Rhinosinusitis in an Australian mare caused by Flavodon flavus, a recently recognized invasive fungal pathogen of the horse.
Abstract: We describe herein the clinical, endoscopic, computed tomography (CT), pathologic, and microbiologic features of an infection caused by an under-recognized fungal pathogen, , in a 25-y-old Australian Quarter Horse. The horse had a unilateral obstructive nasal mass, resulting in stertor and dyspnea. On endoscopy, the mass was tan, multinodular, and completely obstructed the nasal passage. CT analysis revealed a large, soft tissue-attenuating and partially mineralized mass in the right nasal passage and dorsal-conchofrontal sinus, expanding into adjacent paranasal sinuses with associated bone lysis and rhinosinusitis. Histopathology of the mass on 2 occasions revealed suppurative inflammation initially, and pyogranulomatous inflammation subsequently. The inflammatory reaction surrounded numerous spherical fungal structures (~60-80 µm diameter) that stained positively on periodic acid-Schiff and Grocott methenamine silver stains. PCR for the fungal internal transcribed spacer 1 and 2 regions followed by Sanger sequencing on a cultured isolate identified the agent as , which has only been reported previously as pathogenic in one horse in the United States, to our knowledge. Previous reports described this fungus as a nonpathogenic, environmental commensal fungus associated with insects and plants.
Publication Date: 2019-12-26 PubMed ID: 31876248PubMed Central: PMC7003237DOI: 10.1177/1040638719897610Google Scholar: Lookup
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Summary
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The research explores a case of rhinosinusitis in a 25-year-old horse caused by a less recognized fungal pathogen, Flavodon flavus. It describes the clinical symptoms, diagnostics used, pathology, and microbiological features of this infection.
Clinical and Endoscopic Features
- The symptoms of the disease in the horse included a unilateral (one-sided) nasal blockage, which led to noisiness in breathing (stertor) and difficulty in breathing (dyspnea).
- Using an endoscope, a device used to visualize the internal parts of an animal, the horse was found to have a tan-colored, many-noduled mass that completely blocked the nasal passage.
Computed Tomography and Pathologic Features
- Using CT scan imaging, the mass was found to consist of soft tissue and partly mineralized portions. It was present in the right nasal passage and also the upper concha-frontal sinus (part of the horse’s complex sinus system).
- The mass had spread to nearby paranasal sinuses which led to bone lysis (decomposition) and rhinosinusitis, inflammation of nasal and sinus cavities.
- Pathological tests of the mass at two different times showed initial suppurative inflammation, a condition in which pus forms within tissues, and subsequent pyogranulomatous inflammation, a chronic inflammatory response where mass of immune cells, necrotic debris and fibrous tissue develops.
Microbiologic Features
- The mass consisted of many spherical fungal cells measuring 60-80 micrometers in diameter which stain positively on periodic acid-Schiff and Grocott methenamine silver stains, both of which are techniques used to visualize fungi.
- By using Polymerase Chain Reaction (PCR), a molecular technique to amplify DNA, the researchers were able to detect and sequence the internal transcribed spacer regions 1 and 2 from the fungal cells.
- The fungus was identified as Flavodon flavus using Sanger sequencing on the cultured isolate. This species has previously only been reported to cause disease in one horse in the United States.
- Flavodon flavus was hitherto known as a nonpathogenic fungus associated with insects and plants. This study, therefore, highlights a novel pathogenic role for this organism.
Cite This Article
APA
Suen WW, Zedler S, Price R, Maguire T, Halliday C, Rosenblatt AJ, Allavena RE, Owen H, Medina-Torres CE.
(2019).
Rhinosinusitis in an Australian mare caused by Flavodon flavus, a recently recognized invasive fungal pathogen of the horse.
J Vet Diagn Invest, 32(1), 162-165.
https://doi.org/10.1177/1040638719897610 Publication
Researcher Affiliations
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
- School of Veterinary Science, Faculty of Science, The University of Queensland, Gatton, Queensland, Australia (Suen, Zedler, Price, Maguire, Rosenblatt, Allavena, Owen, Medina-Torres).
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia (Suen).
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia (Halliday).
MeSH Terms
- Animals
- Australia
- Basidiomycota / isolation & purification
- Female
- Horse Diseases / microbiology
- Horses
- Humans
- Male
- Mycoses / microbiology
- Mycoses / veterinary
- Paranasal Sinuses
- Polymerase Chain Reaction
- Rhinitis / microbiology
- Rhinitis / veterinary
- Sinusitis / microbiology
- Sinusitis / veterinary
- Tomography, X-Ray Computed
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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