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Peer-reviewed veterinary case report

Use of dapsone in the treatment of Pneumocystis carinii pneumonia in a foal.

Journal:
Journal of the American Veterinary Medical Association
Year:
2004
Authors:
Clark-Price, Stuart C et al.
Affiliation:
Department of Clinical Sciences · United States
Species:
horse

Plain-English summary

A 6-month-old male Quarter Horse was having ongoing trouble with his breathing. Tests showed he had inflammation in his lungs and a type of pneumonia caused by a parasite called Pneumocystis carinii. Initially, he was treated with a common antibiotic, but after a week, he developed severe diarrhea and was found to have a resistant bacteria in his stool, leading to a diagnosis of colitis, which is inflammation of the intestines. To treat the pneumonia, he was given a medication called dapsone for about two months, and fortunately, he recovered from both the pneumonia and the diarrhea. This suggests that dapsone could be a helpful option for treating this type of pneumonia in horses, especially if they can't handle other treatments.

Abstract

A 6-month-old male Quarter Horse was evaluated for chronic respiratory tract disease. Diagnostic investigations revealed pulmonary inflammation; Pneumocystis carinii was detected within macrophages. Lymphocyte subpopulation phenotyping and immunoglobulin concentration analysis were performed and results suggested immune suppression. Trimethoprim-sulfamethoxazole administration was initiated; the colt was discharged but was reexamined 8 days later because of profuse diarrhea and endotoxemia. Bacterial culture of feces recovered Salmonella spp resistant to trimethoprim-sulfamethoxazole, and a diagnosis of antimicrobial-associated colitis was made. Bilateral fibrinous hypopyon developed and was treated with topical medication and intracameral injections of human recombinant tissue plasminogen activator. Dapsone (3 mg/kg [1.4 mg/lb], PO, q 24 h; dose extrapolated from human data) was administered for treatment of P carinii pneumonia (56-day treatment period). The colt recovered from the pneumonia and diarrhea. Dapsone may be a useful adjunct to traditional treatment for P carinii pneumonia in horses or as a sole medication for horses that cannot tolerate other treatments.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/14765801/