Meningitis After Tooth Extraction and Sinus Lavage in a Horse.
Abstract: A five-year-old Thoroughbred mare was evaluated because of chronic, malodorous, unilateral nasal discharge, and suspected maxillary cheek tooth root abscess. Skull radiographs revealed bilateral sinusitis suspected secondary to tooth root abscessation of 109 and 210. Following oral extraction of 109, bilateral conchofrontal sinus trephination and lavage; fever, tachycardia, and cervical stiffness developed. A lumbosacral cerebrospinal fluid tap was performed, and a presumptive diagnosis of bacterial meningitis was made. Targeted therapy consisted of antibiotic treatment with penicillin, enrofloxacin, and metronidazole, as well as antiinflammatory treatment with flunixin meglumine, dexamethasone, and dimethyl sulfoxide. Following the resolution of fever, tachycardia, and cervical stiffness, the second abscessed tooth, 210, was extracted. The mare was discharged receiving enrofloxacin. Twelve months later, the mare continued to do well with no residual signs of meningitis. Bacterial meningitis should be regarded as a life-threatening, although rare, the complication of dental or sinus surgery in horses. Early diagnosis and therapy may result in a successful outcome.
Published by Elsevier Inc.
Publication Date: 2020-11-16 PubMed ID: 33478768DOI: 10.1016/j.jevs.2020.103323Google Scholar: Lookup
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Summary
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The research article documents a case of a thoroughbred racehorse who developed meningitis after tooth extraction and sinus treatment. Effective treatments were used to manage the condition and the horse made a full recovery.
Objective of the Research
This study presents an uncommon case of bacterial meningitis in a horse after maxillary cheek tooth extraction and sinus surgery, detailing its prompt diagnosis and subsequent successful treatment.
Case Presentation
- A five-year-old Thoroughbred mare demonstrated chronic, foul-smelling, one-sided nasal discharge with a supposed cheek tooth root abscess. Radioimages of the skull indicated the horse had bilateral sinusitis due to abscessed tooth roots (109 and 210).
- After the 109 tooth was removed and a subsequent sinus cleansing procedure, the horse developed a high temperature (fever), rapid heart rate (tachycardia), and stiff neck.
- A lumbar puncture was performed to extract cerebrospinal fluid, leading to a provisional diagnosis of bacterial meningitis—a dangerous inflammation of the meningeal layers around the brain and spinal cord, usually due to bacterial infection.
Interventions and Outcome
- Targeted antibiotic therapy, involving penicillin, enrofloxacin, and metronidazole, was given. To control inflammation, flunixin meglumine, dexamethasone, and dimethyl sulfoxide were employed.
- Once the fever, rapid heartbeat, and neck rigidness subsided, the second abscessed tooth (210) was also extracted.
- The mare was released while still on the enrofloxacin treatment. One year later, the mare remained healthy with no leftover symptoms of meningitis.
Conclusion
The study concludes that while bacterial meningitis is a rare post-operative complication of dental or sinus surgeries in horses, it is potentially life-threatening. Therefore, early diagnosis and responsive treatment are crucial for beneficial outcomes. The successful treatment of the mare in this case study provides an example of effective management.
Cite This Article
APA
Zetterström S, Groover E, Lascola K, Cole R, Velloso A, Boone L.
(2020).
Meningitis After Tooth Extraction and Sinus Lavage in a Horse.
J Equine Vet Sci, 97, 103323.
https://doi.org/10.1016/j.jevs.2020.103323 Publication
Researcher Affiliations
- Department of Clinical Sciences, J. T. Vaughan Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL.
- Department of Clinical Sciences, J. T. Vaughan Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL.
- Department of Clinical Sciences, J. T. Vaughan Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL.
- Department of Clinical Sciences, J. T. Vaughan Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL.
- Department of Clinical Sciences, J. T. Vaughan Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL.
- Department of Clinical Sciences, J. T. Vaughan Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL. Electronic address: lhb0021@auburn.edu.
MeSH Terms
- Animals
- Female
- Horse Diseases / diagnosis
- Horses
- Sinusitis / veterinary
- Therapeutic Irrigation / veterinary
- Tooth
- Tooth Extraction / adverse effects
- Tooth Extraction / veterinary
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