A nodular granulomatous posthitis caused by Halicephalobus sp. in a horse.
Abstract: This report describes a case of nodular posthitis caused by Halicephalobus gingivalis in a 24-year-old warmblood horse. Macroscopic examination revealed a multinodular, partially ulcerated mass on the external lamina of the prepuce. Nematode migration from unfixed biopsy material in phosphate-buffered saline revealed adult nematodes with the typical morphological features of H. gingivalis: distinctive rhabditiform oesophagus with corpus, isthmus and bulb and the dorsoflexed ovary. The main histopathological features consisted of submucosal confluent granulomatous foci containing cross- and tangential sections of larval and adult nematodes surrounded by cellular debris, epitheloid macrophages, multinucleated giant cells, lymphocytes and plasma cells. Therapy including oral administration of moxidectin and local application of an ointment containing prednisolone and moxidectin was initiated but clinical response was poor. Five months later, the nodular mass was still present and histologically, the same lesions with numerous intact nematodes were identified. In the present case, a localized infection with granuloma formation in the area of the prepuce was observed. Clinically, it cannot be distinguished from other nematode infections or even from a squamous cell carcinoma. An accurate clinical examination followed by histopathological and parasitological examinations was necessary to establish the final diagnosis. This case is unusual in that the lesions were locally very extensive (10 cm), but they remained confined to the preputium and the nematodes did not spread haematogenously to other internal organs.
Publication Date: 2008-01-08 PubMed ID: 18177292DOI: 10.1111/j.1365-3164.2007.00643.xGoogle Scholar: Lookup
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Summary
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This research article describes a case of nodular posthitis in a horse, caused by Halicephalobus gingivalis, a type of nematode worm. The presented therapy showed poor results, as the nodular mass persisted after five months.
Research Background and Objectives
- The study was instigated by an unusual case; a 24-year-old warmblood horse presenting a multinodular, partially ulcerated mass in the lamina of its prepuce (the protective fold of skin covering the horse’s penis).
- The objective was to determine the cause of this condition and evaluate its treatment efficacy.
Methods and Findings
- Initial macroscopic examination of the mass revealed adult nematodes with distinctive rhabditiform oesophagus and dorsoflexed ovary common to Halicephalobus gingivalis.
- Further histopathological analysis revealed submucosal confluent granulomatous foci containing sections of larval and adult nematodes.
- The nematodes were surrounded by cellular debris, macrophages, giant cells, lymphocytes, and plasma cells, indicating an immune response.
- After identifying the pathogen, therapy was initiated, including oral administration of moxidectin (an antiparasitic medication) and a topical ointment containing prednisolone and moxidectin.
- Despite treatment, no significant improvement was observed. Five months later, the nodular mass was still present, with intact nematodes.
Conclusions and Implications
- The study documented a localized infection of Halicephalobus gingivalis in the horse’s prepuce, resulting in the formation of a granuloma.
- This infection could not be distinguished from other nematode infections or a squamous cell carcinoma, requiring detailed clinical, histopathological, and parasitological examinations for correct diagnosis.
- This case proved unusual as the infection was highly localized and the nematodes did not spread to any internal organs, unlike most nematode infections.
- The response to therapy was poor; thus, the study implies that the established treatment might not be effective against such localized infections by Halicephalobus gingivalis.
Cite This Article
APA
Muller S, Grzybowski M, Sager H, Bornand V, Brehm W.
(2008).
A nodular granulomatous posthitis caused by Halicephalobus sp. in a horse.
Vet Dermatol, 19(1), 44-48.
https://doi.org/10.1111/j.1365-3164.2007.00643.x Publication
Researcher Affiliations
- Institute for Animal Pathology, Vetsuisse - Faculty, University of Bern, Länggassstrasse 122, CH-3001 Bern, Switzerland.
MeSH Terms
- Administration, Oral
- Animals
- Anthelmintics / administration & dosage
- Anthelmintics / therapeutic use
- Diagnosis, Differential
- Granuloma / diagnosis
- Granuloma / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / drug therapy
- Horse Diseases / parasitology
- Horses
- Macrolides / administration & dosage
- Macrolides / therapeutic use
- Male
- Rhabditida / isolation & purification
- Rhabditida Infections / diagnosis
- Rhabditida Infections / veterinary
- Skin Diseases, Parasitic / diagnosis
- Skin Diseases, Parasitic / veterinary
Citations
This article has been cited 9 times.- Noiva R, Ruivo P, de Carvalho LM, Fonseca C, Fevereiro M, Carvalho P, Orge L, Monteiro M, Peleteiro MC. First description of a fatal equine infection with Halicephalobus gingivalis in Portugal. Relevance for public health. Vet Med Sci 2019 May;5(2):222-229.
- Onyiche TE, Okute TO, Oseni OS, Okoro DO, Biu AA, Mbaya AW. Parasitic and zoonotic meningoencephalitis in humans and equids: Current knowledge and the role of Halicephalobus gingivalis. Parasite Epidemiol Control 2018 Feb;3(1):36-42.
- Pintore MD, Cerutti F, D'Angelo A, Corona C, Gazzuola P, Masoero L, Colombo C, Bona R, Cantile C, Peletto S, Casalone C, Iulini B. Isolation and molecular characterisation of Halicephalobus gingivalis in the brain of a horse in Piedmont, Italy. Parasit Vectors 2017 Mar 7;10(1):135.
- Taulescu MA, Ionicã AM, Diugan E, Pavaloiu A, Cora R, Amorim I, Catoi C, Roccabianca P. First report of fatal systemic Halicephalobus gingivalis infection in two Lipizzaner horses from Romania: clinical, pathological, and molecular characterization. Parasitol Res 2016 Mar;115(3):1097-103.
- Lim CK, Crawford A, Moore CV, Gasser RB, Nelson R, Koehler AV, Bradbury RS, Speare R, Dhatrak D, Weldhagen GF. First human case of fatal Halicephalobus gingivalis meningoencephalitis in Australia. J Clin Microbiol 2015 May;53(5):1768-74.
- Henneke C, Jespersen A, Jacobsen S, Nielsen MK, McEvoy F, Jensen HE. The distribution pattern of Halicephalobus gingivalis in a horse is suggestive of a haematogenous spread of the nematode. Acta Vet Scand 2014 Sep 19;56(1):56.
- Jung JY, Lee KH, Rhyoo MY, Byun JW, Bae YC, Choi E, Kim C, Jean YH, Lee MH, Yoon SS. Meningoencephalitis caused by Halicephalobus gingivalis in a thoroughbred gelding. J Vet Med Sci 2014 Mar 1;76(2):281-4.
- Springer A, Krüger C, Strube C, Steinhauer D. Worms and reproductive failure: First evidence of transplacental Halicephalobus transmission leading to repeated equine abortion. Curr Res Parasitol Vector Borne Dis 2025;8:100309.
- Sousa TM, Toma HS, Lima AP, Junior ACCL, Nunes MM, Silva APCD, Wouters D, Albuquerque AS, Varaschin MS, Raymundo DL, Toma CDM, Batista FA. Pathological fracture induced by Halicephalobus gingivalis (Nematoda: Rhabditida) in a horse limb. Parasites Hosts Dis 2024 Feb;62(1):131-138.
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