Multinodular pulmonary fibrosis,pancytopenia and equine herpesvirus‐5 infection in a Thoroughbred gelding

A 21‐year‐old Thoroughbred gelding was examined for intermittent fever, lethargy, inappetance and weight loss. Initial diagnostic evaluation revealed pancytopenia (anaemia, thrombocytopenia and neutropenia), hyperfibrinogenaemia and multifocal pulmonary nodules. Bacterial and fungal culture and viral isolation on transtracheal aspirate samples were negative, consistent with either pulmonary neoplasia, idiopathic granulomatous pneumonia or equine multinodular pulmonary fibrosis (EMPF). Bone marrow evaluation was consistent with pancytopenia due to a combination of peripheral consumption/destruction and suppression/destruction of progenitor cells at the level of the marrow. Pancytopenia resolved and clinical signs improved transiently with immunosuppressive corticosteroid therapy, but the horse deteriorated rapidly one month after presentation and was subjected to euthanasia. Necropsy findings were consistent with EMPF, and equine herpesvirus‐5 (EHV‐5) DNA was found in both the lung and bone marrow. The specific role of EHV‐5 in the development of the pulmonary pathology in EMPF and the pancytopenia in this horse is unclear, but an aberrant host immune/inflammatory response to EHV‐5 infection may be important.