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Respiratory > Pathology and Microbiology > Flashcards

Pathology and Microbiology Flashcards

0
Q

What does chlamydophila cause most commonly?

A

conjunctivitis in cats (c. felis)
- nasal discharge
- progression to interstitial bronchopnumonia
> also abortion in sheep, bird disease, zoonotic

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1
Q

How can chlamydophila be detected?

A
  • ELISA for ag
  • PCR
  • Kosters of fluorescein-labelled ab
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2
Q

What does chlamydophila cause in the dog?

A
  • does not affect the dog
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3
Q

Is chlamydophila vax available?

A

Yes for cats - Fel-O-Vax 4 or 5

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4
Q

What type of bacteria is chlamydophila?

A
  • Gram -ve (outer membrane present)
  • INTRACELLULAR (people used to think was a virus)
  • No growth on lab media (need cells)
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5
Q

What do chlamydophila form during their lifecycle?

A
  • reticular bodies
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6
Q

What is the most common disease associated with mycoses?

A

Aspergillosis

- canine nasal aspergillosis

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7
Q

Why is dx of aspergillosis difficult?

A

The fungus is present everywhere! Bread, walls etc. so detecting the fungus does not indicate pathology associated
- compile radiology, endoscopy, serology, culture, microscopy

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8
Q

Tx of canine nasal aspergillosis?

A
  • surgical delivery of antifungal
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9
Q

Pathophysiology of nasal aspergillosis? DDx?

A
  • nasal turbinates progressively destroyed
  • chronic and granulomatous (and eosinophilic) inflammation
  • yellow-green mycotic exudate in the caudal nasal cavity
  • may be unilateral
    > Ddx nasal carcinoma
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10
Q

How can fungal infections be identified?

A 
Fungal hyphae stain
- PAS stain (pink)
- silver Grocott stain (black)
> asexual sporing heads seen on microscopy typical of aspergillosis 
> numerous fungal hyphae on histopath
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11
Q

Which dogs are predisposed to canine nasal aspergillosis?

A

GSD

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12
Q

What can be carried out to ensure tx will be effective? Common practice?

A
  • antifungal sensitivity testing

- rarely done!

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13
Q

Which viruses commonly affect the resp tract of sheep and cattle?

A
  • bovine herpesvirus
  • respiratory syncytial virus
  • bovine parainfluenza virus
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14
Q

Which bacteria commonly infect the respiratory tract of cattle and sheep?

A
  • manhaemia
  • pasturella
  • histophilus
  • mycobacterium
  • mycoplasma
  • actinomyces
  • actinobacillus
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15
Q

What factors may impact resp disease? What disease complexes are generally seen in diffreent species?

A
  • crowding
  • virus (usually inciting cause)
    -bacteria
  • stress
  • poor ventilation
    > porcine respiratoy disease complex
    > bovine/ovine respiratory disease complex
    > kennel cough
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16
Q

What is bovine respiratory disease complex (BRDC) also known as?

A

Shipping fever

Enzootic pnuemonia

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17
Q

Which pathogens are involved in BRDC?

A
  • PI3 (bovine parainfluenza virus)
  • RSV (respiratory syncytial virus)
  • IBR (bovine herpesvirus)
  • Mycoplasma bovis
    > followed by
  • pasturella multocida
  • mannhaimia haemolytica (used to be called pasturella or pasturellosis)
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18
Q

What does bovine herpesvirus cause?

A
  • infectious bovine rhinotracheitis (IBR)
  • red nose
    > URT infection
    > fibrinous laryngitis and tracheitis
    > intranuclear viral inclusions
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19
Q

Iss BHV (IBR) vaccine available?

A

YEs

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20
Q

What family is BRSV in?

A

Paramyxoviridae

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21
Q

What does BRSV cause?

A

(Bovine Respiratory Syncitial Virus)
- URT infections
- bronchitis/bronchiolitis sometimes
> syncitia formation and membrane formation to allow replication in cytoplasm and evade immune response

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22
Q

What family is bovine parainfluenza virus?

A

Paramyxoviridae

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23
Q

What is bovine parainfluenza virus also called?

A

parainfluenza 3 (PI3)

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24
Q

What does PI3 cause?

A

URT infections (mild)

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25
Q

Are vax available for PI3?

A

Yes

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26
Q

What diseases does manheimia haemolytica cause?

A
  • epizootic pneumonia in cattle “shipping fever” (bovine pneumonic pasteurellosis)
  • pasteurellosis in sheep
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27
Q

What is one sybtype of mainheimia haemolytica also called?

A
  • P. trehalosii
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28
Q

Is mannheimia haemolytica a commensal?

A

YES! NAsopharynx of ruminants

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29
Q

Gross path of manheimia haemoltica?

A

-Cranioventral lung consolidation
-fibrinosupparative effusion with neutrophils
- lots of yellowy fibrin indicates pasturella or manheimia!
> bronchopnumonia

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30
Q

What are the 2 main pathologic mechanisms of manheimia haemolytica?

A
  • lipopolysacharide

- leucotoxin

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31
Q

What are the 2 pathogens involved in 80% bovine respiratory diseases?

A
  • m. haemolytica

- p. multocida

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32
Q

What other pathologies may m. haemolytica and p. multocida cause?

A
  • meningitis and polyarthritis in 2-4mo calves
  • sporadic cases of peracute fatal mastitis in cow if suckling calves trasnfer organis
  • pasteurellosis in lambs septicaemia, severe pleuritis and pericarditis
  • mastitis (severe) insheep and goats
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33
Q

Can cattle develop natural protection against m. haemolytica?

A

Yes

- Abs against leukotoxin and capsular polysacharide

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34
Q

Are vax effective against m. haemolytica?

A
  • bacterins, leukotoxin: NO

- Iron restricted OMP in combination with leukotoxin: potentially effective (as express transferrin binding protein)

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35
Q

Where is histophilus somni a commensal?

A

genital tract

transient in upper respiratory tract

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36
Q

What does histophilus somni cause? Common disease?

A
  • peracute death in young calves
  • acute thromboembolic meningoencephalitis (will learn in neuro)
  • pneumonia
  • myocarditis
    > depending on where thromboemboli lodge
  • disease common in UK*
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37
Q

WHat type of bacteria causes TB?

A

Mycobacterium
- Gram + with mycolic acid protective coating
- hence “acid fast” and require ZN stain
> strict anaerobes, very slow growing
> resistant to drying and chemical agents
> virulent species fully resist intracellular killing

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38
Q

What 2 types of mycobacterium exist?

A

Pathogenic

Atypical environmental saprophytes

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39
Q

control of tb?

A

test and slaughter

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40
Q

Pathogenesis of bovine TB?

A
  • chronic eventually fatal pneumonia and wasting
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41
Q

where is tb commonest?

A

areas of intensive dairy practice

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42
Q

How is TB transmitted?

A
  • animal shedding into environment
    > “open case”
  • continuous shedding into the environment form lesions excreting to the exterior eg. kidney, udder, faeces, respiratory secretions
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43
Q

How is incidence of Tb changing?

A

Increasing in UK

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44
Q

Dx of bovine TB??

A
  • comp ID test by injection if PPD

- new methods eg. IFNg release form cultured bovine leucocytes on contact with PPD (looking at lymphocytes)

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45
Q

What is PPD?

A

Purified protein derivative

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46
Q

Gross path of bovine TB?

A
  • granulomatous pneumonia and lymphadenitis

- multifocal nodules have characteristic caseating cheesey cut surface

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47
Q

What immune cells are involved in TB pathophysiology?

A

Macrophages (NOT NEUTROPHILS!)

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48
Q

DO badgers definitely spread TB to cattle?

A

Not sure

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49
Q

Can dogs be infected with huga6mtgbTVNGBWI TBIJQ

A

YES
ACT AAS SENTINELS FOR OWNERS
NICE DOGS

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50
Q

on a scale of 1 to sexy how sexy is hannah?

A

pnoot

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51
Q

which strain of TB can infect widest range of hosts? (m. tuberculosis, m. bovis, m. avium)

A

M. bovis

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52
Q

What are the smallest living bacteria?

A

mycoplasma sp.

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53
Q

Where do mycoplasma sp. infect? Pathogenesis and implications on farm? What disease are they associated with?

A

Mucosal surfaces
- acquire host antigen to evade the immune response
- infection may depress performance and v growth/yield etc.
> associated with BRDC

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54
Q

Growth of mycoplasma - appearance and difficulty?

A
  • difficult to grow
  • fried egg appearance
  • no cell wall -> NOT susceptable to B-lactam ABx
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55
Q

What mycoplasma species affects cattle and what does it cause?

A
  • Mycoplasma Bovis [NB DO NOT CONFUSE WITH MYCOBACTERIUM BOVIS!!!!]
  • arthritis, mastitis, pneumonia
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56
Q

WHere are mycoplasma commensals?

A

respiratory tract

57
Q

Pathology of mycoplasma

A
  • CUffing pneumonia in calves
  • calf pneumonia complex
  • chronic, no necrosis
  • lymphoid follicles hyperplastic (BALT bronchial associated lymphoid tissue normally surrounds bronchioles)
  • > may lead to bronchiectasis and 2* atelectasis
  • do not kill animal*
58
Q

Gross and micro pathology of mycoplasma pneumoina?

A

> Gross
- progressive cranioventral consolidation
- cut surface exudate in main airways of affected lobules with thickening of surrounding connective tissue
Micro
- lymphoid nodules and follicles around airways (may compress bronchioles)
- mixed cellular exudate
- partial atelectasis
- slight thickening of alveolar walls with lymphocytes

59
Q

Which mycoplasma is notifiable?

A
  • m. mycoides mycoides
  • contagious pleuropneumonia
    > serious disease in asia, africa, s. europe
    > mortality ~50% in indiginous breed cattle
    > transmission by aerosol or close contact
    > similar disease in goats M. Capricolum
61
Q

Pathology of contagious pleuropneumonia (CBPP) M. Mycoides?

A
  • fibrino-necrotic bronchopneumonia with fibrinous pleuritis
  • dorsocaudal areas may be affected
  • interstitial septa markedly widened by fibrinous exudate and oedema, and often seen UNILATERALLY (pathonomonic)
  • necrotic areas encapsulated (sequestra)
  • WILL KILL ANIMALS*
62
Q

Which species of mycoplasma cause MINOR problems in sheep and goats?

A
  • M. ovipeumoniae (pneumonia)
  • M. capricolum (pneumonia)
  • M mycoides capri (pneumonia)
63
Q

3 main respiratory viruses of sheep? Are any vaccine licensed for these?

A
  • PI3 (parainfluenza virus) - occasionally causes pneumonia in lambs
  • RSV (respiratory syncitial virus)
  • adenoviruses (ovine and bovine)
    > may predispose to manheimia haemolytica infection as part of enzootic pneumonia complex
    > no vaccines licensed
64
Q

Which fungi are associated with resp disease in cattle and sheep?

A
  • aspergillus
  • micropolysporum
    > respiraotry allergy
    “farmer’s lung”
  • type 1: rhinitis and fungal astham, type 3: allergic alveolitis
  • may be chronic or acute
65
Q

Which bacteria are assocaited with respiratory disease in horses?

A
  • strep equi equi
  • rhodococcus
  • actinobacillus
  • mycoplasmas
66
Q

Which viruses are associated with respiratory disease in horses?

A
  • equine influenza virus

- equine herpes virus 1 and 4

67
Q

What type of bacteria is strep equi equi?

A
  • G+ obligate horse parasite, carried in nasopharynx without disease
  • lancefield group C
  • strongly b haemolytic with mucoid colonies, hyaluronic acid capsule
68
Q

What disease dows strep equi equi cause and what immunity is necessary to prevent it?

A

strangles

  • circulating Ab raised by infection or vaccination
  • muscoal immunity essential
69
Q

What drug is strep equi equi sensitive to?

A

Penicillin (but hard to peentrate abscesses with it!)

70
Q

pathology of strangles technically described as..

A

supparative lymphadenitis and gutteral pouch empyema

- may be termed gutteral pouch chondrosis as resembles cartilage

71
Q

Which vaccines are availble against strangles? Are they effective?

A 
> strepguard
- useless
> Equilis strep E
- live modified bacteria 
- effective but only for short lived mucosal immunity
72
Q

Is strep pneumoniae infection comon?

A

No

- may occassionaly cause resp disease in training horses

73
Q

What type of bacteria is rhodococcus equi? Where is it found?

A

G+ rod, variably acid fast

  • naturally present in soil and intestines of horses
  • persistent in manure for long periods of time
74
Q

Alternative name for rhodococcus equi?

A

Corynebacterium equi

75
Q

What disease does rhodococcus equi cause? What age horse is affected?

A
  • chronic supparative bronchopneumonia in foals 2-6mo

* adults are immune*

76
Q

Pathogenesis of rhodococcus equi? Prognosis?

A
  • resists host digestion by complex lipid cell wall,facultative intracellular replicating inside macrophages
  • > foci of caseous necoriss in lungs and sometimes bronchial LNs
  • lesions often extensive before clinical signs apparent
  • 40-80% mortality
  • spread to abdo organs can occour eg. liver and intestin, mesenteric LNs
  • Adults are immune*
77
Q

What do rhodococcus lesions appear similar to?

A

TB (horses much less suceptable to TB)

78
Q

What horses are affected by actinobacillus?

A

Adults esp TBs

79
Q

Which mycoplasma may be involved in equine resp disease?

A
  • M. felis relevant in pleuritis and predisposition to 2* infect
80
Q

How are influenza viruses classified?

A
  • haemaglutanin and neuraminidase eg. H7N7, H3N8 in horses
81
Q

What does EIV cause? (equine influenza virus)

A
  • URTI can spread to LRT -> bronchitis and bronchiolitis
  • cough, pyrexia, depression
  • 2* infection (strep, staph, klebsiella) most important to pathogenesis
82
Q

EIV vax available?

A
  • inactivated vaccine containing both H7N7 and H3N8 sybtypes but not effective against all strains
  • requirement for competing horses UK
83
Q

Which equine herpesviruses cause resp disesae? Clinical signs? What other signs may be seen with each?

A 
1 + abortion and paresis 
4 + mainly resp, most common
5 - equine multinodular pulmonary fibrosis NEW! 
> URTI 
> nasal discharge, coughing, pyrexia
84
Q

Vax available for EHV?

A
  • innactivated vax for EHV1 and EHV 4
85
Q

What fungus is associated with equine gutteral pouch mycoses?

A

aspergillus nidulans

86
Q

Clinical signs of gutteral pounch mycosis

A
  • severe epistaxis (internal carotid) v serious

- dysphagia (glossopharyngeal and vagus nn.)

87
Q

Diagnostics for investigating gutteral pouch mycosis?

A
  • endoscopy
  • radiography
  • serology
  • culture
  • microscpy
88
Q

Tx of gutteral pouch mycosis

A
  • Local delivery of antifungals
  • ligation of carotid
  • systematic azole antifungal
89
Q

Bacterial respiratory disease of pigs

A
  • bordatella/pasturella
  • actinobacillus
  • haemophilus
  • mycoplasmas
90
Q

Viral respiratory disease of pigs

A
  • porcine reproductive and respiratory sydrome virus (PRRSV)
  • swine influenza
  • porcine circovirus
91
Q

What causes atrophic rhinitis in pigs?

A

> early colonisation of nasal planum with

  • Bordatella Bronchiseptica (dermonecrotic toxin damages osteoblasts -> turbinate atrophy)
  • and Pasturella Multocida (osteolytic toxin stimulates osteoclasts -> atrophic rhinitis)
  • produce osteolytic toxin
  • > malformed twisted snout in growing pigs and ^ risk 2* disease
92
Q

Is atrophic rhinitis common?

A

Not any more (effective vax)

93
Q

What pathogen causes contagious pleurpneumonia?

A
  • actinobacillus pleuropneumoniae

- G- rod

94
Q

Pathogenesis of actinobacillus pleuropneumonia? Which species get this commonly?

A
  • acute/chronic fibrinohaemorrhagic/necrotic bronchopneumonia with pleuritis (pleurisy) and pleural adhesions due to fibrin deposition
  • all lung lobes (cranioventral distribution may not be evident similar to M. haemolytica in cattle)
  • intensive PIG production
  • worldwide distribution
  • high morbidity and mortality if newly introduced to the herd, progresses to chronic status with sporadic cases
  • subclinical carriers and recovered carriers with degrees of immunity
95
Q

Is fibrin deposition seen with mycoplasma?

A

only m. mycoides, otherwise no

96
Q

how is actinobacillus pleurppneumoniae grown in the lab? how many serotypes exist?

A
  • chocolate agar (NAD dependant)
  • waxy, sticky colonies, delicate G- organism
  • 15 serotypes
97
Q

pathogenicity factors of actinobacillus pleuropneumoniae?

A
  • apx toxins
  • capsule polysacharide
  • takes iron from porcine transferrin
    > pulmonary inflam stimulated -> haemorrhage and oedema
98
Q

Vax available for actinobacillus pleuropnuemoniae?

A
  • suvaxyn HPP no longer available

- porcillis APP no available in UK but effective

99
Q

Which pathogens can cause disease in high health status animals?

A
  • actinobacillus suis

- haemophilus parasuis

100
Q

Which pathogen causes glassers disease? Clinical signs?

A
  • haemophilus parasuis
  • multisystemic disease of pigs
  • polyserositis (pleuritis, pericarditis, peritonitis) meningitis, polyarthritis and supparative bronchopneumonia with fibrinous exudate in high health status animals
  • mortality high in young animals
101
Q

Predisposing factors for Glassers disease?

A
  • stress eg. mixing, weaning, adverse environmental conditions
102
Q

What does mycoplasma hyopneumoniae cause?

A
  • enzootic pneumonia (EP)
  • wipdespread and v common in young pigs
  • predisposes other resp disease
  • transmission by aerosol -> coughing -> resolves
103
Q

Pathology of mycoplasma hypopneumoniae infections in pigs

A
  • enzootic pneumonia
  • chronic, non-fatal disease unless 2* disease sets in
  • commonly seen at slaughter
  • v growth rate and coughing
    > cranioventral consolidation (apical and cardiac lobes,) red/grey discolouration, bronchopnuemonia
    > microscopic features similar to cuffing pneumonia in calves
104
Q

Is m. hyopneumoniae easy to culture? Alternative dx?

A

No difficult and slow

- serological dx by competition ELISA

105
Q

Vax for m. hyopneumoniae?

A

Yes, very efffective
- eg. Stellamune
Strategic medication is common

106
Q

Which other mycoplasmas may affect the pig and what do they cause?

A
  • m. hyosynoviae: arthritis

- m. hyorhinis: commonly found in resp tract, cause of polyserositis and arthritis

107
Q

What type of virus is PRRS?

A
  • arteriviridae
108
Q

PRRS clinical signs and pathogenesis?

A
  • URT, systemic spread in macrophages
  • resp signs, interstital pneumonia
  • frequently subclinical
  • predisposes/enhances effects of infection with other pathogens (eg. influenza, m. hyopneumoniae)
  • highly pathogenic varient recently emerged in E. Asia
109
Q

What is PRRS part of?

A

Porcine respiratory disease complex

110
Q

Clinical signs of swine influenza?

A
  • sudden outbreaks of respiratory disease
  • barking cough
  • resp disease
  • naive herds
  • bronchiolitis and pneumonia
    > if endemic in herds, weaned piglets develop clinical signs as soon as MDA wanes
111
Q

Is swine influenza a 1* pathogen?

A
  • 1* pathogen

- if endemic may also contribute to porcine respiratory disease complex

112
Q

Vaccines for swine influezna?

A

None licensed

113
Q

Why is swine influenza dangerous?

A

Zoonotic risk

114
Q

PAthogenesis of porcine circovirus?

A
  • immune suppressive
  • predisposes other infections
    > possible involvement in:
  • porcine respiratory disease complex
  • post weaning multisystemic wasting syndrome (PSWS)
  • porcine dermatitis and nephropathy sydrome (PDNS)
    = PCAD
115
Q

Vax for porcine circovirus?

116
Q

Where is bacteria normally present within the resp tract?

A

Upper only - lower should be sterile (bronchi onwards)

117
Q

BActeria normally present in URT…

A 
> strep (non-/a-/b- haemolytic)
-  pasteurella [b]
> staph (coag+/-) 
- E. COli
- Actinobacillus
- Proteus
- Bordatella
- Pseudomonas
- Neisseria
- Lactobacillus
- Clostridium
- Bacillus
- Mycoplasmas
- Chlamydophila 
> not exhaustive so many more too!!
118
Q

How does viral resp infection differ to bacterial?

A
  • viruses commonly spread URT -> LRT (bronchitis-bronchiolitis)
  • bacteria may preferentially infect LRT only
    > NB. all viruses predispose to 2* bacterial infections which may be more likely to cause morbitity
119
Q

How may infections be classified?

A
  • 1/2 (2* more important)

- pure/mixed

120
Q

Main pathogens causing resp disease in smallies?

A
  • Bordatella
  • Pasteurella
  • Actinomyces and nocardia (branching)
  • Chlamydophila
  • B Haemolytic strep (?)
  • Mycoplasmas
121
Q

4 species of Bordatella?

A
  • b. bronchiseptica
  • b. pertussis (whooping cough humans, NOT animals)
  • b. parapertussis (humans and sheep)
  • b. avium (coryza in turkeys, not UK)
122
Q

What type of bacteria is bordatella bronchiseptica? How is it spread?

A
  • strict aerobe
  • G- rod
  • slow growing
  • commensal of URT
    > endogenous/exogenous infection, survival outside host is poor
123
Q

What diseases is b. bronchiseptica associated with?

A
  • tracheaobronchitis (KC)

- bronchopneumonia following distemper infection (rarer now due to vax)

124
Q

Vax for b. bronchiseptica? Is this cross protective across strains?

A
  • Intrac (? efficacy)
  • Nobivac KC
    > all strains have same LPS so will cross protect after vax or infection
    > BUT NO VAX VERY EFFECTIVE
125
Q

Does b. bronchiseptica affect the cat? Vax?

A
  • yes, early exposure to kittens
  • link between b.b. and disease unclear
    > vax: Nobivac BB
126
Q

PAthogenesis of b. bronchiseptica?

A
  • initial trauma or viral infection
  • adherance to cilia
  • proliferation and toxin release -> irritation and coughing, destruction of inflam cells (leucocyte toxin)
  • epithelial necrosis
  • peribronchial inflammation and interstitial pneumonia with chronic infection (not true interstitial pneumonia)
  • severe pneumonia due to 2* pathogens eg. b-haemolytic strep s. zooepidemicus
127
Q

Distribution of pneumonia seen with b. bronchiseptica?

A
  • cranioventral
128
Q

What type of bacteria is pasteurella multocida?

A
  • G- rod
  • firms mucoid colonies
  • strong catarrhal smell
  • normal oral bacteria
  • > 2* infection in URTI and bite wounds
129
Q

Is vax against pasteurella multocida available?

A

No, not appropriate

- as noramly present in URT

130
Q

Pathogenesis of pasteurella multocida in dogs and cats

A
  • severe supparative pneumonia and pleuritis (pyothorax/empyema)
  • seen following cat bite wounds
  • important in MIXED infections eg. anaerobes like clostridia
131
Q

Does pasteurella multocida affect other species?

A
  • Rabbit snuffles (enzootic pasteurellosis)
  • endemic in rabbit population (often no clinical signs)
  • some rabbits not infected but difficult to eradicate disease as highly contagious
    > chronic nasal discharge and sneezing, epiphora, chronic supparative rhinitis and sinusitis, abscessates in lungs, sometimes fatal
    > colonises U/LRT, middle ear, sinuses, genitaloia, occasionally lungs (CILIOTROPIC)
132
Q

How may rabbit snuffles be controlled?

A
  • vax available but ineffective

- long term Abx (enrofloxacin) needed for control/eradication in an individual

133
Q

How does the physiology of a rabbit abscess differ from other animals?

A
  • have heterophils instead of neutrophils

- tend to form cottage cheese, dry abscesses (not watery pus)

134
Q

What type of bacteria is actinomyces viscosus?

A
  • G+, filamentous and branching
  • aerobic
  • commensal in oral cavity of dog
135
Q

What does actinomyces viscosus cause?

A
  • granulomatous thoracic infection in dogs
  • EXUDATE CONTAINING SULPHUR GRANULES!!
  • localised granulomatous abscesses of skin (chronic and progressive)
136
Q

What type of bacteria are nocardia spp? Pathogenesis?

A
  • G+ rods, short but filamentous
  • partially acid fast
  • growth within and destruction of macrophages
    > supparative chronic, progressive thoracic granulomas
137
Q

Which antimicrobials are nocardia spp. resistnat to?

A
  • penicillin and others

- need TMP, tetracycline, ampicillin prolonged use

138
Q

Where are actinomyces and nocardia found naturally?

139
Q

pathogenesis of nocardiosis?

A
  • red-brown exudate in pleural cavity (strawberry milkshake)
  • may form adhesions
  • EXUDATE CONTAINS SULPHUR GRANULES!!
    > yellow lumps, not actually sulphur
140
Q

What may nocardiosis be confused with?

A
  • tumour as causes a chronic wasting disease

Respiratory (18 decks)

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