Valvular endocarditis associated with Helcococcus ovis in a cow in Southern Brazil / Endocardite vegetativa associada à Helcococcus ovis em uma vaca no Sul do Brasil

A 4-year-old cow with a history of breathing difficulty, progressive weight loss, and muffled heart sound was treated for a period of two weeks, but died and underwent necropsy examination. Macroscopic examination revealed heart with vegetative proliferative lesion firmly adhered to pulmonary valve, lungs with marked consolidation, and the presence of thrombus in vessels. There were grade II ulcers in abomasal mucosa associated to blood clots. Microscopic examination revealed marked thickening of the pulmonary valve due to the proliferation of fibrous connective tissue, inflammatory neutrophil infiltration, fibrin deposition, and a significant number of coccoid basophilic bacteria. Septic thromboemboli were present in the large and small pulmonary blood vessels suggestive of embolic pneumonia. The bacterial culture of the valve showed growth of small, nonhemolytic colonies that demonstrated satellitism to coagulase-negative staphylococci contaminating colonies, which were subjected to 16S gene sequencing and were compatible with Helcococcus ovis in GenBank. This was the first report of H. ovis endocarditis in cattle in South America.(AU)

Um bovino, fêmea, 4 anos com histórico de dificuldade respiratória, perda de peso progressiva e som cardíaco abafado, foi tratado por um período de duas semanas, porém veio a óbito e foi submetido a exame de necropsia. No exame macroscópico, notou-se coração com lesão proliferativa vegetativa firmemente aderida em valva pulmonar, pulmões com consolidação acentuada, e presença de trombos no interior de vasos. Havia ainda úlcera abomasal grau II em mucosa associada a coágulo sanguíneo. No exame microscópico notou-se acentuado espessamento da valva pulmonar por proliferação de tecido conjuntivo fibroso, infiltrado inflamatório de neutrófilos, deposição de fibrina e acentuado número de miríades bacterianas basofílicas cocoides. Tromboembolia séptica foi vista no interior de vasos pulmonares de pequeno e médio calibre, sugestivo de pneumonia embólica. Em cultivo bacteriano da valva notou-se crescimento de colônias pequenas, não hemolíticas que demonstravam satelitismo a colônias contaminantes de estafilococos coagulase negativa, essas foram submetidas ao sequenciamento do gene 16S e foram compatíveis com Helcococcus ovis no GenBank. Este foi o primeiro relato de endocardite por H. ovis em bovino na América do Sul.(AU)

Aortic valve endocarditis due to Bartonella clarridgeiae in a dog in Brazil / Endocardite de válvula aórtica por Bartonella clarridgeiae em um cão no Brasil

We report the first documented case of endocarditis associated with Bartonella clarridgeiae in a dog in Latin America. Infective vegetative valvular aortic endocarditis was diagnosed in a 10-year-old male mixed breed dog. The dog presented grade V/VI systolic and diastolic murmur, hyperthermia, and progressive weight loss. Cardiomegaly and presence of diffuse alveolar pattern in the lung fields were observed in the thorax radiography evaluation. Irregular and hyperechogenic structures adhered to the aortic leaflets, causing obstruction of the left ventricular outflow tract and severe aortic insufficiency, were observed in the echocardiography evaluation. A vegetative, whitish, hardened structure measuring 1.0 cm in diameter was observed in aortic semilunar valve at necropsy. Based on a combination of pre-enrichment insect-based medium liquid culture, quantitative real-time and conventional PCR assays based on nuoG and gltA genes, respectively, followed by sequencing and phylogenetic inferences, B. clarridgeiae DNA was detected in the patients aortic valve lesions. Clinical, echocardiographic, anatomopathologic and molecular features supported the diagnosis of severe aortic vegetative endocarditis possibly caused by B. clarridgeiae in a dog in Brazil.(AU)

Relatamos o primeiro caso documentado de endocardite associada à Bartonella clarridgeiae em um cão na América Latina. Endocardite aórtica valvar vegetativa infecciosa foi diagnosticada em um cão sem raça definida de 10 anos de idade. O cão apresentou sopro sistólico e diastólico de grau V / VI, hipertermia e perda progressiva de peso. Cardiomegalia e presença de padrão alveolar difuso nos campos pulmonares foram observados na avaliação radiográfica do tórax. Estruturas irregulares e hiperecogênicas aderidas aos folhetos aórticos, causando obstrução da via de saída do ventrículo esquerdo e insuficiência aórtica grave, foram observadas na avaliação ecocardiográfica. À necropsia, foi observada uma estrutura vegetativa, esbranquiçada e endurecida medindo 1,0 cm de diâmetro na válvula semilunar aórtica. Por meio de uma combinação de cultura líquida baseada em meio de pré-enriquecimento de inseto, ensaios de PCR quantitativa em tempo real e convencional baseados nos genes nuoG e gltA, respectivamente, seguidos de sequenciamento e inferências filogenéticas, DNA de B. clarridgeiae foi detectado no tecido valvular lesionado do paciente. O diagnóstico de endocardite vegetativa aórtica grave, possivelmente causado por B. clarridgeiae em um cão no Brasil, foi apoiado por características clínicas, ecocardiográficas, anatomopatológicas e moleculares.(AU)

Thromboembolic encephalitis secondary to bacterial valvular endocarditis in a red-billed curassow (Crax blumenbachii)

A case of bacterial (Pseudomonas aeruginosa) valvular endocarditis in a red-billed curassow is described. A traumatic fracture in one limb of the bird was considered the port of entry for the bacterium, followed by septicemia and seeding of the heart valve. Brain embolism resulting from detached thrombus fragments followed.

Thromboembolic encephalitis secondary to bacterial valvular endocarditis in a red-billed curassow (Crax blumenbachii)

A case of bacterial (Pseudomonas aeruginosa) valvular endocarditis in a red-billed curassow is described. A traumatic fracture in one limb of the bird was considered the port of entry for the bacterium, followed by septicemia and seeding of the heart valve. Brain embolism resulting from detached thrombus fragments followed.(AU)

Babesiose bovina associada à endocardite vegetativa: relato de caso / Babesiosis associated vegetative endocarditis: Case Report

A babesiose bovina é uma hemoparasitose provocada por um protozoário Babesia spp. que causa diversos sinais clínicos, entre eles a redução no ganho de peso, o aborto, a anemia intensa, a febre e hemoglobinúria, sendo responsável por altos indices de morbidade e letalidade, de acordo com a categoria animal acometida, trazendo grandes perdas econômicas relacionadas aos custos com tratamentos nos rebanhos acometidos. O presente trabalho tem objetivo relacionar casos de babesiose bovina aos achados de necropsia de endocardite vegetativa na tricuspide. Entre os meses de outubro de 2015 e julho de 2016, 14 animais apresentaram sinais clínicos da doença, destes, quatro vieram a óbito. As 11 vacas adultas apresentaram redução na produção de leite, redução do apetite, emagrecimento, febre, anemia, variação no volume globular de 15% a 28%, além de alta infestação por carrapatos. Os animais enfermos foram tratados com dipropionato de imidocarb na dose única de 4mg/kg. A uma das vacas ainda foi fornecido o tratamento de suporte com fluidoterapia, vitamina B12, transfusão sanguínea e transfaunação, no entanto, não houve resposta ao tratamento. Este animal apresentou uma piora gradativa no estado geral, diarreia, não se mantinha em estação, mesmo com auxílio, vindo a óbito dois dias após a terapia de suporte. Dos pacientes que vieram a óbito, foi realizada a necropsia de três animais (A, B e C), nos quais foi possível observar entre os achados: anemia na carcaça e hepatoesplenomegalia. Na vaca A, além desses achados havia áreas de hemorragia na serosa do abomaso e no pericardio. Na vaca B observou-se efusão peritoneal (ascite), áreas hemorrágicas na serosa do rúmen, cardiomegalia, efusão pleural e degeneração gelatinosa das gorduras. Nas vacas A e B foi observado proliferação de tecido vegetativo na válvula da tricuspide, com tamanho de aproximadamente 7x5 centimetros, com superficie enrugada e margens irregulares em forma de couve flor e coloração esbranquiçada, caracterizando a endocardite. O diagnóstico de babesiose foi realizado a partir dos sinais clinicos, de dados hematológicos, dos achados de necropsia e do esfregaço sanguíneo onde foi encontrada a variedade Babesia bigemina. Os achados patológicos foram essenciais para o diagnóstico da endocardite, pois este é considerado o teste ouro para tal enfermidade. Nos bovinos a válvula tricuspide geralmente é a mais acometida, sendo característico da endocardite a proliferação de tecido nessa válvula. Sabe-se que a endocardite é a principal doença do endocárdio de bovinos, estando constantemente associada a infecções nos cascos, glândulas mamária, metrite, retículo pericardite, ou outras enfermidades que possam levar a uma bacteremia crônica, e, ocasionalmente, afecções parasitárias. Existem sinais clínicos da babesiose que são comuns a endocardite, como a febre intermitente, a taquicardia, dispneia e sopro cardíaco. No entanto, nem sempre os animais acometidos pela endocardite apresentam um quadro de falhas cardíacas, manifestando-os nos casos mais severos e avançados. Acredita-se que a via hematógena seja a principal forma de disseminação de bactérias que causam a endocardite nos bovinos, sendo a Trueperella (Archanobacterium) pyogenes e o Streptococcus sp., os principais microrganismos responsáveis pela enfermidade. A debilidade extrema dos animais pode ter causado um quadro de imunossupressão nos animais mortos na propriedade, possibilitando a bacteremia e então a lesão valvular dos animais. Todavía, mais estudos precisam ser realizados para determinar se há uma relação entre babesiose e a endocardite, assim como outros fatores predisponentes.

Candida glabrata septicemia in a piglet

Background: Candida organisms are ubiquitous pathogens that may cause mucosal or systemic infection in humans and animals. Candida albicans was the main Candida specie associated with cases of systemic candidosis, and Candida glabrata is the second most isolated in those cases. In animals there are few reports of candidosis. In pigs C. albicans was described as mucocutaneous disease affecting oral mucosa, esophagus and aglandular stomach of pigs affected by porcine circovirus type 2. Systemic invasion by Candida species in pigs is rare. This report describes the pathological changes observed in a case of systemic candidosis due to C. glabrata infection in a piglet. Case: In a nursery facility with 500 piglets a 47-days-old piglet showed lateral recumbency that progressed to inabilit to stand, paddling and death. In the necropsy it was observed valvular vegetative endocarditis in the left atrio-ventricular valve and in the kidneys multifocal to coalescing whitish foci in the sub-capsular and in the cut surface. Microscopical examination of the cerebral cortex, brain steam and cerebellum revealed multifocal random necrotic suppurative focci surrounded by mononuclear cells, epithelioid and multinucleated giant cells together with discret linfoplasmocitic meningitis. In the kidneys there was embolic suppurative nephritis with multifocal abscesses in renal parenchyma, characterized by large amount of neutrophils surrounded by mononuclear cells. In the left valve surface of the hearth there was extensive proliferation of connective tissue with large amount of fibrin, neutrophils and intralesional Gram-positive bacterial colonies with coccoid shape morphology. In brain, hearth and kidneys slides stained with Grocott's methenamine silver and periodic acid-Schiff technique a large amount of yeasts cells round to ovoid in shape were observed associated with necrotic foci and in multinucleated giants cells. Discussion: In the present report, a 47-days-old weaned piglet showed neurological signs that suggested a Streptococcus suis meningitis, and a presumptive diagnostic was reached based on those signs. Antibiotic therapy with amoxicillin was attempted, but there was no improvement in the clinical signs and the piglet died. S. suis was not isolated in the bacteriological analysis, however, PCR technique allowed the detection of the pathogen from the heart, raising the possibility for a role of the agent in the endocardial lesion, but not in the brain. Candida glabrata was detected in the hearth, kidneys and brain suggesting a septicemic spread candidosis in the piglet. Due to the presence of C. glabrata in the piogranulomatous lesions observed in the brain we assumed that the neurological signs were associated with the candidal infection. In humans, it is described the association among intracardiac candidal infection and an increased risk for the development of central nervous system infection. A recent study in slaughter pigs have shown that brain lesions associated with bacterial valvular endocarditis are common. Immunosuppression, low birth weight and broad spectrum antibiotic therapy are among the predisposing factor to the development of septicemic candidosis. In our case report, the piglet was the lighter in the litter at weaning and in the day of necropsy, besides antibiotic therapy was attempted twice in the piglet what could act as another predisposing factor for the septicemic candidosis. This was an unusual case of systemic candidosis with brain involvement and neurological clinical signs associated, due to C. glabrata infection in a piglet.

Candida glabrata Septicemia in a Piglet / Candida glabrata Septicemia in a Piglet

Background: Candida organisms are ubiquitous pathogens that may cause mucosal or systemic infection in humans and animals. Candida albicans was the main Candida specie associated with cases of systemic candidosis, and Candida glabrata is the second most isolated in those cases. In animals there are few reports of candidosis. In pigs C. albicans was described as mucocutaneous disease affecting oral mucosa, esophagus and aglandular stomach of pigs affected by porcine circovirus type 2. Systemic invasion by Candida species in pigs is rare. This report describes the pathological changes observed in a case of systemic candidosis due to C. glabrata infection in a piglet. Case: In a nursery facility with 500 piglets a 47-days-old piglet showed lateral recumbency that progressed to inability to stand, paddling and death. In the necropsy it was observed valvular vegetative endocarditis in the left atrio-ventricular valve and in the kidneys multifocal to coalescing whitish foci in the sub-capsular and in the cut surface. Microscopical examination of the cerebral cortex, brain steam and cerebellum revealed multifocal random necrotic suppurative focci surrounded by mononuclear cells, epithelioid and multinucleated giant cells together with discret linfoplasmocitic meningitis. In the kidneys there was embolic suppurative nephritis with multifocal abscesses in renal parenchyma, characterized

Background: Candida organisms are ubiquitous pathogens that may cause mucosal or systemic infection in humans and animals. Candida albicans was the main Candida specie associated with cases of systemic candidosis, and Candida glabrata is the second most isolated in those cases. In animals there are few reports of candidosis. In pigs C. albicans was described as mucocutaneous disease affecting oral mucosa, esophagus and aglandular stomach of pigs affected by porcine circovirus type 2. Systemic invasion by Candida species in pigs is rare. This report describes the pathological changes observed in a case of systemic candidosis due to C. glabrata infection in a piglet. Case: In a nursery facility with 500 piglets a 47-days-old piglet showed lateral recumbency that progressed to inability to stand, paddling and death. In the necropsy it was observed valvular vegetative endocarditis in the left atrio-ventricular valve and in the kidneys multifocal to coalescing whitish foci in the sub-capsular and in the cut surface. Microscopical examination of the cerebral cortex, brain steam and cerebellum revealed multifocal random necrotic suppurative focci surrounded by mononuclear cells, epithelioid and multinucleated giant cells together with discret linfoplasmocitic meningitis. In the kidneys there was embolic suppurative nephritis with multifocal abscesses in renal parenchyma, characterized

Etiologia e terapia das endocardites bacterianas em cães - revisão / Etiology and therapy of bacterial endocarditis in dogs - review / Etiologia y terapia de endocarditis bacterianas en perros - revisión

A endocardite bacteriana é uma doença caracterizada pela infecção do endocárdio valvular ou mural. Os sinais clínicos inespecíficos, somados a grande variedade de agentes que podem estar implicados na etiologia da doença e as diferenças em relação à suscetibilidade aos antimicrobianos fazem do diagnóstico e tratamento um desafio para o clínico. O objetivo desta revisão é abordar os principais micro-organismos envolvidos e possibilidades terapêuticas da endocardite em cães.(AU)

Bacterial endocarditis is a disease characterized by the infection of the valvular or mural endocardium. The unspecific clinical signs, the wide variety of agents that may be implicated in the etiology and the differences in antimicrobial susceptibility make the diagnosis and treatment a challenge to clinicians. The purpose of this review is to discuss the main microorganisms involved in canine endocarditis and its therapeutic possibilitie.(AU)

Endocarditis bacteriana es una enfermedad caracterizada por la infección del endocardio valvular o mural. Los señales clínicos inespecíficos, sumados a una gran variedad de agentes que pueden estar implicados en la etiología de la enfermedad y las diferencias en relación a la susceptibilidad a los antimicrobianos, hacen del diagnóstico y tratamiento un reto para el clínico. El objetivo de esta revisión es abordar los principales microorganismos implicados y posibilidades terapéuticas de endocarditis en perros.(AU)

Endocardite infecciosa valvular em uma cadela com endometrite: relato de Caso / Infectious endocarditis valvular in a dog with endometritis: case report

Objetiva-se relatar um caso de endocardite da válvula mitral em cadela da raça boxer, com seis anos de idade, que foi encaminhada ao HV da UFRPE. Durante o exame clínico o animal veio a óbito. Na necropsia notou-se no fígado um abscesso de três centímetros de diâmetro e no útero havia grande quantidade de material muco-purulento. No ventrículo esquerdo do coração percebiam-se várias formações de aspecto vegetativo aderidas à válvula mitral. À histopatologia evidenciou-se hiperplasia endometrial cística e endometrite purulenta. Nos fragmentos do coração constatou-se que as massas aderidas às válvulas eram constituídas por tecido conjuntivo frouxo, leucócitos, fibrina, debris celulares e sangue. Cultura da secreção uterina, do abscesso hepático e dos trombos valvulares revelou a presença de Staphylococcus sp. Os achados anatomo-histopatológicos e microbiológicos permitem concluir tratar-se de endocardite bacteriana valvular mitral vegetativa consequente a endometrite crônica.(AU)

The goal of this paper is present a case of mitral valve endocarditis in a 6-year-old female dog due chronic endometritis. The animal was guided to the Veterinary Hospital at Universidade Federal Rural de Pernambuco, Brazil, but the animal died during the physical examination. At the necropsy, a liver abscess, 3,0 cm in diameter, uterine with purulent content and some also vegetative formations adhered to the mitral valve were visually recognized in the left ventricle of the heart. Histopathologically, cystic endometrial hyperplasia (CEH), and purulent endometritis were observed. In the valves a mass adhered was present, which one was constituted by slack conjunctive tissue, leukocyte, fibrin, cellular scraps and blood. Uterine secretion, hepatic abscess content and the valvular clots culture revealed the presence of Staphylococcus sp. In conclusion, this case revealed the importance of the anatomohistopathological and microbiological diagnosis for the vegetative mitral valve endocarditis in dogs with endometritis.(AU)

Endocardite infecciosa valvular em uma cadela com endometrite: relato de Caso / Infectious endocarditis valvular in a dog with endometritis: case report

Objetiva-se relatar um caso de endocardite da válvula mitral em cadela da raça boxer, com seis anos de idade, que foi encaminhada ao HV da UFRPE. Durante o exame clínico o animal veio a óbito. Na necropsia notou-se no fígado um abscesso de três centímetros de diâmetro e no útero havia grande quantidade de material muco-purulento. No ventrículo esquerdo do coração percebiam-se várias formações de aspecto vegetativo aderidas à válvula mitral. À histopatologia evidenciou-se hiperplasia endometrial cística e endometrite purulenta. Nos fragmentos do coração constatou-se que as massas aderidas às válvulas eram constituídas por tecido conjuntivo frouxo, leucócitos, fibrina, debris celulares e sangue. Cultura da secreção uterina, do abscesso hepático e dos trombos valvulares revelou a presença de Staphylococcus sp. Os achados anatomo-histopatológicos e microbiológicos permitem concluir tratar-se de endocardite bacteriana valvular mitral vegetativa consequente a endometrite crônica.

The goal of this paper is present a case of mitral valve endocarditis in a 6-year-old female dog due chronic endometritis. The animal was guided to the Veterinary Hospital at Universidade Federal Rural de Pernambuco, Brazil, but the animal died during the physical examination. At the necropsy, a liver abscess, 3,0 cm in diameter, uterine with purulent content and some also vegetative formations adhered to the mitral valve were visually recognized in the left ventricle of the heart. Histopathologically, cystic endometrial hyperplasia (CEH), and purulent endometritis were observed. In the valves a mass adhered was present, which one was constituted by slack conjunctive tissue, leukocyte, fibrin, cellular scraps and blood. Uterine secretion, hepatic abscess content and the valvular clots culture revealed the presence of Staphylococcus sp. In conclusion, this case revealed the importance of the anatomohistopathological and microbiological diagnosis for the vegetative mitral valve endocarditis in dogs with endometritis.

Candida glabrata Septicemia in a Piglet / Candida glabrata Septicemia in a Piglet

Background: Candida organisms are ubiquitous pathogens that may cause mucosal or systemic infection in humans and animals. Candida albicans was the main Candida specie associated with cases of systemic candidosis, and Candida glabrata is the second most isolated in those cases. In animals there are few reports of candidosis. In pigs C. albicans was described as mucocutaneous disease affecting oral mucosa, esophagus and aglandular stomach of pigs affected by porcine circovirus type 2. Systemic invasion by Candida species in pigs is rare. This report describes the pathological changes observed in a case of systemic candidosis due to C. glabrata infection in a piglet. Case: In a nursery facility with 500 piglets a 47-days-old piglet showed lateral recumbency that progressed to inability to stand, paddling and death. In the necropsy it was observed valvular vegetative endocarditis in the left atrio-ventricular valve and in the kidneys multifocal to coalescing whitish foci in the sub-capsular and in the cut surface. Microscopical examination of the cerebral cortex, brain steam and cerebellum revealed multifocal random necrotic suppurative focci surrounded by mononuclear cells, epithelioid and multinucleated giant cells together with discret linfoplasmocitic meningitis. In the kidneys there was embolic suppurative nephritis with multifocal abscesses in renal parenchyma, characterized

Background: Candida organisms are ubiquitous pathogens that may cause mucosal or systemic infection in humans and animals. Candida albicans was the main Candida specie associated with cases of systemic candidosis, and Candida glabrata is the second most isolated in those cases. In animals there are few reports of candidosis. In pigs C. albicans was described as mucocutaneous disease affecting oral mucosa, esophagus and aglandular stomach of pigs affected by porcine circovirus type 2. Systemic invasion by Candida species in pigs is rare. This report describes the pathological changes observed in a case of systemic candidosis due to C. glabrata infection in a piglet. Case: In a nursery facility with 500 piglets a 47-days-old piglet showed lateral recumbency that progressed to inability to stand, paddling and death. In the necropsy it was observed valvular vegetative endocarditis in the left atrio-ventricular valve and in the kidneys multifocal to coalescing whitish foci in the sub-capsular and in the cut surface. Microscopical examination of the cerebral cortex, brain steam and cerebellum revealed multifocal random necrotic suppurative focci surrounded by mononuclear cells, epithelioid and multinucleated giant cells together with discret linfoplasmocitic meningitis. In the kidneys there was embolic suppurative nephritis with multifocal abscesses in renal parenchyma, characterized