[Air sac mycosis: topical treatment using enilconazole administered via indwelling catheter].

The research article deals with a situation in which a horse suffering from a chronic unilateral nasal discharge caused by Aspergillus fumigatus was effectively treated using enilconazole, administered through an indwelling through-the-nose-catheter.

Patient Description and Initial Treatment

• The study focused on a horse that showed symptoms of chronic unilateral nasal discharge, leading to the diagnosis of guttural pouch mycosis. This condition is caused by the Aspergillus fumigatus fungus.
• The initial step taken in the treatment process involved the surgical insertion of a percutaneous indwelling catheter into the left guttural pouch of the horse. This enables direct access to the site of infection.
• The first round of treatment utilized a povidone iodine solution, which was administered through the catheter. However, this approach did not yield satisfactory results and was deemed unsuitable for this case.

Implementation of Enilconazole Treatment

• In light of the failure of the povidone iodine treatment, a decision was made to use enilconazole, a potent antifungal medication. The drug was administered through an indwelling catheter that was inserted through the horse’s nose.
• Enilconazole was chosen due to its specific effectiveness against the Aspergillus fumigatus fungus. The drug works by preventing the fungus from producing an essential component of its cell membrane, thereby inhibiting growth and facilitating the death of the fungus.

Outcome of the Enilconazole Treatment

• Following the administration of enilconazole, the horse showed significant improvement. This is evidenced by the fact that the chronic nasal discharge, a key symptom of guttural pouch mycosis, had ceased entirely.
• The complete recovery of the horse following the use of enilconazole demonstrates that this treatment approach can be effective against mycosis caused by Aspergillus fumigatus, at least in this particular case.

Implications of the Study

• This study suggests that enilconazole, when administered directly to the site of infection through an indwelling catheter, can be a successful treatment method for guttural pouch mycosis in horses.
• By demonstrating the efficacy of this treatment approach, the study proposes a viable alternative for cases where the usual treatment, in this case povidone iodine, proves ineffective. However, it does not advocate for the use of enilconazole as a first-line treatment.
• It also underscores the importance of a flexible approach in dealing with fungal infections, given the variability in how these infections may respond to different antifungal agents.