Pleural Empyema in Six Horses: A Retrospective Case Series

The clinical findings of pleural empyema in six horses were retrospectively studied using epidemiological, clinical pathology, microbiological, ultrasound, and post-mortem data. The clinical findings included tachycardia (n = 3/6), tachypnea (n = 6/6), cyanotic mucosa (n = 2/6), hyperthermia (n = 4/6), inspiratory or mixed dyspnea (n = 6/6), presence of fluid and/or pleural rubbing (n = 2/6) and coarse crackling on auscultation (n = 4/6). Horses demonstrated leukocytosis (16.22 x 103/mu L) with neutrophilia (12.32 x 103/mu L) and hyperfibrinogenemia (633.33 mg/dL) and an increase in urea (69.80 mg/kg) and globulins (5.22 g/dL). The pleural fluid exhibited exudate (n = 5/6). The pathogens isolated from transtracheal wash (TTW) and/or pleural effusion included Aspergillus fumigatus, Enterobacter cloacae , alpha and beta hemolytic Streptococcus, Pseudomonas aeruginosa, Salmonella sp., Streptococcus equi subsp. zooepidemicus, and beta hemolytic Staphylococcus . The in vitro tests of microbial sensitivity of the isolates revealed that ceftiofur (5/6) and penicillin (3/6) were the most effective drugs. The fatality rate was 83% (5/6). The main post-mortem finding was the presence of fibrin in the pleural cavity with adhesion between the parietal and visceral pleura. These results show that pleural empyema is a complex disease pathophysiology that is refractory to conventional treatment.(c) 2023 Published by Elsevier Inc.

Automated summary

The clinical findings of pleural empyema in six horses were studied retrospectively. The horses showed various clinical signs, including tachycardia, tachypnea, cyanotic mucosa, hyperthermia, dyspnea, fluid presence, and coarse crackling on auscultation. Blood tests revealed leukocytosis, neutrophilia, hyperfibrinogenemia, and increased urea and globulins. Pathogens such as Aspergillus fumigatus and Streptococcus were isolated from transtracheal wash and pleural effusion. The fatality rate was 83% and post-mortem examination revealed fibrin in the pleural cavity with adhesion between the parietal and visceral pleura. Pleural empyema is a complex disease that is difficult to treat conventionally.