated from a problem identified in practice, namely prematurity in the newly born foal, is described here. The project established a model of equine prematurity for the purpose of studying the diagnosis, pathogenesis and treatment of the condition. It involved practitioners and full time research workers in a number of veterinary and medical institutes.
Klymiuk MC, Speer J, Marco I, Elashry MI, Heimann M, Wenisch S, Arnhold S.Osteoarthritis (OA) is a common and incurable disease in humans and animals. To gain a better understanding of the pathogenesis and identify potential treatments, miRNAs will be extracted and analysed from extracellular vesicles (EVs) of equine adipose derived mesenchymal stem cells (AdMSCs). Methods: For this purpose we cultivated and pretreated AdMSCs under different conditions: interleukin 1β, shock wave, chondrogenic differentiation, chondrogenic differentiation under hypoxia, or after senescence. After treatment, EVs were harvested from the cell culture supernatants. Next-generation sequ...
MacNeill AL, Micheloud JF, Parvin R, Gjessing M, Airas NA, Sant'Ana FJF, Adamek M.Zoonotic poxviruses, including monkeypox virus (MPV), the causative agent for Mpox disease, have gained significant media and scientific attention due to recent outbreaks in human populations across the globe. The increase in human cases of poxvirus infection is not unexpected, as routine vaccination against smallpox (a disease caused by the poxvirus variola virus, which cross protects against other orthopoxviruses) was discontinued in the 1980s after its eradication. Large numbers of vertebrate and invertebrate species are susceptible to infection by . Clinical signs and histologic lesions ca...
Mrzdovnik N, Babič J, Lužnik D, Žigon D, Mrzdovnik M, Tavčar-Kalcher G, Tomič V, Prescott JF, Vengust M.Several bacteria associated with chronic lung pathology use quorum sensing (QS) signaling molecules to regulate their virulence in pure cultures and poly-microbial communities. Their excessive growth and biofilm formation in the respiratory tract increase the morbidity and mortality of inflammatory airway diseases in humans, such as chronic obstructive pulmonary disease (COPD), asthma and cystic fibrosis (CF). In horses, severe equine asthma (SEA) has many parallels to these human diseases. We hypothesized that QS molecules associated with the most common biofilm-forming lung pathogens in huma...
Cserhalmi D, Wermer K.Our paper presents a case study of a Welsh pony mare with grazing-induced severe urticaria. The main clinical signs were eye swelling, depression and extensive urticaria. Physical examination revealed no other abnormalities. Botanical sampling revealed horseweed (Conyza canadensis) as the most abundant species and a potential allergen plant due to sesquiterpene lactones (SQL). Differential diagnosis strongly suggested that the clinical signs were the result of a hypersensitivity reaction to this plant. Former studies brought controversial data about the toxic or allergic potential of horsewee...
Slavik K, Whitlock R, Johnson A.Botulism is a severe and often fatal disease in equine patients worldwide. Clostridium botulinum is a ubiquitous soil organism which produces a potent neurotoxin resulting in neuromuscular blockade and flaccid paralysis in affected animals. Definitive diagnosis is often impractical or impossible, leading to diagnosis and treatment based on clinical experience and presenting signs. Delay in case identification and treatment results in rapid deterioration of the patient. Treatment of recumbent equine botulism cases presents challenges due to patient size and requires intensive nursing care. This...
Thornton JJ, Roberts JF, AuCoin DP, Tuanyok A.We report a presumptive case of melioidosis caused by an atypical Burkholderia pseudomallei serotype in an American quarter horse in north-central Florida, USA, through archived formalin-fixed paraffin-embedded specimens dating back to 2006. This case underscores the potential pathologic impact of emergent B. pseudomallei in the Gulf region of the United States.
