Equine pythiosis in Egypt: clinicopathological findings, detection, identification and genotyping of Pythium insidiosum

BACKGROUND

Equine pythiosis is an emerging, devastating disease that is hard to treat. The tumour-like nodular skin masses grow rapidly and the outcome is generally fatal, and thus early diagnosis and intervention are important.

OBJECTIVES

(i) To highlight the clinical, histological and haematological findings in pythiosis, and (ii) to evaluate the efficacy of direct sample multiplex-PCR targeting the single nucleotide polymorphisms within the ribosomal DNA region for detection and genotyping of Pythium insidiosum.

ANIMALS

Two hundred and twenty horses including 204 Arabian and 16 draft horses were surveyed.

METHODS

Case series study diagnosis was based on clinical, pathological and haematological findings typical of P. insidiosum infection, culture identification, immunohistochemical investigation and direct sample PCR.

RESULTS

The affected horses (24 of 220, 10.91%) presented with unifocal or multiple lesions on the abdomen, limbs, chest, face and mammary gland. Cases commonly had a history of access to stagnant water, ponds and intentionally flooded rice fields. Most were pregnant mares (58.33%). Histopathology revealed granulomatous reaction, blood vessel endotheliosis, heavy infiltration of eosinophils in the dermal layer, multifocal necrosis and Splendore-Hoeppli phenomenon. Unlike direct microscopy (50%) and culture (91.6%), multiplex-PCR assay identified P. insidiosum (Clade II) in all tested samples. To the best of the authors knowledge, this is the first study determining a clade of P. insidiosum causing equine pythiosis in Egypt.

CONCLUSIONS AND CLINICAL IMPORTANCE

Direct sample multiplex-PCR assay is a potential tool for the early and rapid diagnosis of equine pythiosis. It overcomes limitations associated with morphological identification and provides a definitive diagnosis.

GASTRIC PYTHIOSIS IN A BACTRIAN CAMEL ( BACTRIANUS CAMELUS)

Pythium insidiosum, an aquatic oomycete, causes chronic lesions in the skin and digestive tract of multiple species. A captive-bred Bactrian camel ( Camelus bactrianus) showed clinical signs of lethargy and weight loss in a clinical course of 30 days, with no response to treatment. At necropsy, the abdominal cavity had approximately 32 L of a yellow, turbid fluid with fibrin. The third compartment of the stomach (C-3) showed a focal area of rupture covered with fibrin. Close to this area, the C-3 wall was thickened and firm, demonstrating irregular, yellow, and friable areas on cut surface (kunkers). Microscopically, these corresponded to necrosis, characterized by a central amorphous eosinophilic material, surrounded by a pyogranulomatous inflammatory infiltrate and fibrosis. Negatively stained hyphae were observed at the periphery of the necrotic areas, which showed marked immunostaining for P. insidiosum. Pythiosis in camelids may involve the stomach, resulting in peritonitis and death.

Equine pythiosis in the eastern wetlands of Uruguay

ABSTRACT: Equine pythiosis is an ulcerative and granulomatous disease of the skin, caused by the oomycete Pythium insidiosum (Pythiaceae). The objective of this study was to describe seven cases of equine pythiosis that occurred from 2012 to 2017 in the eastern region of Uruguay. Six of the seven cases occurred in the eastern wetland ecosystems of the Merin basin, and the remaining case occurred in the wetland fluvial plains of the Tacuarembó River. Lesions consisted of a large, rapidly growing ulcerated tumor with abundant granulation tissue, serosanguineous secretion, and fistulous tracts containing large concretions or kunkers. The animals presented intense pruritus, claudication and loss of body condition, with death or euthanasia in extremis in six cases. The main histological lesions consisted of an eosinophilic and pyogranulomatous inflammatory process, with numerous foci of eosinophilic necrosis (kunkers), collagenolysis, and a Splendore-Hoeppli reaction. In all cases, silver coloration (Grocott) showed intralesional hyphae compatible with P. insidiosum, which was confirmed by immunohistochemistry in three cases. A horse in the terminal phase of the disease was treated with triamcinolone acetonide (50mg IM every 15 days), and fully recovered after 1 year. It is concluded that equine pythiosis is prevalent in the wetland ecosystems of eastern Uruguay and that treatment with triamcinolone is auspicious.

Evaluation of intravenous regional perfusion with amphotericin B and dimethylsulfoxide to treat horses for pythiosis of a limb

BACKGROUND

Treatment for horses with pythiosis of a limb is challenging. This study aims to evaluate the effects of administering amphotericin B in a 10 % solution of dimethylsulfoxide by intravenous regional limb perfusion (IRLP) to treat horses for cutaneous pythiosis of a limb.

RESULTS

All 15 of the horses treated had complete resolutions of their lesion between 6 to 9 weeks after a single IRLP treatment. No complications were observed at the site of venipuncture for IRLP. Before initiation of treatment, there was anemia and marked leucocytosis which resolved following treatment. Serum biochemistry showed no significant changes.

CONCLUSIONS

IRLP administration of amphotericin B in a 10 % DMSO solution was easily performed, relatively inexpensive and an effective treatment for treating horses for pythiosis of a limb and resolved the infection with no complications.

Utilização da técnica de imuno-histoquímica para confirmar casos de pitiose cutânea equina diagnosticados por meio de caracterização clínica e avaliação histopatológica

Avaliaram-se 12 feridas granulomatosas em membros torácicos e pélvicos de equinos da raça Pantaneira. Foi realizado diagnóstico sugestivo para pitiose cutânea de acordo com as características clínicas das feridas e avaliação histopatológica, com as colorações de hematoxilina-eosina (HE) e Prata Metenamina de Grocott (GMS). A confirmação do diagnóstico foi realizada por exame imuno-histoquímico, método streptavidina-biotina marcada (LSAB). O diagnóstico histopatológico foi de dermatite piogranulomatosa, focal extensa, acentuada, associada a "pseudo-hifas" características de Pythium insidiosum (pitiose cutânea), nos 12 animais desta pesquisa. O diagnóstico de pitiose foi confirmado em 100% dos casos pela imunomarcação positiva (LSAB) para Pythium insidiosum, caracterizada pela visualização de estruturas ramificadas e septadas, sendo observados 100% de paridade entre as técnicas. É possível concluir que a caracterização clínica das feridas granulomatosas com aspecto de pitiose em equinos associada ao resultado histopatológico sugestivo para pitiose equina constituem métodos de diagnóstico confiáveis, os quais podem ser confirmados pela técnica de imuno-histoquímica.

Pathology of nasal infection caused by Conidiobolus lamprauges and Pythium insidiosum in sheep

Conidiobolomycosis and pythiosis are important diseases of sheep in midwestern Brazil. Veterinary practitioners consider it difficult to differentiate between these diseases because they have similar clinical features. In this study, 186 sheep were subjected to necropsy examination over a 6-year period. Thirty (16.1%) cases of rhinitis in sheep that were caused by Conidiobolus lamprauges (n = 15) or Pythium insidiosum (n = 15) were investigated further. The lesions of C. lamprauges infection were mainly rhinopharyngeal (86.7%), localized to the ethmoidal region and associated with exophthalmos. The lesions appear as a white to yellow, firm mass that microscopically appears as a granulomatous inflammatory reaction with numerous giant cells. In contrast, P. insidiosum infection is associated with rhinofacial (93.3%) lesions that mainly involve the frontal region and hard palate and appear as an irregular, friable, yellow to red mass. Microscopically, pythiosis presents as diffuse necrotizing eosinophilic rhinitis. Immunohistochemistry using polyclonal antisera raised specifically against the two organisms was used to confirm the identity of the infectious agent in each disease. This study reports the first immunohistochemical diagnosis of conidiobolomycosis and the first description of a rhinopharyngeal lesion caused by P. insidiosum in sheep.

Gastric pythiosis in a dog

BACKGROUND

Pythiosis is caused by the agent Pythium insidiosum, an aquatic oomycete of the kingdom Stramenopila.

AIMS

To describe the symptoms, pathological changes and diagnosis methods of gastric pythiosis in dogs.

METHODS

A three-year-old female German shepherd, with access to wetlands, was attended due to vomiting and recurrent diarrhea of 30 days of duration. A palpable mass in the abdomen filling the left epigastric region was identified in the clinical examination. Simple and contrasted radiological examination and ultrasound of abdominal cavity were performed. The animal was referred for exploratory laparotomy for the removal of the mass. The extent of the mass prevented from the excision and the animal was euthanized. Samples of the tumor mass were collected and sent for morphological study and immunohistochemistry.

RESULTS

The changes observed in imaging studies were consistent with gastric pythiosis. In cytology and histopathology, non-septate hyphae were identified, and in immunohistochemistry a strong positivity of anti-Pythium antibodies was observed, confirming the diagnosis of pythiosis.

CONCLUSIONS

Pythiosis in dogs is diagnosed late and tends to evolve in the animal's death. The definitive diagnosis is by cytology, histology and immunohistochemistry.