Hemothorax due to vascular necrosis of... (PDF Download Available)
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34.55Sciensano (fusion of Veterinary and Agrochemical Research Centre and Institute for Public Health)AbstractAn aborted foal was presented with the suspicion of equine herpes virus (EHV) infection. On gross pathology, there were no specific EHV lesions present. Histopathology revealed moderate necrotizing inflammatory reactions in several organs associated with (peri)vasculitis. The polymerase chain reaction (PCR) for EHV type 1 on several organs was positive, as well as the seroneutralization test on the mare's serum. The foal had an extensive hemothorax with blood clots due to leakage of blood through a focal necrotic area of the vena caval wall. The relation between the EHV-1 infection and the hemothorax is discussed.Discover the world's research15+ million members100+ million publications700k+ research projects
HE MOT HO RAX DUE TO VAS CU LAR NE CRO SIS OF THE VENA CAVA CAU DA LISIN AN ABOR TED FOAL IN FEC TED WITH EQUI NE HER PES VI RUS 1He mot ho rax
vas cu lai re
cau da lis
ge a bor teerdveu len,
ge ?nfecteerd
1H. De Bos sche re1, S. Roels1, A. B. Caij2,
Va nop den bosch1Ve te ri na ry
Agroche mi cal
Re se arch
(VAR)1 De part ment
Bi o con trol2
De part ment
Vi ro lo gyGroe se len berg
Bel gi umhe deb@var.fgov.beABSTRACTAn abor ted foal was pre sen ted with the sus pi ci on of equi ne her pes vi rus (EHV) in fec ti on. On gross pa -tho lo gy,
spe ci fic
His top atho lo gy
re ve a led
mo de ra te
ne cro ti zing
in flam -ma to ry
re ac ti ons
as so ci a ted
(peri)vas cu li tis.
po ly me ra se
re ac ti on
(PCR)for EHV type 1 on se ver al or gans was po si ti ve, as well as the se ron eu tra li za ti on test on the mare’s se rum.The foal had an ex ten si ve he mot ho rax with blood clots due to le a ka ge of blood through a fo cal ne cro tic areaof the vena ca val wall. The re la ti on be tween the EHV-1 in fec ti on and the he mot ho rax is dis cus sed. SA MEN VAT TINGEen geaborteerd veulen verdacht van een equiene herpes virus (EHV) infectie werd aangeboden voor autopsie.Macroscopisch waren er geen specifieke EHV-letsels zichtbaar. Histopathologisch onderzoek toonde een matigenecrotiserende ontstekingsreactie in verscheidene organen geassocieerd met (peri)vasculitis. Polymerase chainreactie (PCR) voor EHV-type 1 op verscheidene organen was positief, alsook de seroneutralisatietest op het serumvan de merrie. Het veulen had echter een uitgebreide hemothorax met bloedklonters ten gevolge van een lek vaneen lokale necrotische zone in de wand van de Vena cava caudalis. De relatie tussen de EHV-1-infectie en dehemothorax wordt besproken.INTRO DUC TI ONHer pes vi ru ses
abor ti on
do -mes tic ani mals (Acland, 1995). Equi ne her pes vi rustype 1 (EHV-1) is the most im por tant vi ral cau se ofequi ne abor ti on (Allen and Bry ans, 1986; Smith etal., 2003), whi le equi ne her pes vi rus type 4 (EHV-4)is
res pi ra to ry
dis e a se
(Crabband Stud dert, 1995). In one stu dy, only 4% of EHV- in du ced
abor ti ons
at tri bu ted
(VanMaan en
et al., 2000). Up to 95% of EHV-1 abor ti ons oc cur in the lastthird of preg nan cy, and have ra re ly been ob ser ved un -der
con di ti ons
andBryans,
in cre a sed
sus cep ti bi li ty
abor ti ge nic
in fec ti on
li ke lyre la ted
ana to mi cal
en do cri ne
thepla cen tal
fa ci li ta te
co ty le do na ry
in -farc ti on
preg nan cy
1997). EHV-1
as lymp hoid ne cro sis,
to ge ther with mul tiple, small foci of ne cro sis, mild acu te in -flam ma ti on
in tra nu clear
in clu si on
ad ja -cent pa ren chy mal cells in a wide range of or gans(especi al ly li ver, lungs and adre nal glands) are com -mon ly
af fec ted
1995).Vascular
en dot he li al
swel -ling, but the ef fect can be pleur al and pe ri to ne al ef fu -si on
sub cu ta ne ous
in fec ti on
ma -ter nal
en dot he li al
pa tho ge ne sis
abor ti on.
in clu deVlaams Dier ge nees kun dig Tijd schrift, -93
Case re port
throm bo sis,
pe ri vas cu lar
in flam ma ti on,
andsub se quent
avas cu lar
ne cro sis
en do me tri um.
en do me tri um
cau sesse pa ra ti on
ma ter nal
pla -cen ta
ma ter nal
leu co cy tesand ly sed en dot he li al cells to en ter the fe tus (Eding -ton et al., 1991; Acland, 1995). If in fec ti on oc cursclo se to term, the in fec ted foal may be born weak, andusu al ly dies wit hin 7 days due to in ter sti ti al pneu mo -nia
lymp ho re ti cu lar
sy s -tem and adre nal glands, of ten com pli ca ted by se con -da ry
bac te ri al
in fec ti on
1979).The pre sent case des cri bes the abor ti on of a foal af -ter
in fec ti on.
ex ten si ve
he mot ho -rax cau sed by le a ka ge in the wall of the Vena cavacau da lis was de tec ted at ne crop sy. The da ma ged ve -nous
as so ci a ted
ne cro ti zingvas cu li tis.CASE REPORTA 9-year old mare abor ted a foal 3 weeks pre-termand
pre sen ted
re ten tio
se cun di na ri um.
Afterma nu al
re mo val,
mem bra nes
pe -techi ae and a cook ed as pect. The mare did not showany signs of illness. It was the se cond abor ti on on thefarm in one week. An au top sy of the foal was per for med. The re wereno
ma cros co pic
frac tu red
inthe tho rax re gi on which would be in di ca ti ve of trau -ma tic in ju ries cau sed by the mare. The mus cles andmy o card were very pale. The lungs sho wed fe tal ate -lec ta sis
(still-birth).
tho ra cal
fil ledwith se ver al li ters of he morrha gic fluid and bloodclots. The blood ori gi na ted from a le a ka ge in the Venacava cau da lis near the di aphragm. Blood le a ked froma ne cro tic area (about 2 cm in di a me ter) in the wall ofthe Vena cava cau da lis (Fi gu re 1) and fil led the tho ra -cal ca vi ty com ple te ly. The ve nal wall of the ne cro ticzone was dark red to black in color.Se rum of the mare was col lec ted and te sted for thepre sen ce
an ti bo dies
vi rus(EHV) and equi ne vi ral ar te ri tis (EVA) by a stand ardse ron eu tra li za ti on
(ac cor ding
ma nu al).The se rum was ne ga ti ve for EVA, whi le it had an an ti -bo dy ti ter of = 1/256 against EHV. Vi rus iso la ti on wasper for med by
in ocu la ti on
sus pen si ons
a mo no lay er of rab bit kid ney (RK-13) cells. EHV1 wasiso la ted from sus pen si ons of the lung and spleen ofthe fe tus. An EHV1-EHV4 spe ci fic PCR per for medon the lung and spleen sus pen si ons de mon stra ted thepre sen ce of EHV1 in the se or gans. He ma toxy lin-eo sin
re ve -a led
pe ri vas cu lar
in fil tra ti on
neu trop hils,ma crop ha ges
lymp ho cy tes.
Occa si o nal ly
sing le he pa to cy te
ne cro tic.
fol li cles
mo de ra te
ne cro sis.
mi li a ry
ne cro tic
as so ci a ted
in flam ma to ry
re ac ti on
no ti ced.
in tra -nu clear in clu si ons of EHV1 could be ob ser ved. Theexa mi na ti on
re ve a led
se ve rene cro sis
in flam ma to ryre ac ti on,
he morrha ges
clots. DISCUSSIONEHV-1
in fec ted
preg nan cya re of ten fresh and en clo sed in the pla cen ta, with de athdue
suf fo ca ti on
fol lo wing
pla cen tal
se pa ra ti on.Gross
exa mi na ti on
ty pi cal ly
com bi na ti on
ofic te rus,
me co ni um
in te gu ment,
trans u -da ti on
ca vi ties,
sple no me ga ly,
pe ri re nal ede ma, pul mo na ry
he morrha ge
mi -li a ry foci on the cap su le and cut sur fa ces of the li ver.None
cha rac te ris tics
ob ser ved
His to lo gi cal
exa mi na ti ons
ne -cro sis in the li ver, adre nal gland, thy mus, spleen, lungand
in tes ti ne
con sis tent
in fec ti on(Hong
et al., 1993; Smith, 1997). The pre sent casesho wed
pe ri vas cu lar
in fil tra ti on
li verand lungs, mo de ra te lymp hoid ne cro sis in the spleenand mi li a ry ne cro tic foci in the lungs, which could beat tri bu ted
in fec ti on. 92 Vlaams Diergeneeskundig Tijdschrift, 2005, 74Fi gu re
Pho to graph
vas cu lar
ne cro sis
cau da lis.1:
Vena cava cau da lis / 2: Di aphrag ma / Arrow he ad: vas cu -lar ne cro sis with le a ka ge of blood into the tho ra cic ca vi ty.
Li te ra tu re
vas cu lar
ne cro sis
spar se.Machi da
et al. (1997)
en dot he li al
ne cro sisand fi bri noid chang es in the me dia in the my o car di alsmall
ar te ries
ar te ri o les
fe tu ses. Wal ker
et al. (1999) des cri bed cong esti on and ne cro -sis of the middle lay er of
the trop ho blast and cho ri o -nic ne cro sis in the pla cen tae of EHV-1 in fec ted dams.Del Pie ro and ot hers (2000) des cri bed vas cu lar ne cro -sis, ede ma, and he morrha ge with near com ple te en -dot he li al
in clu ding
ef fa ce ment
me -dia and ad ven ti tia in the lung of a fil ly. Ho we ver, thisvas cu lar
ne cro sis
des cri bed
thesmal ler blood ves sels. In the pre sent case, the Ve n acava
cau da lis
was af fec ted. The high ti ter of neu tra li -zing an ti bo dies against EHV of the mare is in di ca ti veof a re cent EHV infection (the mare was not vac ci na -ted). The pre sen ce of EHV1 in fe tal or gans was de mon -stra ted by vi rus iso la ti on and con fir med by PCR.Unfor tu na te ly,
tech ni cal
ableto de mon stra te the pre sen ce of EHV1 in the re gi onwith vas cu lar ne cro sis in the vena cava. Ho we ver apri ma ry
trau ma tic
eti o lo gy
ex clu ded,
in di ca ti ons
trau ma tic
in ju ries
abor ted foal. Tho ra cic trau ma oc curs in new born fo -als and
as so ci a ted
cli ni cal
de ath(Scham bourg
et al., 2003). Frac tu red ribs, he mot ho -rax
sub se quent
pul mo na ry
col lap se
ci tedmost com mon ly as the cau se of de ath (Scham bourg etal., 2003).In con clu si on, EHV-1 is known to cau se abor ti onand vas cu lar ne cro sis of small blood ves sels in equi -nes. Ho we ver, the pre sent case sho wed vas cu lar ne -cro sis of a lar ger blood ves sel, na me ly the Vena cavacau da lis,
re sul ting
he mot ho rax,
as so ci a ted
in fec ti on
(abor ti on).
pre sen ce
EHV-1in fec ted cells in the vena cava could not be de mon -stra ted, but it is strong ly sus pec ted to be the cau sa ti veagent of the vas cu lar ne cro sis. ACKNOW LED GE MENTSThe aut hors would like to thank the staff of the De -part ment of Bi o con trol (VAR) for its tech ni cal as sis -tan ce
(pre pa ring
per for ming
tests). RE FE REN CESAcland H. M. ( 1995). Chap ter 12: Repro duc ti ve Sy stem:Fe ma le. In: Carlton W. W., McGa vin M. D. (Eds.).Thom son’s
Ve te ri na ry
Pat ho lo gy.
edi ti on,Mos by-Year Book Inc., St. Lou is, p. 529 - 530.Allen
Mo le cu lar
epi zoot i o lo gy,pa tho ge ne sis
prop hy laxis
her pes vi rus-1in fec ti ons.
Ve te ri na ry
Mi cro bi o lo gy
and Immu no lo gy, vol. 2, Ba sel, Kar ger, p. 78 - 144.Crabb B. S., Stud dert M. J. (1995). Equi ne her pes vi rus 4(equi ne
rhi nop neu mo ni tis
abor ti on vi rus).
Re se arch
45, 153 - 190.Del Pie ro F., Wil kins P. A., Ti mo ney P. J., Ka dus hin J., Vo -gel back er H., Lee W., Ber ko witz S. J., La Per le K. M. D.(2000).
non neu ro lo gi cal
in fec ti on
ye -ar ling
Ve te ri na ry
Pat ho lo gy
37, 672 - 676.Eding ton N., Smyth B., Grif fiths L. (1991). The role of en -dot he li al
in fec ti on
en do me tri um,
pla cen taand fe tus of equid her pes vi rus 1 (EHV-1) abor ti ons.Jour nal
Com pa ra ti ve
Pat ho lo gy
104, 379 - 387.Hart ley W. J., Dixon R. J. (1979). An out break of foal pe ri -na tal ly mor ta li ty
her pes vi rus
type 1: pa tho -lo gi cal
ob ser va ti ons.
Ve te ri na ry
11,215 - 218.Hong C. B., Do na hue J. M., Gi les R. C. (1993). Equi neabor ti on and stillbirth du ring 1988 and 1989 fo a ling se -a sons.
Ve te ri na ry
Di a gnos tic
Inves ti ga ti on5, 560 - 566.Machi da N., Ta ni guchi T., Na ka mu ra T., Ki ryu K. (1997).Car dio-his top atho lo gi cal
ob ser va ti ons
abor tedequi ne
in fec ted
her pes vi rus
Com pa ra ti ve
Pat ho lo gy
116, 379 -385.Scham bourg M. A., La ver ty S., Mul lim S., Fo gar ty U. M.,Hal ley J. (2003). Tho ra cic trau ma in fo als: post mor temfin dings.
Ve te ri na ry
35, 78 - 81.Smith K. C. (1997). Re view Her pes vi ral abor ti on in do -mes tic ani mals. The Ve te ri na ry Jour nal 153, 253 – 268. Smith K. C., Blun den A. S., Whit well K. E., Dunn K. A.,Wa les A. D. (2003). A sur vey of equi ne abor ti on, still -birth and ne o na tal de ath in the UK from 1988 to 1997.Equi ne
Ve te ri na ry
35, 496 – 501.Van Maan en C., Vrees wijk J., Moon en P., Brink hof J., deBoer-Luijtze E.,
Terp stra C. (2000).
Dif fe ren ti a ti on and ge no mic
an ti ge nic
va ri a ti on
res pi ra to ry,and
neu ro lo gi cal
iso la tes
in fec ti onsin The Ne ther lands. Ve te ri na ry
Qu a ter ly
22, 88 - 93.Wal ker C., Pe rot ti V. M., Love D. N., Whal ley J. M. (1999). Infec ti on
her pes vi rus
strainHVS25A in preg nant mice. Jour nal
Com pa ra ti vePa t ho lo gy
120, 15 - 27.Vlaams Diergeneeskundig Tijdschrift, 2005, 74 93
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