Infection of an equine placenta with a novel mycobacterial species leading to abortion.

A 25-year-old pregnant American Quarter Horse mare presented with a 1-week history of progressively worsening vaginal discharge. Transrectal ultrasound revealed increased thickness of the combined uterus and placenta with evidence of chorioallantoic edema but no placental separation. A thickened amnion was visible on transabdominal ultrasound. Abortion occurred 2 days after presentation despite medical treatment. At necropsy, the chorioallantois had variable but diffuse thickening with focally extensive browning of the chorionic surface in the right horn and adjacent body. There were fluid-filled sacculations on the allantoic surface of the umbilical cord, allantoamnion, and chorioallantois associated with diffuse perivascular fluid microscopically. A nonbranching acid-fast bacterium identified as belonging to the genus Mycobacterium Runyon group IV was isolated from the chorioallantois and uterine fluid. Ziehl-Neelsen stain confirmed the presence of intracellular acid-fast bacilli in trophoblasts of the gravid horn and the cervical star area. The current case is unique in that the mycobacteria did not initiate a significant granulomatous inflammatory response in the chorion unless villar necrosis occurred. Sequence analysis of the 16S ribosomal RNA gene and the rpoß gene, encoding the ß subunit of RNA polymerase, indicated that the strain of mycobacteria isolated in this case belonged to a novel species of rapidly growing mycobacteria and not to an established species. Mycobacteria are an uncommon and sporadic cause of placentitis and abortion, but should be suspected in cases of chronic placentitis that are not restricted to the cervical star area.

Nocardioform placentitis with isolation of Amycolatopsis spp in a Florida-bred mare.

CASE DESCRIPTION: A 4-year-old Thoroughbred mare was evaluated because of placental abnormalities and a retained placental remnant. CLINICAL FINDINGS: Microbial culture of the placenta yielded pure growth of Amycolatopsis spp. Histologic examination of the placenta revealed a focally expanding chorionitis with intralesional gram-positive filamentous bacilli and multifocal allantoic adenomatous hyperplasia on the apposing allantoic surface. TREATMENT AND OUTCOME: Treatment with lavage and oxytocin resulted in expulsion of the placental remnant within hours of parturition. The mare did not become pregnant again despite multiple breedings. The foal appeared healthy but died of complications during an elective surgical procedure at 7 weeks of age. CONCLUSIONS AND CLINICAL RELEVANCE: To the author's knowledge, all previously confirmed cases of nocardioform placentitis have been in mares bred in the central Kentucky region. Indications that the pathogen in the mare reported here is a different species than that isolated in Kentucky suggest that this is an emerging disease. Mares with nocardioform placentitis usually do not have the same clinical signs as mares with placentitis resulting from an ascending pathogen.