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Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc2017; 30(2); 294-299; doi: 10.1177/1040638717737125

Infectious necrotic hepatitis caused by Clostridium novyi type B in a horse: case report and review of the literature.

Abstract: A 14-y-old bay Quarter Horse gelding was presented with progressive neurologic signs, elevated rectal temperature, and icterus for 3 d prior to death. Postmortem examination revealed icterus, large amounts of serosanguineous fluid in the abdominal cavity, widespread petechiae and ecchymoses in several organs, and a large, pale, and well-demarcated focus of necrosis in the liver. Histologically, there was coagulative necrosis surrounded by a rim of inflammatory cells and large numbers of gram-positive rods, which were identified as Clostridium novyi by immunohistochemistry. Liver samples tested by PCR were positive for C. novyi type B flagellin and alpha toxin genes, but negative for Clostridium haemolyticum and other clostridia. Based on postmortem findings and ancillary tests, a definitive diagnosis of infectious necrotic hepatitis (INH) was made. Mostly a disease of ruminants, also known as black disease, INH has rarely been reported in horses, and a definitive etiologic diagnosis has not been achieved previously; the etiology of all cases reported to date was identified as C. novyi but the type was not determined. Animals are predisposed to clostridial hepatitis when hepatic anaerobiosis is established. Such conditions allow germination and proliferation of bacterial spores, resulting in production and release of toxins. INH, caused by C. novyi type B, and bacillary hemoglobinuria, caused by C. haemolyticum, are mechanistically and pathologically almost indistinguishable. Because these 2 microorganisms are closely related, differentiation requires molecular tools.
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Publication Date: 2017-12-10 PubMed ID: 29224513PubMed Central: PMC6505884DOI: 10.1177/1040638717737125Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research presents a case of a horse diagnosed with Infectious Necrotic Hepatitis, a disease majorly affecting ruminants, caused by Clostridium novyi type B, a bacterium classified largely on its molecular components. The cause of this embolic hepatic infection is identified by established microscopic and molecular assessment tools.

Case Presentation

The horse in the study:

  • Had been showing signs of neurological illness, increased body temperature, and jaundice for three days before it died.
  • The necropsy showed large volumes of blood-stained fluid in the abdomen, yellow pigmentation, and extensive areas of minor bleeding and bruising in several organs.
  • The liver, in particular, had a large, clearly defined necrotic (dead tissue) region.
  • This sort of tissue death, known as coagulative necrosis, was accompanied by an inflammation response and an abundance of gram-positive bacteria which were identified as Clostridium novyi.

Diagnosis

  • Immunohistochemistry – a diagnostic tool for identifying specific cells or antigens in tissues – identified the bacteria in the liver samples as Clostridium novyi.
  • The liver samples were also tested through a Polymerase Chain Reaction (PCR), a modern diagnostic tool used to replicate and identify specific DNA in a sample.
  • The PCR results showed the presence of a specific component (flagellin and alpha toxin genes) of Clostridium novyi type B, but no traces of Clostridium haemolyticum or other types of Clostridium.
  • Based on these findings, the researchers definitively diagnosed the horse as suffering from Infectious Necrotic Hepatitis (INH), a rare disease in horses mostly affecting ruminants.
  • The researchers also noted the importance of molecular diagnostic tools in differentiating between similar infectious agents. In this case, differentiating Clostridium novyi and Clostridium haemolyticum, which could cause almost similar infections and damage.

Disease Mechanism

  • The horses become prone to clostridial infection when the liver becomes anaerobic (without oxygen). This anaerobic state, owing to certain conditions, allows the activation and multiplication of bacterial spores, leading to the production and release of toxins.

Cite This Article

APA
Nyaoke AC, Navarro MA, Beingesser J, Uzal FA. (2017). Infectious necrotic hepatitis caused by Clostridium novyi type B in a horse: case report and review of the literature. J Vet Diagn Invest, 30(2), 294-299. https://doi.org/10.1177/1040638717737125

Publication

Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc
ISSN: 1943-4936
NlmUniqueID: 9011490
Country: United States
Language: English
Volume: 30
Issue: 2
Pages: 294-299

Researcher Affiliations

Nyaoke, Akinyi C
  • California Animal Health and Food Safety Laboratory System, School of Veterinary Medicine, University of California, Davis, San Bernardino, CA.
Navarro, Mauricio A
  • California Animal Health and Food Safety Laboratory System, School of Veterinary Medicine, University of California, Davis, San Bernardino, CA.
Beingesser, Juliann
  • California Animal Health and Food Safety Laboratory System, School of Veterinary Medicine, University of California, Davis, San Bernardino, CA.
Uzal, Francisco A
  • California Animal Health and Food Safety Laboratory System, School of Veterinary Medicine, University of California, Davis, San Bernardino, CA.

MeSH Terms

  • Animals
  • Clostridium / classification
  • Clostridium / genetics
  • Clostridium / isolation & purification
  • Clostridium Infections / diagnosis
  • Clostridium Infections / veterinary
  • Diagnosis, Differential
  • Hepatitis, Animal / blood
  • Hepatitis, Animal / diagnosis
  • Hepatitis, Animal / microbiology
  • Horse Diseases / blood
  • Horse Diseases / diagnosis
  • Horse Diseases / microbiology
  • Horses
  • Male
  • Necrosis / diagnosis
  • Necrosis / veterinary
  • Polymerase Chain Reaction / veterinary

Conflict of Interest Statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Citations

This article has been cited 14 times.
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