c Dermatitis, pyrexia, and hemorrhagic syndrome (DPHS) is a rare bovine syndrome of unclear etiology. We describe two DPHS cases, the first to occur in Italy, with clinicopathological findings suggesting a potential pathogenetic role of bovine herpesvirus-4 (BoHV-4).
CASE REPORT
Two Italian Holstein-Friesian cows, 5 and 6 years old, from the same herd were referred to the Teaching Hospital of the Department of Veterinary Science of Turin University because of acute onset of pyrexia, pruritus, and skin lesions. One animal (cow A) was referred 1 week after the onset of clinical signs and displayed forced decubitus; the other animal (cow B) was referred 36 h after the onset of clinical signs. Both animals were anorectic, showed signs of depressed mental status, with decreased/absent milk production, pyrexia (rectal temperature, ϟ41.0°C), and disseminated pruritic papulocrustous dermatitis of the head, neck, tail, perineum, and udder ( Fig. 1A to C). In addition, cow B presented hemorrhagic suffusion of the vulvar mucosal membrane (Fig. 1D) and bloody diarrhea.In cow A, the complete blood cell count (ADVIA 120 hematology system; Bayer) was unremarkable. In cow B, the hematological parameters were significantly altered: severe leukopenia (white blood cell count, 2,680 cells/ml [reference range, 6,200 to 13,600 cells/ml]), lymphopenia (2,004 cells/ml [reference range, 4,000 to 9,800 cells/ ml]), neutropenia (390 cells/ml [reference range, 1,100 to 3,600 cells/ ml]), monocytopenia (160 cells/ml [reference range, 200 to 1,300 cells/ml]), and thrombocytopenia (190, Serological investigations showed antibody (Ab) titers of 3ϩ and 2ϩ for bovine herpesvirus 4 (BoHV-4) (PrimaCheck bovine respiratory syncytial virus [BRSV] Ab; Agrolabo) in cow A and cow B, respectively. No serum antibodies for BoHV-1, bovine BoHV-2, BoHV-5, bovine virus diarrhea/mucosal disease (BVD/ MD), parainfluenza 3 virus (PI3), BRSV, pseudorabies virus (PrV), Mycoplasma spp., or Mycobacterium avium subsp. paratuberculosis were detected in either animal.Parasitological and mycological investigations of the skin and hair samples were negative in both animals.Cow A was euthanized for animal welfare reasons; cow B died spontaneously after 8 days despite supportive treatment. Gross examination revealed multifocal whitish areas involving the renal cortex in both animals; subcutaneous hematomas and severe multifocal hemorrhages of the intercostal muscles were noted in cow B (Fig. 2A). The major histopathological findings for both animals were cutaneous leukocytoclastic vasculitis (Fig. 2B) associated with superficial and deep dermatitis, hyperkeratosis (Fig. 2C), and subepidermal separations and ulcerations, in addition to chronic interstitial nephritis associated with vasculitis (Fig. 2D). Severe and diffuse splenic depletion associated with histiocytic giant cells and neutrophilic infiltrates and minimal multifocal interstitial pneumonia were observed in cow B.Bacteriological examination and indirect immunofluorescence testing (IIFT) for anti-bovine IgG in s...