Equis ISSN 2398-2977

Guttural pouch: mycosis

Contributor(s): Safia Barakzai, Tim Brazil, Christopher Brown, John P Caron, Graham Munroe, Prof Jonathon Naylor

Introduction

Print off the Owner factsheet on Epistaxis - nosebleed to give to your clients.

Pathogenesis

Etiology

  • Aspergillusspp   Aspergillus spp   - probably opportunist invader.
  • The precise cause is unknown, but an underlying lesion of the arterial wall such as an aneurysmal dilatation has been suggested as a predisposing factor.

Pathophysiology

  • InhaledAspergillus nidulansspores   →   colonize wall of arterial vessel in the guttural pouch (for normal anatomy see   Guttural pouch: normal 03 - endoscopy  ).
  • Growth of mycotic plaque and erosion of arterial wall   →   spontaneous hemorrhage   →   epistaxis or catastrophic hemorrhage   →   death.
  • More rarely, mycotic plaque impinges major nerves, eg vagus (sympathetic trunk), glossopharyngeal, hypoglossal, facial nerve   →   Horner's syndrome   Neurology: Horner's syndrome  , pharyngeal paralysis and facial paralysis   Facial nerve: trauma  .
  • Mycotic plaque is variable in size and composed of necrotic tissue, cell debris, bacteria and fungal mycelia. Usually brown, yellow, black or white attached to wall of pouch. The majority are in the medial part of the pouch on the dorsal caudal aspect medial to the temporohyoid articulation. Occasional lesions are more lateral and in the ventrolateral part of the pouch   Guttural pouch: mycosis 02 - pathology  .

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Dobesova O, Schwarz B, Velde K, Jahn P, Zert Z & Bezdekova B (2012)Guttural pouch mycosis in horses: retrospective study of 28 cases.Vet Rec171(22), 561 PubMed.
  • Jones A, Davison K & Coomer R (2010)Investigation and management of epistaxis secondary to guttural pouch mycosis in a horse.UK Vet15(7), 10-18 VetMedResource.
  • Hahn C (2008)Common peripheral nerve disorders in the horse.In Pract30(6), 328-329 VetMedResource.
  • Archer D (2008)Differential diagnosis of epistaxis in the horse.In Pract30(1), 20-29 VetMedResource.
  • Pollock P J (2007)Diagnosis and management of guttural pouch mycosis.Equine Vet Educ19(10), 522-527 VetMedResource.
  • Lepage O M & Piccot-Crézollet (2005)Transarterial coil embolisation in 31 horses (1999-2002) with guttural pouch mycosis: a 2-year follow-up.Equine Vet J37(5), 430-434 PubMed.
  • Lepage O M, Perron M F & Cadore J L (2004)The mystery of fungal infection in the guttural pouches.Vet J168(1), 60-64 PubMed.
  • Leveille R, Hardy Jet al(2000)Transarterial coil embolization of the internal and external carotid and maxillary arteries for prevention of hemorrhage from guttural pouch mycosis in horses.Vet Surg29(5), 389-397 PubMed.
  • Speirs V Cet al(1995)Is specific antifungal therapy necessary for the treatment of guttural pouch mycosis in horses?Equine Vet J27(2), 151-152 PubMed.
  • Davis E Wet al(1994)Successful treatment of guttural pouch mycosis with itraconazole and topical enilconazole in a horse.J Vet Intern Med8(4), 304-305 PubMed.
  • Lane J G (1989)The management of the guttural pouch mycosis.Equine Vet J21(5), 321-324 PubMed.
  • Greet T R (1987)Outcome of treatment in 35 cases of guttural pouch mycosis.Equine Vet J19(5), 483-487 PubMed.


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