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Clostridium piliforme infection (Tyzzer disease) in horses: retrospective study of 25 cases and literature review.

Abstract: Tyzzer disease (TD) is caused by Clostridium piliforme, a gram-negative and obligate intracellular bacterium. The disease occurs in multiple species. A triad of lesions, namely colitis, hepatitis, and myocarditis, is described in cases of TD in some species, such as rats and mice. We carried out a retrospective analysis of 25 equine cases with a diagnosis of TD; 24 of 25 cases occurred in foals <45 d old; the remaining foal was 90 d old. There were 12 males and 12 females; no sex information was available for one foal. The affected breeds were Quarter Horse, Thoroughbred, Arabian, Paint, and Hanoverian. Most of the cases (19 of 25) occurred in the spring. There were 9 cases of sudden death; the remaining animals had diarrhea, fever, distended abdomen, depression, weakness, non-responsiveness, and/or recumbency. Gross findings included icterus, hepatomegaly with acinar pattern, serosal hemorrhages, pulmonary edema, and/or fluid content in small and large intestine. Microscopically, all foals had severe, multifocal, necrotizing hepatitis. Necrotizing lymphohistiocytic colitis was observed in 10 of 25 foals, and multifocal necrotizing myocarditis was found in 8 of 25. Gram-negative, Steiner-positive, intracytoplasmic filamentous bacteria were observed in hepatocytes, enterocytes, and myocardiocytes, respectively. PCR detected C. piliforme DNA in the liver (24 of 24), colon (20 of 24), and heart (5 of 25). Our results indicate that necrotic hepatitis is the hallmark of TD in horses; the so-called triad of lesions is not a consistent characteristic of the disease in this species.
Publication Date: 2021-07-08 PubMed ID: 34238069PubMed Central: PMC9254052DOI: 10.1177/10406387211031213Google Scholar: Lookup
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Summary

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This research article discusses a study on Tyzzer disease (TD) in horses, specifically examining 25 cases of the condition. The researchers found necrotizing hepatitis to be a common symptom, while the customary triad of symptoms, colitis, hepatitis, and myocarditis, was not consistently observed in horses.

Background

  • The study examined Tyzzer disease (TD), an illness caused by Clostridium piliforme, a type of gram-negative, obligate intracellular bacterium. This disease occurs in various species, and is typically characterized by a combination of three symptoms: colitis, hepatitis, and myocarditis. These symptoms, however, do not occur consistently across all species.

Methods and Findings

  • In this particular retrospective study, the researchers investigated 25 cases of TD in horses, 24 of which occurred in foals less than 45 days old. The remaining case was in a 90-day-old foal.
  • The researchers observed cases in both male and female foals, affecting several breeds including the Quarter Horse, Thoroughbred, Arabian, Paint, and Hanoverian. No specific gender was recognized as more susceptible to the disease.
  • Most of the TD cases (19 out of 25) occurred during the spring season.
  • Symptoms presented varied across patients. Nine cases involved sudden death, while the remaining horses showed a variety of symptoms, such as diarrhea, fever, abdominal swelling, depression, weakness, unresponsiveness, and laying down excessively. Pathologic findings included jaundice, liver enlargement, blood vessels bleeding, lung edema, and excess fluid in the intestines.

Microscopic Analysis and PCR Detection

  • All foals were observed to have severe, multifocal, necrotizing hepatitis on a microscopic level.
  • 10 of the 25 foals showed signs of necrotizing lymphohistiocytic colitis, and 8 out of 25 foals had multifocal necrotizing myocarditis.
  • The researchers identified gram-negative, Steiner-positive, intracytoplasmic filamentous bacteria in the foals’ hepatocytes, enterocytes, and myocardiocytes, indicating C. piliforme infection.
  • PCR analysis identified C. piliforme DNA in various tissues, predominantly in the liver and less commonly in the colon and heart.

Conclusion

  • Based on their findings, the researchers concluded that necrotic hepatitis is the consistent symptomatic hallmark of TD in horses. Meanwhile, the so-called triad of lesions (colitis, hepatitis, and myocarditis) historically associated with TD is not a consistent characteristic of the disease in equines.

Cite This Article

APA
García JA, Navarro MA, Fresneda K, Uzal FA. (2021). Clostridium piliforme infection (Tyzzer disease) in horses: retrospective study of 25 cases and literature review. J Vet Diagn Invest, 34(3), 421-428. https://doi.org/10.1177/10406387211031213

Publication

ISSN: 1943-4936
NlmUniqueID: 9011490
Country: United States
Language: English
Volume: 34
Issue: 3
Pages: 421-428

Researcher Affiliations

García, Juan A
  • Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
Navarro, Mauricio A
  • California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California-Davis, San Bernardino, CA, USA.
  • Instituto de Patología Animal, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Chile.
Fresneda, Karina
  • California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California-Davis, San Bernardino, CA, USA.
Uzal, Francisco A
  • California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California-Davis, San Bernardino, CA, USA.

MeSH Terms

  • Animals
  • Clostridiales
  • Clostridium / genetics
  • Clostridium Infections / microbiology
  • Clostridium Infections / veterinary
  • Colitis / veterinary
  • Female
  • Horse Diseases / diagnosis
  • Horses
  • Male
  • Mice
  • Myocarditis / veterinary
  • Rats
  • Retrospective Studies

Conflict of Interest Statement

Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to theresearch, authorship, and/or publication of this article.

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