Efficacy of clindamycin in the treatment of Staphylococcus aureus osteomyelitis in dogs

The efficacy of clindamycin in the treatment of experimentally induced, posttraumatic Staphylococcus aureus osteomyelitis was studied in dogs. At the end of the experiment, bacteria could not be isolated from bone marrow of 15 of 16 (93.7%) dogs treated with clindamycin, whereas bacteria could not be isolated from similar specimens obtained from 6 of 13 (46.1%) untreated dogs. None of the 16 dogs treated with clindamycin had histopathologic evidence of osteomyelitis at the end of the experiment. Five of the 13 untreated control dogs had histopathologic evidence of osteomyelitis. The recovery rate was 31% in untreated dogs, whereas 94% of dogs treated with clindamycin recovered from osteomyelitis. Clindamycin, 11 mg/kg of body weight, given orally, q 12 h, for 28 days, was efficacious in the treatment of experimentally induced, posttraumatic S aureus osteomyelitis in dogs.     

Suspected sphenoid bone osteomyelitis causing visual impairment in two dogs and one cat

Objective  To present the clinical and magnetic resonance imaging (MRI) characteristics of sphenoid bone osteomyelitis.
Procedures  Two dogs (English Springer Spaniel – ESS, Golden Retriever – GR) and one cat (Domestic Long Haired) were presented with a 2–14-day history of visual deficits and reduced pupillary light reflexes. Investigations included physical, ophthalmologic and neurological examination as well as hematology, serum biochemistry, MRI of the head and cerebrospinal fluid (CSF) analysis.
Results  MRI changes included thickening of the sphenoid bone and a loss of normal bone marrow signal on T1W MRI. Enhancement of the sphenoid bones, ventral meninges and ventral surface of the brain was present using paramagnetic contrast medium. CSF analysis was abnormal in the two dogs with increased cellularity, neutrophilic pleocytosis, intracellular bacteria and increased total protein in one, and with lymphocytic pleocytosis in another. CSF analysis was normal in the cat.
An underlying cause for the osteomyelitis could not be identified. The use of broad-spectrum antibiotics for 3–6 weeks combined with anti-inflammatory medications proved effective. Full clinical recovery occurred with no relapse during the follow up time of 7 (ESS) and 4 (Domestic Long Haired) years. The GR relapsed 10 months after treatment and recovered following a second 3-week course of broad-spectrum antibiotics with no relapse during the following 3 years.
Conclusion  Visual pathway deficits in dogs and cats may be due to sphenoid bone osteomyelitis. MRI and CSF analysis can assist diagnosing this potentially treatable condition. To the authors' knowledge this is the first report of sphenoid bone osteomyelitis in these species.     

BONE INFECTION IN THE BOVINE APPENDICULAR SKELETON: A CLINICAL, RADIOGRAPHIC, AND EXPERIMENTAL STUDY

Four hundred and forty-five bovines with bone infection of the appendicular skeleton were selected for clinical and radiographic assessment. A distinction was made between hematogenous and post-traumatic origin (wound/fracture). Bone infection was classified into four types according to the site of infection: type 1 is metaphyseal and/or epiphyseal osteomyelitis close to the growth plate; type 2 is primary subchondral osteomyelitis mostly accompanied by septic arthritis; type 3 is infectious osteoarthritis with subchondral osteomyelitis implicating that infection in the subchondral bone originates from the infection. Type 4 summarizes bone infections which can not be categorized in the previous groups. Hematogenous osteomyelitis is 3.2 times more frequent than post-traumatic osteomyelitis. Within the different groups, the relation of hematogenous to post-traumatic infection changed significantly. In type 1 infection the ratio was 5/1, in type 2 the ratio was 8/1 and in type 3 it was 3/1. Epiphyseal or metaphyseal osteomyelitis exhibited early radiographic bone changes, whereas with infection eminating from the joint, the bone lesions were detected later, because the bone was infected as a consequence of a primary septic arthritis. In smaller bones, severe and complete bone destruction was often present. Hematogenous bone infection never involved the entire diaphysis. Actinomyces pyogenes was discovered to be the main etiologic agent, whether or not combined with anaerobes. Bone fragments from the metaphysis of young calves were subjected to the effect of pure cultures of different bacteria. Radiographic changes to the structure of the bone were not identified within 2 weeks. Rapid radiographic changes in osteomyelitis cannot be explained by the direct effect of the bacteria on bone tissue in vivo. General infections of the lungs, disorders of the intestines and other internal organs were rarely responsible for osteomyelitis or septic arthritis. Osteomyelitis and infectious osteoarthritis is probably often induced by external and internal traumatic events to joints and bones in cattle.     

Neutropenia with a probable hereditary basis in Border Collies

This paper documents a disease of Border Collies characterised by chronic neutropenia which probably resulted in recurrent bacterial infections manifesting as osteomyelitis and sometimes gastroenteritis. The neutropenia occurred despite hyperplasia of the myeloid cells in the bone marrow and a shift to the right in myeloid cell maturation. The underlying defect is currently unknown but may result from the inability of neutrophils to escape from the bone marrow into the peripheral circulation. Necrosis and new bone formation commonly involved the metaphyseal regions of long bones. Other findings included a fasting hypercholesterolaemia and the occasional presence of nucleated red blood cells in circulation, despite a non-regenerative anaemia. An autosomal recessive mode of inheritance is suspected. This condition has some features of a rare human disease called myelokathexis which is also believed to have in autosomal recessive mode of inheritance.     

Neutropenia associated with osteomyelitis due to Hepatozoon canis infection in a dog

A 4-year-old, intact male Shiba dog was referred to Yamaguchi University Animal Medical Center, Yamaguchi, Japan, for the following complaints: anorexia, lethargy, intermittent fever, gingival bleeding and abdominal purpura. The dog presented with persistent neutropenia. Histopathological examination of a bone marrow sample revealed round to oval structures that resembled Hepatozoon micromerozoites and formed a "wheel-spoke" pattern. Furthermore, mature neutrophils were observed around these structures. PCR and sequencing using bone marrow aspirate confirmed Hepatozoon canis (H. canis) infection. These findings suggest that the neutropenia observed in this case was associated with osteomyelitis due to H. canis infection. This is the first report of neutropenia associated with H. canis infection. H. canis infection can be included in the differential diagnosis in canine cases of neutropenia in areas where the disease is endemic.     

Diffuse osteomyelitis of the fourth metacarpal bone in a horse caused by Clostridium perfringens

Osteomyelitis in adult horses, often associated with trauma or iatrogenic infection following surgery, usually presents as a focal area of infected bone. Diffuse osteomyelitis, affecting both the cortex and medulla, along the full length of a bone is encountered less frequently and treatment of such infections is not well reported in horses. The 2-year-old Warmblood mare in this case was diagnosed with diffuse osteomyelitis affecting the 4th metacarpal bone with concurrent unicortical fracture of the third metacarpal bone following traumatic injury. Computed tomography (CT) aided diagnosis in this case, providing critical additional detail to that obtained with radiography and ultrasound. This case highlights the value of CT in the diagnosis of diffuse osteomyelitis. This is the first reported case of diffuse osteomyelitis caused by Clostridium perfringens in horses. Successful treatment in this case consisted of surgical debridement of the associated abscess, followed by systemic and locoregional antimicrobial therapies.     

Detection of Leishmania infantum DNA by real-time PCR in saliva of dogs

This study developed a real-time quantitative PCR (qPCR) assay to detect L. infantum kinetoplast DNA (kDNA) in canine saliva. The qPCR showed an efficiency of 93.8%, a coefficient of correlation of 0.996 and a detection limit of 0.5 fg/reaction (0.005 parasites), although it detected until 0.25 fg/reaction (0.0025 parasites). When samples from 12 dogs experimentally infected with L. infantum were collected, L. infantum kDNA was detected at 16-weeks post-infection (wpi) in 41.7% and 91.7% of saliva and bone marrow samples, respectively, and at 47-wpi in 75% of both samples. L. infantum kDNA can be detected by qPCR in canine saliva, with lower sensitivity in the early stages of infection and a lower parasite load estimation compared to bone marrow. However, saliva had similar sensitivities to bone marrow in the later stages of the infection and could be used to detect L. infantum kDNA being aware of its limitations.     

Review on skeletal disorders caused by Staphylococcus spp. in poultry

Lameness or leg weakness is the main cause of poor poultry welfare and serious economic losses in meat-type poultry production worldwide. Disorders related to the legs are often associated with multifactorial aetiology which makes diagnosis and proper treatment difficult. Among the infectious agents, bacteria of genus Staphylococcus are one of the most common causes of bone infections in poultry and are some of the oldest bacterial infections described in poultry. Staphylococci readily infect bones and joints and are associated with bacterial chondronecrosis with osteomyelitis (BCO), spondylitis, arthritis, tendinitis, tenosynovitis, osteomyelitis, turkey osteomyelitis complex (TOC), bumblefoot, dyschondroplasia with osteomyelitis and amyloid arthropathy. Overall, 61 staphylococcal species have been described so far, and 56% of them (34/61) have been isolated from clinical cases in poultry. Although Staphylococcus aureus is the principal cause of poultry staphylococcosis, other Staphylococcus species, such as S. agnetis, S. cohnii, S. epidermidis, S. hyicus, S. simulans, have also been isolated from skeletal lesions. Antimicrobial treatment of staphylococcosis is usually ineffective due to the location and type of lesion, as well as the possible occurrence of multidrug-resistant strains. Increasing demand for antibiotic-free farming has contributed to the use of alternatives to antibiotics. Other prevention methods, such as better management strategies, early feed restriction or use of slow growing broilers should be implemented to avoid rapid growth rate, which is associated with locomotor problems. This review aims to summarise and address current knowledge on skeletal disorders associated with Staphylococcus spp. infection in poultry.     

Use of a commercial methylcellulose medium with and without recombinant bovine granulocyte colony-stimulating factor for culturing bovine bone marrow cells

A commercial methylcellulose culture medium, with and without the addition of recombinant bovine granulocyte colony-stimulating factor (rbG-CSF), was utilized for culturing bovine bone marrow cells in a colony-forming unit assay. Bone marrow mononuclear cells were isolated and cultured in a commercial methylcellulose-based medium containing several recombinant human cytokines. Cultures were prepared with and without 100 ng/mL of rbG-CSF. The size and mean number of colonies per plate from culture days 3 to 9 were compared. We concluded that bovine bone marrow colony growth was supported by this culture medium. The addition of rbG-CSF yielded larger and more numerous colonies. There were significantly more colonies on day 3 (P < 0.001), day 4 (P < 0.001), and day 5 (P = 0.03) with rbG-CSF. Both culture media had the highest colony counts on day 5.     

Cervical vertebral osteomyelitis in a 4‐month‐old foal

Vertebral body osteomyelitis in the cervical spine secondary to Rhodococcus equi has been treated both medically and surgically. This Case Report describes a 4‐month‐old foal exhibiting severe neurological signs from R. equi vertebral body osteomyelitis. Rapid, significant resolvement of neurological signs was noted in this case with surgical debridement and use of synthetic bone filler. The outcome suggests that aggressive surgical therapy in conjunction with synthetic allograft may be indicated in treatment of cervical vertebral body osteomyelitis.     

PUNCTURE WOUNDS INTO THE NAVICULAR BURSA OF THE HORSE

Radiography was used to evaluate 32 horses presented for puncture wounds into the navicular bursa. At the initial radiographic examination, 21 horses had no radiographic signs of osteomyelitis, while 11 did. The mean-time interval between injury and radiographic examination was 20.6 days for horses without evidence of osteomyelitis and 59.3 days for those with evidence of osteomyelitis. Radiographic signs of osteomyelitis of the navicular bone included flexor cortical destruction and irregularity of the flexor surface. Other abnormalities included pathologic fracture of the navicular bone, subluxation of the distal interphalangeal joint, or secondary joint disease. The lateromedial and palmaroproximal-palmarodistal oblique projections were most useful for identifying abnormalities of the navicular bone. There was a high correlation between horses that had positive presurgical radiographic signs and surgical findings. However, approximately 50% of horses that had negative radiographic findings initially had positive surgical findings. Ten of 21 horses with negative radiographic findings on initial examination had evidence of bony lesions when reevaluated from 3 weeks to 6 years later. Nine of 11 horses with radiographic signs of osteomyelitis on initial radiographic examination were euthanatized or had an unsatisfactory outcome. Seven of 10 horses with radiographic signs on reexamination were euthanatized. Thirteen of 20 horses with positive surgical findings for navicular bone infection were euthanatized or had an unsatisfactory outcome.     

Use of cancellous bone graft in treatment of navicular bone osteomyelitis in a foal

A 3-month-old Quarter Horse filly stepped on a fence staple and developed navicular bone osteomyelitis of the right hindfoot. A 1.5-cm spherical portion of medullary cavity containing purulent material was debrided and flushed with 0.9% NaCl solution. Cancellous bone was collected from a caudal sternebra and placed into the defect. The solar defect had filled with granulation tissue and was epithelialized 6 weeks after surgery. At 6-month follow-up evaluation, the navicular bone defect had healed and the foal was sound on the limb. Cancellous bone grafting may have merit for the treatment of navicular bone osteomyelitis in the horse.     

The radioprotective effects of the hexane and ethyl acetate extracts of Callophyllis japonica in mice that undergo whole body irradiation

The radioprotective activity of extracts from the red seaweed Callophyllis (C.) japonica was investigated in mice that underwent whole-body exposure to gamma radiation. A methanol extract of C. japonica and its fractions [hexane, ethyl acetate (EtOAc), butanol and the remaining H₂O] were used. Each fraction (100 mg/kg body weight) was administered intraperitoneally (i.p.) 2 times into the BALB/c mice, once at 1 and once at 24 h before exposure to 9 Gray (Gy) of gamma radiation. Pre-irradiation administration of the hexane and EtOAc fractions saved the mice, with their survival rates being greater than 80% at 30 days post-irradiation; the mice that were pretreated with the other fractions showed survival rates lower than 20% over the same time period. To examine the effect of each C. japonica fraction on the survival of intestinal and bone marrow stem cells, the number of intestinal crypts and bone marrow cells in the gamma-irradiated mice were examined. Pre-treatment of mice (i.p., 100 mg/kg body weight at 1 and 24 h before irradiation) with the hexane or EtOAc fraction prior to 6-Gy irradiation significantly protected the number of jejunal crypts and bone marrow cells at 9 days after irradiation. These findings suggest that certain extracts from C. japonica, when they are administered prior to irradiation, play an important role in the survival of irradiated mice, and this is possibly due to the extracts protecting the hematopoietic cells and intestinal stem cells against gamma irradiation.     

MESENTERIC HETEROTOPIC OSSIFICANS IN A FERRET (MUSTELA PUTORIUS FURO): A RARE CAUSE OF SOFT TISSUE OSSIFICATION

Heterotopic ossification (HO) is a rare condition characterized by abnormal bone production in soft tissue. Very few cases of HO have been reported in animals (e.g., dogs and horses) and this disease process is often a consequence of a traumatic incident. A 5-year-old, male European ferret (Mustela putorius furo) was referred for anorexia, generalized weakness, and weight loss. Clinical examination revealed multiple abdominal masses. An explorative laparotomy identified omental, white/tan, nodular to coalescing hard lesions. The omentum and spleen were surgically removed during the surgical procedure, with both subsequently submitted for histopathologic evaluation. Microscopically, the omental masses were composed of a meshwork of lamellar and woven bone admixed with islands of cartilage and lacunae containing either blood, fat, and/or bone marrow. Multifocal mineralization and bone lamellae were also present in the grossly normal omentum. The finding of multiple bone nodules containing bone marrow and/or adipose tissue, with no Harversian system, and minimal intratrabecular connective tissue favored a diagnosis of HO.     

FEMORAL OSTEOMYELITIS AND OSTEOSARCOMA IN A DOG

An eight-year-old, female, spayed Golden Retriever was referred to the University of Missouri Veterinary Teaching Hospital for a persistent lameness of 9 days duration. The initial diagnosis made by cytology and culture was Clostridium spp osteomyelitis of the right femoral head and neck. After approximately 1 month of treatment with ampicillin, it was noted radiographically that the lesion was progressing. An excision arthroplasty was done. Histological examination of the surgical specimen revealed osteogenic sarcoma. This case documents the importance of bone biopsy in differentiating osteomyelitis from a primary bone tumor.     

Porcine circovirus type 2 in muscle and bone marrow is infectious and transmissible to naïve pigs by oral consumption

Pork products are a possible source of introduction of PCV2 isolates into a pig population. However, limited work has been done on the transmission through meat of porcine circovirus type 2 (PCV2), a virus associated with several disease syndromes in pigs. The objectives of this study were to determine if pork products from PCV2-infected pigs contain PCV2 DNA/antigen and to determine if the PCV2 present in the tissues is infectious by performing in vitro and in vivo studies. Skeletal muscle, bone marrow, and lymphoid tissues from pigs experimentally inoculated with PCV2 were collected 14 days post-inoculation (DPI). The tissues were tested for presence of PCV2 DNA by quantitative real-time PCR, for PCV2 antigen by immunohistochemistry (IHC), and for presence of infectious PCV2 by virus isolation and inoculation of PCV2 naïve pigs. Lymphoid tissues contained the highest amount of PCV2 (positive by PCR, IHC, and virus isolation), bone marrow contained a lower amount of PCV2 (positive by PCR and IHC but negative by virus isolation), and skeletal muscle contained the lowest amount of PCV2 (positive by PCR but negative by IHC and virus isolation). Naïve pigs fed for three consecutive days with either skeletal muscle, bone marrow, or lymphoid tissues all became PCV2 viremic as determined by quantitative real-time PCR on serum starting at 7 DPI. The pigs also seroconverted to PCV2 as determined by PCV2 IgM and IgG ELISA. In addition, PCV2 antigen was detected by IHC stains in lymphoid tissues and intestines collected from the majority of these pigs. Results from this study indicate that uncooked PCV2 DNA positive lymphoid tissues, bone marrow, and skeletal muscle from PCV2 viremic pigs contain sufficient amount of infectious PCV2 to infect naïve pigs by the oral route.     

Retrospective study of 108 foals with septic osteomyelitis

Objective   To determine the clinical characteristics, short-term outcome and future athletic performance of foals with septic osteomyelitis.
Design   Retrospective clinical study of 108 Thoroughbred foals with radiographic evidence of bone infection that were presented at the Scone Veterinary Hospital between August 1995 and December 2001. Medical records were reviewed and information concerning signalment, the clinical, laboratory and radiographic findings, treatment and outcome was obtained. Racing records were obtained and evaluated for surviving foals that had reached racing age.
Results   Mean age of foals at initial evaluation was 39 days (range 1–180 days); 21 foals had multiple radiographic bone lesions (19.4%), and 76 had concurrent septic arthritis (70.4%). The most frequently affected bones were the femur, tibia and distal phalanx. In total, 87 foals were discharged from the hospital (80.6%), 79 survived long-term to reach racing age and 52 raced (65.8%). Overall, 48% (52/108) of the foals treated for osteomyelitis raced. Foals less than 30 days of age at the time of diagnosis, critically ill foals and those with multiple bones or joints affected were significantly less likely to be discharged from hospital. Multiple septic joints, but not multiple bone involvement, had an unfavourable prognosis for racing.
Conclusions   The prognosis for survival of foals with septic osteomyelitis or osteitis is favourable. Multiple bone or joint involvement is an important short-term prognostic indicator; however, the involvement of multiple joints, but not multiple infected bones, is associated with an unfavourable prognosis for racing.     

Q fever osteomyelitis: a case report and literature review

Q fever is a worldwide zoonosis caused by Coxiella burnetii. The clinical manifestations of Q fever include endocarditis, pneumonitis and hepatitis. Disease awareness and evolving diagnostic tests have enabled the recognition of unusual manifestations of Q fever. We report a case of Q fever osteomyelitis. A 51-year-old patient was admitted to hospital because of fever, leg weakness, and asthenia. His past medical history included surgery and a bone graft for the treatment of a giant cell tumor on the distal part of the femur. Blood and bone biopsy cultures were negative. Bone histological examination was consistent with a sub-acute or chronic inflammatory reaction that involved foci of epithelioid and gigantocellular infiltrates and necrosis. Serology testing revealed high antibody titers to C. burnetii antigens (phase I: IgG 3200; IgA 200; phase II: IgG 6400; IgA 400), which is indicative of chronic Q fever. The specific Polymerase Chain Reaction (PCR) of the abscess sample from the femoral region was positive for C. burnetii. The patient was treated for chronic Q fever with doxycycline and hydroxychloroquine for 18 months and recovered gradually without recurrence of pain or functional impairment. Q fever osteomyelitis is a rare and most likely underestimated disease. Epithelioid and gigantocellular granulomatous osteomyelitis in the context of culture-negative bone specimens should raise suspicion of Q fever. Serological tests, specific PCR and cell culture can provide evidence of a C. burnetii infection. Although bone diffusion may be a concern, the currently recommended treatment for Q fever was effective in this case.     

Actinomyces as a Cause of Osteomyelitis of the Nasofrontal Suture in a Gelding

A 7-year-old American Quarter Horse gelding was referred to the JT Vaughan Large Animal Teaching Hospital at Auburn University, College of Veterinary Medicine, for an investigation of a recurrent swelling of the nasofrontal region. Computed tomography examination of the skull was most consistent with a sequestrum of the left nasofrontal suture with associated focal osteomyelitis and left conchofrontal sinusitis. Surgery to remove the sequestrum, debride the devitalized bone, and flush the left conchofrontal sinus was performed. A microbial culture was obtained at the time of surgery, which yielded a mixed heavy growth of an Actinomyces species. Quantitative PCR indicated a species with 93% resemblance to Actinomyces funkei. A treatment course of two weeks of oral chloramphenicol was prescribed. At three-month follow-up, the owner reported resolution of the swelling.