Peer-reviewed veterinary case report
Progression of mycosis of the auditory tube diverticulum (guttural pouch) after arterial occlusion in a horse with contralateral temporohyoid osteoarthropathy.
- Journal:
- Journal of the American Veterinary Medical Association
- Year:
- 2006
- Authors:
- Ernst, Nicolas S et al.
- Affiliation:
- Department of Large Animal Clinical Sciences · United States
- Species:
- horse
Plain-English summary
A 6-year-old Appaloosa mare was brought in because she was eating less than usual, had trouble eating, and had swelling with discharge from her right eye. Tests showed no major issues, but a closer look at her eye revealed scarring and ulcers, and examinations of her throat showed thickening of a bone and signs of a fungal infection in one of her throat pouches. After surgery to remove part of the affected bone and blocking a blood vessel to the infected area, she initially improved and could eat without problems. Unfortunately, about seven weeks later, she returned with new symptoms, including trouble swallowing and weight loss, and further examination showed that the fungal infection had worsened, leading to her being euthanized. This case highlights that blocking the blood vessel, which is usually a helpful treatment for this type of infection, did not work as expected in this mare.
Abstract
CASE DESCRIPTION: A 6-year-old Appaloosa mare was examined because of inappetance, difficulty eating, and swelling and mucopurulent discharge in the right eye. CLINICAL FINDINGS: Results of a CBC and serum bio-chemical analysis revealed no important findings. Ophthalmologic examination revealed scarring and ulceration of the superficial layers of the cornea. Endoscopic examination of the upper portion of the respiratory tract and auditory tube diverticula (guttural pouches) revealed abnormal thickness of the right stylohyoid bone and a plaque suggestive of mycotic growth on the left internal carotid artery. Radiographic examination revealed right-sided otitis media. Temporohyoid osteoarthropathy in the right guttural pouch and mycosis in the left guttural pouch were diagnosed. TREATMENT AND OUTCOME: Ceratohyoidectomy of the right stylohyoid bone was performed, and the left internal carotid artery was occluded via placement of stainless steel spring embolization coils. The mare regained the ability to eat without difficulty and improved clinically for approximately 4 weeks. However, the mare returned to the medical center 53 days after surgery with left-sided Horner syndrome, atrophy of the right side of the tongue, and a 3-week history of dysphagia and weight loss. Endoscopic evaluation revealed progression of mycotic growth in the left guttural pouch. The mare was euthanatized. CLINICAL RELEVANCE: Although the mycotic lesion in the left guttural pouch was an incidental finding at the time of initial examination, the lesion progressed to cause dysphagia and Horner syndrome after occlusion of the left internal carotid artery, a treatment that is typically associated with resolution of guttural pouch mycosis. Arterial occlusion is not necessarily a reliable method of resolving guttural pouch mycosis.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/17173535/