Halicephalobus gingivalis encephalomyelitis in a horse

An 8-year-old, Arabian mare presented with acute progressive ataxia and a firm swelling over the right mandible. Radiographs revealed multiple radiolucent areas on the mandibles. The mare's neurological signs progressed, she was consequently euthanized. Postmortem examination revealed mandibular granulomatous reactions and meningoencephalitis due to the nematode Halicephalobus gingivalis.     

Unsuccessful treatment of a horse with mandibular granulomatous osteomyelitis due to Halicephalobus gingivalis

An 8-year-old horse was presented with a submandibular swelling. Biopsy of the lesion indicated granulomatous osteomyelitis due to Halicephalobus gingivalis. In the absence of evidence of involvement of the central nervous system at the time of diagnosis, the horse was treated with ivermectin. Unfortunately, the horse did not survive.     

Treatment of a granuloma caused by Halicephalobus gingivalis in a horse.

A 12-year-old Arabian gelding with a granuloma caused by the nematode Halicephalobus gingivalis caudal and dorsal to the left orbit was examined. There was no evidence of dissemination of the nematode to the kidneys or the CNS, and the horse was treated with ivermectin (1.2 mg/kg [0.55 mg/lb] of body weight, p.o., every 2 weeks for 3 treatments). The granuloma was surgically debulked 2 days after the first dose of ivermectin. The granuloma resolved with no evidence of nematode infection after 18 months. Halicephalobus gingivalis is a ubiquitous saprophytic nematode that has been reported to infect humans and horses. The nematode may form granulomas in the integument or may disseminate to various organs with a tropism for the CNS and kidneys. Once clinical signs of CNS involvement develop, the disease is rapidly fatal.     

Haemoabdomen secondary to granulomatous periarteritis due to parasitism with Halicephalobus gingivalis in a mare

A 22‐year‐old Quarter Horse mare exhibited neurological signs consisting of head pressing, central blindness, minimal ataxia and dysphagia. Despite treatment, the mare collapsed and died shortly after onset of signs. On necropsy, there were approximately 15 l of free blood in the abdominal cavity. A 12 × 4 cm diameter, irregularly‐shaped, nodular, firm, tan/yellow mass was found adhered to the outer surface of the right lateral aspect of the caudal abdominal aorta. A similar mass also affected the caudal aspect of the right kidney. Histopathology of the aortic and renal masses revealed multiple coalescing granulomas containing intralesional nematodes compatible with Halicephalobus gingivalis. Inflammatory cells disrupted the aortic tunica adventitia as well as the outer tunica media. Similar exudate also affected the cerebrum, cerebellum and brainstem. Polymerase chain reaction amplification and sequencing of a portion of the large subunit ribosomal ribonucleic acid gene were performed using previously published primers for H. gingivalis to confirm the identity of the nematode. Although rupture of a blood vessel could not be demonstrated grossly, the histological findings suggest that inflammation may have breached a small calibre artery and caused the haemoabdomen.     

Halicephalobus gingivalis infection in a 5-year-old Tinker gelding

A 5-year old Tinker gelding was referred to the Department of Equine Sciences with a left eye uveitis and fever. At presentation the horse showed a mild lethargy, fever and decreased vision of the left eye. Rectal examination revealed an enlarged left kidney, with a hard and an irregular surface. The cranial mesentery artery had an enlarged and irregular aspect. Blood analysis showed anaemia, leucocytosis, increased blood urea nitrogen and creatinine and a hyperproteinemia. Urine analysis repeatedly showed a marked proteinuria and an increased gammaGT/creatinine ratio. The amount of abdominal fluid was slightly increased. However, the aspect, amount of cells and protein were normal. In the following two days the fever persisted and the horse showed anorexia and severe neurological signs. The horse was euthanized with permission of the owner. Post mortem examination showed a generalized parasitic infestation of Halicephalobus gingivalis in the uvea of the left eye, the kidneys and the central nerve system.     

The distribution pattern of Halicephalobus gingivalis in a horse is suggestive of a haematogenous spread of the nematode

The majority of Halicephalobus gingivalis-infections in horses have been fatal and are usually not diagnosed before necropsy. Therefore, knowledge about the nematode and the pathogenesis of infection in horses is limited. This has resulted in an on-going discussion about the port of entry and subsequent dissemination of H. gingivalis within the host. The present case of H. gingivalis-infection in a horse was diagnosed ante mortem. Post mortem findings, the distribution pattern of H. gingivalis nematodes in the brain, a high prevalence of inflammation in close relation to blood vessels, and the presence of the nematode in multiple organs with a disseminated pattern of distribution strongly suggested a haematogenous spread of the nematode in the horse.     

Granulomatous nephritis and meningoencephalomyelitis caused by Halicephalobus gingivalis in a pony gelding

A ten-year-old Shetland pony gelding showed low appetite, ataxia, peculiar swaying, clouding of consciousness, and ultimately died. At necropsy, multiple coalescing granulomatous foci were detected in the kidneys, and small necrotic lesions were found in the cerebellum. Histologic examination of the renal tissue sections revealed extensive granuloma, and Halicephalobus gingivalis-like nematodes were seen. Similar nematodes were found in the granulomatous or necrotic lesions of the renal lymph nodes and cerebellum, and were also frequently detected in cerebrospinal meningovascular lesions. Morphologic features together with partial ribosomal RNA gene sequences of the nematodes in the lesions revealed that they were H. gingivalis. The present results indicated that H. gingivalis caused granulomatous nephritis and meningoencephalomyelitis in this pony gelding.     

A nodular granulomatous posthitis caused by Halicephalobus sp. in a horse

This report describes a case of nodular posthitis caused by Halicephalobus gingivalis in a 24-year-old warmblood horse. Macroscopic examination revealed a multinodular, partially ulcerated mass on the external lamina of the prepuce. Nematode migration from unfixed biopsy material in phosphate-buffered saline revealed adult nematodes with the typical morphological features of H. gingivalis: distinctive rhabditiform oesophagus with corpus, isthmus and bulb and the dorsoflexed ovary. The main histopathological features consisted of submucosal confluent granulomatous foci containing cross- and tangential sections of larval and adult nematodes surrounded by cellular debris, epitheloid macrophages, multinucleated giant cells, lymphocytes and plasma cells. Therapy including oral administration of moxidectin and local application of an ointment containing prednisolone and moxidectin was initiated but clinical response was poor. Five months later, the nodular mass was still present and histologically, the same lesions with numerous intact nematodes were identified. In the present case, a localized infection with granuloma formation in the area of the prepuce was observed. Clinically, it cannot be distinguished from other nematode infections or even from a squamous cell carcinoma. An accurate clinical examination followed by histopathological and parasitological examinations was necessary to establish the final diagnosis. This case is unusual in that the lesions were locally very extensive (10 cm), but they remained confined to the preputium and the nematodes did not spread haematogenously to other internal organs.     

Halicephalobus gingivalis (Nematoda) infection in a Grevy's zebra (Equus grevyi).

A 6-yr-old female Grevy's zebra (Equus grevyi) with a disseminated rhabditiform nematode infection is described. Antemortem clinical signs were limited to blindness and abnormal behavior believed to be caused by a recurrent nematode-induced uveitis. Histologic examination of the kidneys, heart, eyes, uterus, and lymph nodes revealed granulomas containing multiple sections of rhabditiform nematodes. Most of the recovered nematodes were larval stages with only a few adult females noted. The adults measured 243-297 microm x 11-16 microm (x = 269 x 14 microm). The distinctive rhabditiform esophagi had corpus:isthmus:bulb proportions of 19:11:5. On the basis of adult morphology, the nematode was identified as Halicephalobus gingivalis. This is the first report of this parasite in a zebra and indicates that this parasitic granulomatous disease should be considered in zebras with neurologic disease.     

Ataxia due to lymphosarcoma in a young horse

A 20-month-old, Standard-bred colt was presented with an acute onset of hindlimb ataxia. Clinical and radiographic examination identified a compressive lesion affecting the spinal cord at the level of the 17th to 18th thoracic vertebrae. After euthanasia, post-mortem examination revealed a tumour in the epidural space, diagnosed histologically as a lymphosarcoma. Neoplastic lymphoid cells were also present in the abdominal lymph nodes and brain. Because of the disseminated nature of lymphosarcoma in the horse, involvement of the central nervous system is likely to be more common than is presently recognised.     

Keratitis due to Histoplasma spp. in a horse

A 5-year-old Holsteiner gelding from Germany was presented 2 months after a whitish discoloration of the left cornea was observed. Cytologic examination revealed intra- and extracellular globular structures, up to 4 micro m in size, consisting of a central spherical deeply basophilic body surrounded by an unstained halo. The structures were morphologically consistent with Histoplasma spp. Infection with Histoplasma organisms is not endemic in Europe. Topical use of fluconazole was successful in eliminating Histoplasma organisms within 10 days of initiation of treatment.     

Jejunal perforation due to porcupine quill ingestion in a horse

An 8-month-old Andalusian filly was treated for jejunal perforations due to ingestion of a porcupine quill. During exploratory laparotomy, 2 separate stapled side-to-side jejunojejunal resection and anastomoses were performed. Post-operative complications after 2 years follow-up included mild incisional herniation following incisional infection and chronic intermittent colic.     

Halicephalobus gingivalis (H. deletrix) infection in two horses in southern California.

Two horses, a 16-year-old male Holsteiner and a 5-year-old male miniature horse, were diagnosed with halicephalobiasis at the California Veterinary Diagnostic Laboratory System, San Bernardino Branch, in April and June of 1998. Over a period of 4 weeks, the Holsteiner horse developed renal dysfunction, blepharospasm, and blindness in the right eye. A 15-cm-diameter mass was detected on ultrasound examination in the right kidney. Terminally, the animal developed seizures and was euthanized. The miniature horse had a 6-week-long illness characterized by testicular enlargement and uveitis. This animal developed ataxia and died. Necropsy examination revealed bilateral enlargement of the kidneys in both horses, petechial hemorrhages of the optic nerve (Holsteiner), and a diffusely firm and enlarged left testicle (miniature horse). Microscopic evaluation of tissues revealed granulomatous nephritis, optic neuritis, retinitis, and encephalitis in both horses and orchitis in only the miniature horse with intralesional rhabditiform nematodes. Halicephalobus gingivalis was found in the urine sediment of both animals and in semen of the Holsteiner horse.     

Pelvic limb lameness due to malignant melanoma in a horse

Malignant melanoma in a 21-year-old, gray, Arabian gelding was manifested by rapidly deteriorating lameness of the right pelvic limb. A melanotic, cutaneous mass of small dimensions was identified in the left jugular furrow. Exploratory laparoscopy revealed widespread infiltration of melanotic masses into the structures of the abdominal cavity. Necropsy indicated the lameness to have resulted from infiltration of neoplastic cells into the sacral nerves, dorsal root ganglia, proximal ischiatic nerve, and gluteal muscle fibers. The primary tumor could not be identified.