RESUMEN
OBJECTIVE: To evaluate the clinical and histopathological features of a case of xanthogranulomatous keratitis in a mixed-breed dog. ANIMAL: Mixed-breed dog. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: An 11-year-old spayed female mixed-breed dog was presented for mild blepharospasm, corneal cloudiness, and increasing conjunctival hyperemia OD. Ophthalmic examination revealed multifocal pink and cream-colored consolidated corneal infiltrative lesions and generalized neovascularization with suspected diagnosis of stromal abscessation. There was no improvement after 1 month of medical management, so a keratectomy was performed, and corneal tissue was sent for histopathological evaluation. TREATMENT AND OUTCOME: The nonulcerative keratitis was refractive to medical management including topical and systemic antibiotics, topical antifungal, and systemic anti-inflammatory, so keratectomy was performed. Histopathologic diagnosis of xanthogranulomatous keratitis was made 1 week postoperatively. The patient was prescribed 0.05% difluprednate ophthalmic emulsion and 0.2% tacrolimus ophthalmic ointment (initially q 8 h, OD). The difluprednate was tapered and discontinued after 2 months, but the tacrolimus was continued (q 12 h, OD). No lesion recurrence had been documented 1 year postoperatively. CLINICAL RELEVANCE: There has been little published on canine xanthogranulomas, especially in veterinary ophthalmology. Ocular xanthogranulomas have been reportedly found intraocularly and at the ocular surface. Histologically, they are characterized by well-delineated nodules that contain histiocytes and abundant lipid-laden macrophages. The treatment in this clinical case was surgical excision followed with topical immunosuppression/anti-inflammatory therapy with no recurrence 1 year postoperatively. Xanthogranulomatous keratitis should be an added differential diagnosis when nonulcerative keratitis is found on examination, specifically with consolidated, corneal infiltrate and minimal pain.
Asunto(s)
Enfermedades de la Córnea , Enfermedades de los Perros , Queratitis , Animales , Perros , Femenino , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Córnea/patología , Enfermedades de la Córnea/veterinaria , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/cirugía , Enfermedades de los Perros/tratamiento farmacológico , Queratitis/diagnóstico , Queratitis/veterinaria , Queratitis/tratamiento farmacológico , Tacrolimus/uso terapéuticoRESUMEN
OBJECTIVE: To describe common bacterial organisms cultured from retrobulbar cellulitis and abscess lesions, in vitro susceptibility patterns, common diagnostic techniques utilized, etiologies encountered, and prevalence of blindness. ANIMALS STUDIED: Thirty-eight dogs diagnosed with retrobulbar cellulitis or abscessation from 2007 to 2017. PROCEDURE: For cases of orbital cellulitis or abscess, signalment, orbital imaging, cytology, histopathology, bacterial culture and susceptibility testing, presence of vision at the initial examination and resolution, and presumed cellulitis/abscess etiology were recorded. RESULTS: Most cases were medically (78.9%) versus surgically managed (18.4%). Most common form of orbital imaging was computed tomography (48.5%) followed by ocular ultrasound (18.2%). Fifteen of eighteen cultures (83.3%) showed growth of aerobic bacterial organisms, anaerobic bacterial organisms, or both. Most common aerobic bacteria were gram-negative bacilli (40.0%) followed by Corynebacterium sp. (26.7%) and α-hemolytic Streptococci sp. (26.7%) but Micrococcus and Bacillus spp. were also identified. Most common anaerobic bacteria were gram-negative bacilli (40.0%). Antibiotics with highest susceptibility patterns included gentamicin, followed equally by amoxicillin/clavulanic acid, cephalothin, chloramphenicol, and imipenem. No bacteria were susceptible to cefovecin. Six cases presented with vision loss due to retrobulbar disease (15.8%). Idiopathic (50%) disease and tooth root abscessation (23.7%) were most commonly diagnosed cause of orbital disease. CONCLUSION: Retrobulbar cellulitis/abscess is a serious and vision-threatening process, which can be effectively managed by broad-spectrum antibiotics such as gentamicin or amoxicillin/clavulanic acid, but not cefovecin. This study identified three organisms that have not been previously reported to be associated with orbital cellulitis (Corynebacterium sp., Bacillus sp. and Micrococcus sp.).