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Clinical findings in 10 foals with bacterial meningoencephalitis.
Abstract: Bacterial meningoencephalitis is a severe complication in septic foals and there is scarce and often unclear information in the equine literature. Objective: To report the most frequent clinical signs, clinicopathological findings, causative agents, treatments given and outcome of a group of foals with confirmed bacterial meningoencephalitis. Methods: Foals aged < 6 months of age admitted to the Universitat Autonoma de Barcelona (2004-2009) with confirmed bacterial meningoencephalitis were retrospectively included in the study Diagnosis of bacterial meningoencephalitis was made by cerebrospinal fluid (CSF) culture, CSF analysis consistent with bacterial infection, observation of bacteria in CSF cytology or postmortem confirmation. Results: Nine neonates and one 5-month-old foal were included. The most frequently observed clinical signs were alterations in mental status (10/10), recumbency (8/10), weakness (8/10), abnormal pupillary light reflexes (6/10), decreased suckling-reflex (6/9), seizures and/or nystagmus (4/10). Common clinicopathological alterations included hyperfibrinogenaemia (8/9), hyperlactataemia (7/7), and neutropenia (5/10) or neutrophilia (5/10). Most neonates (8/9) developed bacterial meningoencephalitis despite having a sepsis score near the cut-off value (median = 12). On CSF analysis, pleocytosis (9/9), increased total protein concentration (5/6) and intracellular bacteria (6/9) were detected. The most frequently isolated bacterium was Escherichia coil. Once bacterial meningoencephalitis was diagnosed, antimicrobial therapy was switched to third and fourth generation cephalosporins. Conclusions: The diagnosis of bacterial meningoencephalitis is established based on CSF analysis and culture. Clinical recognition of bacterial meningoencephalitis is difficult and can be easily overlooked. Moreover, severe sepsis is not necessary to develop bacterial meningoencephalitis. Conclusions: CSF analysis should be considered more often in sick newborn foals with signs indicative of central nervous system (CNS) involvement. Cerebrospinal fluid (CSF) cytology and culture would help to confirm or rule out unnoticed bacterial meningoencephalitis, and to choose appropriate antimicrobial therapy
Publication Date: 2012-05-19 PubMed ID: 22594036DOI: 10.1111/j.2042-3306.2011.00508.xGoogle Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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This research investigated septic foals under 6 months who were diagnosed with bacterial meningoencephalitis to better understand the frequent symptoms, causative microbes, treatments applied, and outcomes, utilizing data from the Universitat Autonoma de Barcelona from 2004-2009. Even foals with a low sepsis score could develop this severe condition, and the most common signs were changes in mental state, recumbency, weakness, and abnormal pupillary light reflexes.
Research Methodology
- The research data was collected retrospectively from foals aged less than 6 months admitted to the Universitat Autonoma de Barcelona between 2004 and 2009 who were confirmed to have bacterial meningoencephalitis. Confirmation was done through cerebrospinal fluid (CSF) culture, CSF cytology, CSF analysis showing evidence of bacterial infection, or postmortem verification.
Clinical Findings
- The primary symptoms were altered mental status, recumbence (inability to stand), weakness, abnormal pupil reflexes, diminished suckling reflex, nystagmus (rapid, uncontrolled eye movement), and seizures.
- The common clinicopathological alterations, which were physiological changes related to the disease, were hyperfibrinogenaemia (a state of increased production of fibrinogen in the blood), hyperlactatemia (excess lactic acid in the blood), neutropenia (abnormally low count of a type of white blood cell), and neutrophilia (an abnormally high white blood cell count).
- Most foals developed bacterial meningoencephalitis despite having a sepsis score near the cut-off value, suggesting that severe sepsis, a systemic inflammatory response to infection, is not a necessary precursor to bacterial meningoencephalitis.
- On CSF analysis, pleocytosis (excessive accumulation of cells in the CSF), increased total protein concentration , and intracellular bacteria were detected.
Bacterial Agents and Treatment
- The bacteria most frequently isolated was Escherichia coli.
- Upon diagnosis of bacterial meningoencephalitis, therapy was switched to third and fourth-generation cephalosporins, a type of antibiotic.
Conclusion: Importance of CSF Analysis
- The study concluded that the diagnosis of bacterial meningoencephalitis is mainly established based on CSF analysis and culture.
- The findings suggest that severe sepsis isn’t a necessary condition to develop bacterial meningoencephalitis, highlighting the need for early suspicion and diagnosis of the condition in neonatal foals.
- The authors suggest that CSF analysis and culture should be frequently considered in assessing sick newborn foals showing signs that may indicate central nervous system involvement to either confirm or rule out bacterial meningoencephalitis and subsequently administer appropriate antimicrobial therapy.
Cite This Article
APA
Viu J, Monreal L, Jose-Cunilleras E, Cesarini C, Añor S, Armengou L.
(2012).
Clinical findings in 10 foals with bacterial meningoencephalitis.
Equine Vet J Suppl(41), 100-104.
https://doi.org/10.1111/j.2042-3306.2011.00508.x Publication
Researcher Affiliations
- Servei de Medicina Interna Equina, Facultat de Veterinaria, Universitat Aut6noma de Barcelona, Barcelona, Spain.
MeSH Terms
- Animals
- Animals, Newborn
- Anti-Bacterial Agents / therapeutic use
- Encephalitis / drug therapy
- Encephalitis / microbiology
- Encephalitis / pathology
- Encephalitis / veterinary
- Horse Diseases / drug therapy
- Horse Diseases / microbiology
- Horse Diseases / pathology
- Horses
- Meningitis, Bacterial / drug therapy
- Meningitis, Bacterial / pathology
- Meningitis, Bacterial / veterinary
Citations
This article has been cited 4 times.- Countrymann K, Ruby R, Miller AD. A retrospective study of 171 cases of equine meningoencephalomyelitis in the United States, 1996-2023. J Vet Diagn Invest 2026 Jan;38(1):100-111.
- Kabir A, Lamichhane B, Habib T, Adams A, El-Sheikh Ali H, Slovis NM, Troedsson MHT, Helmy YA. Antimicrobial Resistance in Equines: A Growing Threat to Horse Health and Beyond-A Comprehensive Review. Antibiotics (Basel) 2024 Jul 29;13(8).
- Fu DJ, Ramachandran A, Miller C. Streptococcus pluranimalium meningoencephalitis in a horse. J Vet Diagn Invest 2021 Sep;33(5):956-960.
- Taylor S. A review of equine sepsis. Equine Vet Educ 2015 Feb;27(2):99-109.
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