Cervical vertebral osteomyelitis secondary to Streptococcus equi infection in an adult horse - case report

Abstract

A 15-year-old, mixed breed, male horse was attended with a history of multiple abscesses in the cervical region with a three-year evolution. Upon admission, three fistulous tracts with drainage of purulent secretions in the cervical region, low body score, restriction of cervical movements, and painful sensitivity to palpation were observed. The horse was diagnosed with osteomyelitis secondary to Streptococcus equi infection. The initial treatment was antibiotic therapy and local curative. Owing to the lack of response, surgical debridement was performed. An initial favorable response was observed; however, after 4 months, drainage recurred, and the animal was euthanized. A post-mortem computed tomography scan was performed to obtain details of the injury. Cervical osteomyelitis is rare, and its occurrence through hematogenous spread in adult horses and the tomographic findings had not been reported previously. The long period of evolution, difficulty in performing an aggressive debridement, and the presence of multi-drug resistant bacteria contributed to the negative outcome. RESUMOUm equino macho, sem raça definida, de 15 anos de idade, foi atendido com histórico de múltiplos abscessos cervicais com evolução de três anos. Na admissão, foram observados: três trajetos fistulosos com drenagem de material purulento na região cervical; baixo escore corporal; restrição de movimentos cervicais; e sensibilidade dolorosa à palpação da região. Foi diagnosticada osteomielite vertebral cervical secundária à infecção por Streptococcus equi. O tratamento inicial consistiu na administração de antibióticos e curativo local. Na ausência de resposta à terapia, realizou-se o debridamento cirúrgico. Inicialmente, obteve-se uma resposta favorável, entretanto, após quatro meses, houve recidiva da lesão e o animal foi submetido à eutanásia. Realizou-se tomografia computadorizada no post mortem para detalhamento da lesão. A osteomielite vertebral cervical é rara, e sua ocorrência por meio de disseminação hematógena em animais adultos não foi previamente reportada. O longo período de evolução, aliado à dificuldade de realização de um debridamento agressivo, e a característica multirresistente do agente etiológico contribuíram para o desfecho negativo do caso. Palavras-chave: tomografia, infecção óssea, debridamento cirúrgico

Ultrasonography of the cervical articular processes in donkeys and mules: technique and reference images

“…Regarding this literary absence, it is important to acquire data for specific ultrasound technique for the examination of cervical joints and joint processes in donkeys and mules, considering the established applicability in horses (Abuja et al, 2014;Aleman et al, 2014;Alonso et al, 2019;Audigié et al, 2004;Chope, 2008;Gollob et al, 2002;Johnson et al, 2017;Mackenzie et al, 2017;Mattoon et al, 2004;Pease et al, 2012) in the diagnosis of diseases and as an aid to ultrasound-guided intra-articular punctures in these joints, whether for diagnosis or therapy.…”

“…Chope (2008) reported the usefulness of performing radiography and nuclear scintigraphy, if available, prior to ultrasound examination to assist in the location and interpretation of osteoarthritis in cervical vertebral joints in horses. Also, as a diagnostic aid, ultrasound was used in the diagnosis of cervical vertebral osteomyelitis in a horse with a history of multiple cervical abscesses (Alonso et al, 2019), with the identification of areas with accumulation of secretion, in addition to certifying that there were no foreign bodies related to the injuries. Ultrasonographic examination of the cranial nuchal bursa of horses was used in (Abuja et al, 2014) to compare anatomical aspects and images obtained by magnetic resonance imaging of this structure.…”

Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine

“…VO is a well-known condition in food-producing animals and has been reported in several animal species such as cattle, sheep, goats, pigs and horses, as well as in domestic animals (Radostits et al 2006 ; Alonso et al 2019 ; Shivapour et al 2019 ; Giebels et al 2020 ; Vieira‐Pinto et al 2020). However, the traditional name in veterinary medicine for this infection is spondylitis, or discospondylitis if the intervertebral disc is affected (Moore 1992 ; Thomas 2000 ).…”

“…VO is not frequently reported in juvenile cattle. However, some studies have reported VO in calves and foals (Alonso et al 2019 ; Lamm et al 2021 ). VO in foals often develops secondary to other conditions such as brucellosis or tuberculosis (Alonso et al 2019 ).…”

“…However, some studies have reported VO in calves and foals (Alonso et al 2019 ; Lamm et al 2021 ). VO in foals often develops secondary to other conditions such as brucellosis or tuberculosis (Alonso et al 2019 ). VO in cattle causes weakness, ataxia and recumbency, and has been associated with a wide range of microorganisms such as Streptococcus epidermidis , Fusobacterium spp.…”