Bovis ISSN 2398-2993

Pyemia

Synonym(s): Systemic infection, sepsis, bacteremia

Contributor(s): Mike Reynolds , Georgios Oikonomou

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Introduction

  • Cause: pyemia is defined as a clinical or pathological state characterized by the formation of a number of secondary abscesses in a number of organs and/or tissues.
  • Signs: see below.
  • Diagnosis: clinical examination, hematology and abdominal ultrasound findings.
  • Treatment: extended antibiotics, based on culture and sensitivity or procaine penicillin in their absence.
  • Prognosis: guarded.

Pathogenesis

Etiology

  • In cattle pyemia is often associated with an embolic spread, from a septic focus such as metritis, mastitis or hepatic abscesses, with Truperella pyogenes Truperella pyogenes, Staphlyococccus spp Staphlyococccus spp and Fusobacterium necrophorum Fusobacterium necrophorum the most common bacterial isolates implicated in disease. 
  • Liver abscesses may be sequelae to disease extension in cattle or be the source of a pyemic extension to other body systems. The routes by which the bacteria gain access to the liver include the portal vein, the hepatic artery, the umbilical vein (only in the newborn) Umbilical disorders, the bile duct, and by direct extension.
  • Subacute rumen acidosis Subacute rumen acidosis (SARA) is a common cause of liver abscesses in dairy and feedlot cattle. Rumen bacteria leak across the inflamed rumen wall and portal blood flow serves as a conduit to the liver where walled off abscesses form. Should rumen bacteria clear the liver, or gain entry to the bloodstream from liver established liver abscesses then pyemic spread  may cause pathology  in the lungs, heart valves, joints or kidneys, causing pneumonia and caudal vena cava syndrome, endocarditis, arthritis and pyelonephritis respectively .

Predisposing factors

General

  • Concomitant pyogenic bacterial infection.

Specific

  • Concomitant pyogenic bacterial infection.
  • Immune suppression.

Pathophysiology

  • Fusobacterium necrophorum is a commensal of the gastrointestinal and respiratory tract in animals. Leukotoxin is the major virulence factor involved in fusobacterial infection, being toxic to polymorphonucelar cells and hepatocytes.
  • Truperella pyogenes is a commensal of the mucus membranes of the respiratory and digestive tracts in animals and is frequently isolated as a single or mixed culture from various pyogenic infections, including mastitis, abortion, pyometra, arthritis, and foot abscesses in domestic animals. It has various virulence factors contributing to its pathogenicity including, exotoxin (hemolysin or leukotoxin) and enzymes such as proteases, DNases, and neuraminidases.
  • It is thought that a synergism exists between Truperalla pyogenes and Fusobacterium necrophorum, supported by the fact that Truperella pyogenes is able to induce liver abscesses when injected intraportally with either a subinfective dose of F necrophorum or its leukotoxin, but not by itself.

Timecourse

  • Secondary signs of pyemic spread may occur days or weeks after the primary insult has occurred. 
  • Depending on the site of pyemic spread, clinical signs may persist for the life of the animal.

Epidemiology

  • High yielding dairy cows and feedlot cattle fed high grain diets are more prone to disease caused by subacute rumen acidosis (SARA).
  • The presence of concomitant bacterial infection may lead to pyemic spread in other classes of animals.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMed Resource.
  • Oetzel G R (2017) Diagnosis and Management of Subacute Ruminal Acidosis in Dairy Herds. Vet Clin Food Anim (33) pp 463–480.
  • Sherwin V, Baiker K & Wapenaar W (2015) Consequences of endocarditis in an adult cow with a ventricular septal defect. Vet Rec Case Rep (3) pp 1-5.
  • Buczinski S, Tsuka T & Tharwat M (2012) The diagnostic criteria used in bovine bacterial endocarditis: A meta-analysis of 460 published cases from 1973 to 2011. The Veterinary Journal (193) pp 349–357.
  • Buczinski S, Rezakhani A & Boerboom D (2010) Heart disease in cattle: Diagnosis, therapeutic approaches and prognosis. The Veterinary Journal (184) pp 258–263.
  • Steiner A & LeJeune B (2009) Ultrasonographic assessment of umbilical disorders. Vet Clin Food Anim (25) pp 781–794.
  • Bexiga R, Mateus, Philbey A W, Ellis K et al (2008) Clinicopathological presentation of cardiac disease in cattle and its impact on decision making. Veterinary Record (162) pp 575-580.
  • Nagaraja T G & Lechtenberg K F (2007) Liver Abscesses in Feedlot Cattle. Vet Clin Food Anim (23) pp 351–369.

Other sources of information

  • Jeon S J et al (2017) Blood as a route of transmission of uterine pathogens from the gut to the uterus in cows. [online] Available at: www.microbiomejournal.biomedcentral.com.
  • Reef V B & McGuirk S M (2015) Diseases of the cardiovascular system. In: Large Animal Internal Medicine. 5th Edn. pp 439-441.
  • Andrews A H, Blowey R W, Boyd H & Eddy R G (2008) Bacterial Conditions. In: Bovine Medicine: Diseases and Husbandry of Cattle. pp 737.
  • Radostits O M, Gay C C, Blood D C & Hinchcliff K W (2005) Diseases of the cardiovascular system. Veterinary medicine. 9th Edn. pp 387-389.


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