Lower Aiways -dz

Question 1

What kind of bacteria from the oropharynx may proliferate In case of BACTERIAL PNEUNOMIA?

What kind of infections are also common (in addition to bacterial infections)?

Answer 1

G+ (like streptococcus equi subsp.)

G- (like pasteurella and actinobacillus spp.)

Anaerobic (fusobacterium spp. And bacterioides fragilis, peptostreptococcus anaerobicus)

In addition to bacterial infections, olymicrobic infections are also common!

Question 2

Bacterial pneumonia may develop after…..

Answer 2

Can happen after….

• Viral infections 🦠
• Athletic events 🐎
• Transportation 🚗
• General anesthesia 🏨

Question 3

What are other factors that can contribute to BACTERIAL PNEUMONIA developing?

Answer 3

Overcrowding 🐎🐎🐎🐎🐎

Poor nutrition 🍔

Exposure to COLD and WET weather 🥶 💦

Question 4

What kind of dysfunction in the horses body can lead to BACTERIAL PNEUMONIA?

Answer 4

Laryngeal AND pharyngeal dysfunction

- aspiration of oropharyngeal bacteria

Question 5

In case of Esophageal obstruction what can happen?

Answer 5

—->ASPIRATION PNEUMONIA

Question 6

Early clinical signs of bacterial pneumonia

Answer 6

Early:

gurgling sounds of exudates in trachea

Fever

Depression

Question 7

Clinics signs when bacterial pneumonia progresses

Answer 7

Intermittent fever

Tachypnea

MUCOPURULENT discharge

Coughing

Inappetence

Exercise intolerance

Weight loss

Question 8

Clinical findings in bacterial pneumonia

Answer 8

Harsh breath sounds dorsalky

Crackles wheezes and dullness centrally

Manipulation of trachea larynx can cause coughing

Halitosis — anaerobic infection

Mandibular lymphoadenopathy (strangles, Burak infection)

Question 9

Pleuropneumonia/ septic pleuritis aiheuttaa

Answer 9

Pneumonia or pulmonary abscessation

Thoracic trauma, Esophageal rupture, penetration of the esophagus/stomach by a foreign body

Question 10

Pleuropneumonia/ septic pleuritis what is most often isolated

Answer 10

Aerobes; streptococcus, pasteurella, actinobacillus, e. Coli and Enterobacter spp.

Anaerobes: bacterioides spp., peptostreptococcus spp., fusobacterium spp. And clostridium spp.

Question 11

Risk factors of Pleuropneumonia/ septic pleuritis are the same as in …

Answer 11

PNEUMONIA

Question 12

Other causative factors of Pleuropneumonia/ septic pleuritis

Pulmonary defense mechanisms ⬇️

Answer 12

• Bacterial contamination of the lower resp. Tract 🌪
• Extension of infectious process into the pleural space causes PLEURITIS 🚀
• PARENCHYMAL INFLAMMATION increases permeability of the capillaries in the visceral pleura 🦌——> FLUID ACCUMULATION (fluid has: PROTEIN🍗, cells 🔬 and bacteria 🧫)

Question 13

Pleuropneumonia/ septic pleuritis

Acute stage

Answer 13

• slight nasal discharge 👃 💦
• shallow breathing pattern🎙
• cough 🌬 🌬
• lethargic horse 🐴 💧
• painful and stilted gait 🐎 💊
• abnormal thoracic auscultation 👂🏻
  (Pleural friction rubs and ventral dullness if present)

Question 14

Pleuropneumonia/ septic pleuritis

Severe acute case

🆘🆘🆘🆘🆘🆘🆘

Answer 14

• nostrils flaring 👃 🌑🌑
• tachycardia ♥️
• jugular pulsations 💢
• toxic mucous membranes ♒️
• guarded and soft cough 🧸
• SEROSANGUINEOUS FETID discharge
  (Both blood and yellow fluid)

Question 15

What about chronic cases of Pleuropneumonia/ septic pleuritis

What symptoms?

Answer 15

+2weeka

• intermittent fever 🥵
• weight loss
• SUBSTERNAL AND LIMB EDEMA

Question 16

How to diagnose Pleuropneumonia/ septic pleuritis ?

Answer 16

• in thoracic auscultation
  dorsally - vesicular sounds 🐷
  Ventrally - NO LUNG SOUNDS
• thoracic percussion
  May elicit a painful response (pleurodynia)
• blood work!
• ULTRASOUND
  Free and loculated fluid, pleural thickening, abcesses in kings, consolidation of lungs, fluid in airways, fibrinous adhesions and concurrent pericarditis)

FLUID LOOKS ANECHOIC or HYPOECHOIC
🌑🌑🌑🌑🌑🌑🌑⚙️⚙️⚙️⚙️⚙️⚙️⚙️

• RADIOGRAPHY (abscess in pneumothorax)
  👹👹👹👹👹👹👹

Question 17

What blood finding you might have in pleuropneumonia/ septic pneumonia

Answer 17

• Bloods analysis

ACUTE
normal or toxemic leukogram 💀 and chemistry findings 🧪

CHRONIC
anemia, neutrophilia, hyperfibrinogenemia and hyperprotenimea

Question 18

Microbiology and cytology.

what to do in case of pleuropneumonia

Answer 18

Transtracheal aspiration -always

Pleural fluid aspirates via thorackcemtesis

Question 19

Pleuropneumonia findings in cytology

Answer 19

WBC and total protein 🔼
Glucose low (<40mg/dL)
May have odor (anaerobes)
- absence of odor does not preclude anaerobes

Question 20

What are the aims of treatment in pleuropneumonia

Answer 20

1. Remove fluid from pleura
   - ultrasound guidance
   - aseptically from 7. Or 8. Intercostal space
   - 24 to 32 -Fr chest tube
   - 30-40litres
2. Give systemic antimicbials go inhibit bacterial growth
   - based on sensitivity testing
   - penicillin +metronidazole +aminoglycosides/3gen-cephalosporins
   - 2-4mo. Until gaining weight, hematology okay and no evidence of resp tract dz
   - limited exercise and avoid stress also
3. Anti-inflammatory (flunixin meglumine) and analgesic drugs to prevent secondary problems
4. Supportive care