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Equine veterinary journal2020; 53(4); 718-726; doi: 10.1111/evj.13355

Acute interstitial pneumonia in foals: A severe, multifactorial syndrome with lung tissue recovery in surviving foals.

Abstract: Acute interstitial pneumonia in foals has been sparsely described in literature, and the individual authors disagree on the underlying aetiology. Histopathological follow-up from surviving foals is not available. Objective: Description of clinical and histopathological findings in the course of acute interstitial pneumonia and in recovery. Investigating the aetiology and possible triggering factors of acute interstitial pneumonia. Methods: Case series. Methods: Post-mortem examination of nine affected foals; seven died during the acute phase, and two had recovered from acute interstitial pneumonia. Data from clinical examinations on the day of death were recorded for all foals. Complete necropsy, special histological staining, virological and microbiological examinations were performed. Results: Seven foals died during the acute phase with severe respiratory distress, fever and increased numbers of comet tail artefacts in lung ultrasound. In post-mortem examination, a wide variety of possible triggering factors was identified. Microbiology revealed Escherichia coli, Rhodococcus equi and Klebsiella pneumoniae as the most common bacterial pathogens. Equine herpesvirus 2 was detected in all foals by PCR. Those with high viral loads also displayed histopathological changes suggestive of viral infections. Pneumocystis carinii was detected in all acutely affected foals. Histopathological changes in lung parenchyma clearly differed between the foals that had recovered from acute interstitial pneumonia and those dying in the acute phase. While lungs in acute phase featured marked parenchymal collapse and necrosis, the recovered foals revealed nearly normal ventilated lung parenchyma and alveolar structure. Conclusions: Small number of cases. Because all foals are from the same breeding farm with endemic occurrence of pathogens, it is not certain whether the results of this study can be transferred to other foals without restrictions. Conclusions: Acute interstitial pneumonia seems to be based on a multifactorial aetiology. Lungs from foals that have survived acute interstitial pneumonia appear to be able to regenerate completely, leaving no permanent changes.
Publication Date: 2020-10-27 PubMed ID: 32986272DOI: 10.1111/evj.13355Google Scholar: Lookup
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  • Journal Article

Summary

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This research investigates the causes and potential recovery factors of acute interstitial pneumonia (AIP) in foals, a disease not extensively described in scientific literature. Post-mortem examinations were performed on nine foals affected by AIP, revealing numerous potential triggers such as various bacterial pathogens, and findings suggested that foals surviving AIP may experience full lung tissue recovery.

Objective and Methodology

  • The aim of this study was to detail the clinical and histopathological (cellular-level) findings related to the progression and recovery from AIP in foals, as well as to investigate its causes and potential triggers.
  • To achieve this, the researchers conducted a case series analysis on nine foals affected by AIP. Seven of these foals passed away during the acute stage of the pneumonia, while the remaining two had successfully recovered.
  • All foals were subjected to full necropsies, special histological staining, and virological and microbiological examinations, with data from their clinical examinations recorded as well.

Results

  • Of the nine foals, seven succumbed during the acute phase, displaying severe respiratory distress, fever and abundance of comet tail artefacts (a specific ultrasound pattern linked to lung disease) in lung ultrasound tests.
  • On post-mortem examination, they were found to have been exposed to a number of potential disease triggers. Microbiological analysis revealed the presence of several common bacterial pathogens, such as Escherichia coli, Rhodococcus equi, and Klebsiella pneumoniae.
  • In addition, every foal tested positive for Equine herpesvirus 2, with those displaying high viral loads also exhibiting histopathological changes in keeping with viral infections.
  • All acutely affected foals also tested positive for Pneumocystis carinii, a type of fungus you can find in the lungs.
  • Relevantly, cellular-level changes in lung tissue varied greatly between foals that had survived AIP and those that died during the acute phase. Specifically, while lung parenchyma (functional lung tissue) in the acute stage showed notable collapse and necrosis (cell death), recovered foals presented nearly normal lung parenchyma and alveolar (lung air sac) structure.

Conclusion

  • This study was conducted on a small number of foals from the same breeding farm with endemic occurrence of these pathogens, which means the conclusions might not be universally applicable to foals from different or varying environments.
  • Nevertheless, the study deduces that AIP in foals seems to have multifactorial origins.
  • Furthermore, it suggests that the lungs of foals which successfully overcome AIP may be able to fully regenerate, leaving no permanent structural changes in the lungs.

Cite This Article

APA
Punsmann S, Hoppe J, Klopfleisch R, Venner M. (2020). Acute interstitial pneumonia in foals: A severe, multifactorial syndrome with lung tissue recovery in surviving foals. Equine Vet J, 53(4), 718-726. https://doi.org/10.1111/evj.13355

Publication

ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 4
Pages: 718-726

Researcher Affiliations

Punsmann, Sophia
  • Equine Clinic, School of Veterinary Medicine, Hanover, Germany.
Hoppe, Judith
  • Department of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.
Klopfleisch, Robert
  • Department of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.
Venner, Monica
  • Veterinary Clinic, Destedt, Germany.
  • Stiftung Tierärztliche Hochschule Hannover (TIHO).

MeSH Terms

  • Actinomycetales Infections / veterinary
  • Animals
  • Hamman-Rich Syndrome / veterinary
  • Horse Diseases
  • Horses
  • Lung
  • Rhodococcus equi

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Citations

This article has been cited 2 times.
  1. Weissenbacher-Lang C, Blasi B, Bauer P, Binanti D, Bittermann K, Ergin L, Högler C, Högler T, Klier M, Matt J, Nedorost N, Silvestri S, Stixenberger D, Ma L, Cissé OH, Kovacs JA, Desvars-Larrive A, Posautz A, Weissenböck H. Detection of Pneumocystis and Morphological Description of Fungal Distribution and Severity of Infection in Thirty-Six Mammal Species.. J Fungi (Basel) 2023 Feb 7;9(2).
    doi: 10.3390/jof9020220pubmed: 36836334google scholar: lookup
  2. Altan E, Hui A, Li Y, Pesavento P, Asín J, Crossley B, Deng X, Uzal FA, Delwart E. New Parvoviruses and Picornavirus in Tissues and Feces of Foals with Interstitial Pneumonia.. Viruses 2021 Aug 14;13(8).
    doi: 10.3390/v13081612pubmed: 34452477google scholar: lookup