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Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc2022; 34(3); 429-438; doi: 10.1177/10406387211065044

Phlegmonous gastritis in 2 yearling horses.

Abstract: Phlegmonous gastritis was diagnosed in 2 yearling fillies that were presented with a 1-wk history of fever, lethargy, and hypoproteinemia, associated with a previous diagnosis of equine proliferative enteropathy based on clinical signs and PCR assay detection of Lawsonia intracellularis in fecal samples. Abdominal ultrasound revealed enlargement of the stomach and expansion of its submucosal layer with hypoechoic fluid, as well as thickened hypomotile small intestinal segments. Given the poor prognosis and poor response to treatment, both horses were euthanized, one on the day of presentation and the other after 3 wk of intensive medical management including a combination of antimicrobials, analgesics, and intravenous colloids. At autopsy, acute mural gastritis characterized by severe submucosal edema with suppurative inflammation (i.e., phlegmonous gastritis) and necroulcerative enteritis compatible with the necrotizing form of equine proliferative enteropathy were identified in both horses. The gastric inflammation was associated with thrombosis and mixed bacterial populations, including Clostridium perfringens, that were confined to the submucosa without evidence of mucosal involvement; toxin genes compatible with C. perfringens type C were identified in one case. Human phlegmonous gastritis is an uncommon, often-fatal pyogenic infection that is often associated with mucosal injury, bacteremia, or immunocompromise. Our finding of this unusual gastric lesion in 2 horses with similar signalment, clinical disease, and spectrum of postmortem lesions suggests a similar etiopathogenesis that possibly involves local, regional, or distant hematogenous origin, and should be considered a potential complication of gastrointestinal mucosal compromise in horses.
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Publication Date: 2022-01-10 PubMed ID: 35000510PubMed Central: PMC9254054DOI: 10.1177/10406387211065044Google Scholar: Lookup
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Summary

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The study explores cases of Phlegmonous gastritis in two fillies which were previously diagnosed with equine proliferative enteropathy. Despite rigorous treatment, both horses were euthanized due to lack of progress. An autopsy revealed acute gastritis and necroulcerative enteritis. The researchers hypothesize a correlation between these occurrences and gastrointestinal mucosal compromise in horses.

Problem Area

  • The researchers studied two yearling fillies that manifested symptoms of poorly responsive to treatment, chronic lethargy, and hypoproteinemia.
  • Both horses had been previously diagnosed with equine proliferative enteropathy, a disease commonly affecting the intestinal lining in horses.

Conducted Research and Findings

  • The teams carried out abdominal ultrasonographic examinations which revealed stomach enlargement and expansion of its submucosal layer with hypoechoic fluid. Additionally, a thickening and reduced motion of the small intestines were observed.
  • Both filies were euthanized, due to poor prognosis and lack of improvement with treatment. One was put down on the day of presentation while the other survived three weeks of rigorous medical management including intense antimicrobials, analgesics, and intravenous colloids administration.
  • An autopsy was then conducted on the horses which revealed acute mural gastritis (severe submucosal edema with suppurative inflammation) – a condition referred to as Phlegmonous gastritis.
  • The autopsy also highlighted necroulcerative enteritis, a condition that aligns with the final stages of equine proliferative enteropathy.
  • The inflammation observed in the stomach was linked with thrombosis and mixed bacterial populations that were confined to the submucosa without mucosal involvement. This inflammation presented toxin genes aligned with a type C strain.

Implications and Conclusions

  • The occurrences of Phlegmonous gastritis, an uncommon and often fatal gastric lesion generally associated with mucosal injury, bacteremia, or immunocompromise in humans, in the two horses suggested the likelihood of a similar etiopathogenesis in horses.
  • The postmortem lesions and clinical manifestations in the horses, as well as the similarity in their age and breed, strengthen this theory.
  • The researchers concluded that this could also be viewed as a potential complication of gastrointestinal mucosal compromise in horses, and recommend further research into the disease’s prevalence in the equine population and possible treatment methods.

Cite This Article

APA
Engiles JB, Uzal FA, Navarro MA, Reef VB, Bender SJ. (2022). Phlegmonous gastritis in 2 yearling horses. J Vet Diagn Invest, 34(3), 429-438. https://doi.org/10.1177/10406387211065044

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: 34
Issue: 3
Pages: 429-438

Researcher Affiliations

Engiles, Julie B
  • Departments of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
  • Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
Uzal, Francisco A
  • California Animal Health and Food Safety Laboratory, San Bernardino Branch, University of California-Davis, Davis, CA, USA.
Navarro, Mauricio A
  • California Animal Health and Food Safety Laboratory, San Bernardino Branch, University of California-Davis, Davis, CA, USA.
  • Instituto de Patología Animal, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Chile.
Reef, Virginia B
  • Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
Bender, Susan J
  • Departments of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.

MeSH Terms

  • Abdomen / pathology
  • Acute Disease
  • Animals
  • Female
  • Gastritis / diagnosis
  • Gastritis / pathology
  • Gastritis / veterinary
  • Horse Diseases / pathology
  • Horses
  • Inflammation / veterinary
  • Intestinal Diseases / veterinary
  • Lawsonia Bacteria

Conflict of Interest Statement

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

References

This article includes 36 references
  1. Beveridge TJ. Mechanism of gram variability in select bacteria. J Bacteriol 1990;172:1609–1620.
    pmc: PMC208639pubmed: 1689718
  2. Bohlin AM. Lawsonia intracellularis associated equine proliferative enteropathy in Danish weanling foals. Acta Vet Scand 2019;61:12.
    pmc: PMC6407178pubmed: 30850006
  3. Bovee JW. Suppurative phlegmonous gastritis. Am J Med Sci 1908;135:662.
  4. Burn J. Emphysematous gastritis associated with Clostridium perfringens type A in a cat. Vet Rec Case Rep 2017;5:e000540.
  5. Dauvillier J. Diagnostic and epidemiological features of Lawsonia intracellularis enteropathy in 2 foals. Can Vet J 2006;47:689–691.
    pmc: PMC1482453pubmed: 16898113
  6. De Davide L, Beaudoin A. A case of phlegmonous gastritis in a patient with psoriatic arthritis on infliximab. Case Rep Gastrointest Med 2018;2018:3624627.
    pmc: PMC6114249pubmed: 30186641
  7. Delesalle C. Emphysematous gastritis associated with Clostridium septicum in a horse. J Vet Intern Med 2003;17:115–118.
    pubmed: 12564737
  8. Deprez P. Lawsonia intracellularis infection in a 12-month-old colt in Belgium. Vet Rec 2005;157:774–776.
    pubmed: 16339981
  9. Frazer ML. Lawsonia intracellularis infection in horses: 2005–2007. J Vet Intern Med 2008;22:1243–1248.
    pubmed: 18681919
  10. Grau-Roma L. Clostridium perfringens-associated necrotic enteritis-like disease in coconut lorikeets (Trichoglossus haematodus). Vet Pathol 2021;58:423–427.
    pubmed: 33208037
  11. Guarnieri E. Abomasitis in calves: a retrospective cohort study of 23 cases (2006–2016). J Vet Intern Med 2020;34:1018–1027.
    pmc: PMC7096666pubmed: 32056284
  12. Iqbal M. Successful antimicrobial treatment of phlegmonous gastritis: a case report and literature review. Case Rep Hematol 2018;2018:8274732.
    pmc: PMC6164362pubmed: 30305967
  13. Ishioka M. Phlegmonous gastritis: a report of three cases with clinical and imaging features. Intern Med 2018;57:2185–2188.
    pmc: PMC6120850pubmed: 29607969
  14. Jung JH. Emphysematous gastritis associated with invasive gastric mucormycosis: a case report. J Korean Med Sci 2007;22:923–927.
    pmc: PMC2693866pubmed: 17982248
  15. Kavalar R. Phlegmonous gastritis in a patient with rheumatoid arthritis. Wien Klin Wochenschr 2005;117:364–368.
    pubmed: 15989117
  16. Kim GY. Phlegmonous gastritis: case report and review. Gastrointest Endosc 2005;61:168–174.
    pubmed: 15672083
  17. Lawrence JS. Phlegmonous gastritis. Boston Med Surg J 1926;195:800–803.
  18. Lawson GH, Gebhart CJ. Proliferative enteropathy. J Comp Pathol 2000;122:77–100.
    pubmed: 10684678
  19. Morton JJ, Stabins SJ. Phlegmonous gastritis: of Bacillus aerogenes capsulatus (B. welchii) origin. Ann Surg 1928;87:848–854.
    pmc: PMC1398564pubmed: 17865897
  20. Navarro MA. Mechanisms of action and cell death associated with Clostridium perfringens toxins. Toxins (Basel) 2018;10:212.
    pmc: PMC5983268pubmed: 29786671
  21. Olsson Y. Two cases of phlegmonous gastritis. Acta Radiologica 1932;13:134–143.
  22. Page AE. Acute deterioration and death with necrotizing enteritis associated with Lawsonia intracellularis in 4 weanling horses. J Vet Intern Med 2012;26:1476–1480.
    pubmed: 23039901
  23. Patton K. Hemorrhagic gastritis associated with renal failure, hemoglobinuria, and isolation of Clostridium perfringens in a horse. J Equine Vet Sci 2009;29:633–638.
  24. Pritchard JE, McRoberts JW. Phlegmonous gastritis: with a report of four cases. Can Med Assoc J 1931;25:183–187.
    pmc: PMC382610pubmed: 20318404
  25. Pusterla N. Comparison of feces versus rectal swabs for the molecular detection of Lawsonia intracellularis in foals with equine proliferative enteropathy. J Vet Diagn Invest 2010;22:741–744.
    pubmed: 20807932
  26. Reef VB. Adult abdominal ultrasonography. In: Reef VB, ed. Equine Diagnostic Ultrasound. Saunders, 1998:1–91.
  27. Renier AC. Oleander toxicosis in equids: 30 cases (1995–2010). J Am Vet Med Assoc 2013;242:540–549.
    pubmed: 23363288
  28. Rood JI. Expansion of the Clostridium perfringens toxin-based typing scheme. Anaerobe 2018;53:5–10.
    pmc: PMC6195859pubmed: 29866424
  29. Shi D. Phlegmonous gastritis in a patient with mixed-phenotype acute leukemia in the neutropenia phase during chemotherapy: a case report. Medicine (Baltimore) 2019;98:e17777.
    pmc: PMC6855575pubmed: 31702630
  30. Sood BP. CT features of acute phlegmonous gastritis. Clin Imaging 2000;24:287–288.
    pubmed: 11331158
  31. Thierry F. Canine and feline emphysematous gastritis may be differentiated from gastric emphysema based on clinical and imaging characteristics: five cases. Vet Radiol Ultrasound 2019;60:136–144.
    pubmed: 30311329
  32. Uzal FA. Clostridium perfringens toxins involved in mammalian veterinary diseases. Open Toxinology J 2010;2:24–42.
    pmc: PMC3917546pubmed: 24511335
  33. Uzal FA. Alimentary system. In: Maxie MG, ed. Jubb, Kennedy, and Palmer’s Pathology of Domestic Animals. 6th ed. Elsevier, 2016:52–55.
  34. Uzal FA, Diab SS. Gastritis, enteritis, and colitis in horses. Vet Clin North Am Equine Pract 2015;31:337–358.
    pmc: PMC7127504pubmed: 26048413
  35. Welch CE, Jones CM. Emphysematous gastritis. N Engl J Med 1947;237:983–985.
    pubmed: 18919224
  36. Weldon AD. Emphysematous gastritis in a horse. Cornell Vet 1991;81:51–58.
    pubmed: 1993393

Citations

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