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ACTINOBACILLOSIS
(WOODEN TONGUE)
Dr Nadir Hussain
DVM,UVAS Lahore
Definition
 infectious disease of ruminants
 caused by actinobacillus lignieresii
 inflammation of soft tissue of the head
especially tongue
Etiology
 Actinobacillus lignieresii
 gram-negative coccibacilli
Epidemiology
 worldwide in distribution
 sporadic occurrence on individual farms
 most instances --- occasional cases
 sheep flocks a morbidity rate up to 25%
 Rare in horses.
Source of infection and
transmission
 Actinobacillus lignieresii --- normal inhabitant of
oral cavity and rumen
 susceptible to ordinary environmental influences
 does not survive -- more than 5 days on hay or
straw
 Infection in soft tissues --- damage to the oral
mucosa.
Source of infection and
transmission
 ulcerating or penetrating lesions to sulcus of
tongue
 penetrating lesions in the apex
 lacerations to the side of the body of the tongue
 Actinobacillus granulomas on atypical sites
 external nares / jugular furrow
 Iatrogenic infection of surgical wound incision
 Infection of cheeks---bilateral
Pathogenesis
 Local infection --- acute inflammatory reaction
 development of granulomatous lesions
 necrosis and suppuration occur
 discharges of pus to the exterior
Pathogenesis
 Spread to regional lymph nodes
 Lingual involvement --- interfere
prehension and mastication
Clinical Findings
 onset of glossal actinobacillosis is usually acute
 unable to eat for 48 hours
 excessive salivation and gentle chewing of tongue
 tongue is swollen and hard---at the base
 tip normal
 Manipulation of tongue causes pain, resentment
 Nodules and ulcers on the side of the tongue
Clinical Findings
 later stages---acute inflammation --- replaced
fibrous tissue--- tongue ---shrunken and immobile
 interference with prehension
 Lymphadenitis is common
 enlargement of sub-maxillary and parotid nodes
 Local firm swellings ---- rupture --- discharge of
thin, non-odorous pus
Clinical Findings
 Healing is slow and relapse is common
 Enlargement of retropharyngeal nodes --- interfere
swallowing --- loud snoring respiration
 Cutaneous actinobacillosis --- granulomas ---
external nares, cheeks, skin, eyelid, hind limbs
 External trauma -- usual initiating cause.
Clinical Pathology/Diagnosis
 Purulent discharges --- sulfur bodies -- granular in
nature
 microscopic examination--club-like rosettes with
a central mass of bacteria
 Examination of smear or culture of pus---A.
lignieresii
Differential diagnosis
 Foreign bodies in the mouth
 Rabies
 Esophageal obstruction
 Tuberculosis
 Cutaneous Lymphosarcoma
Treatment
 Iodides --- standard treatment
 Oral or IV dosing of iodides
 Potassium iodide, 6-10 gm/day for 7-10 days,
given orally
 Treatment may continued until iodism develops
Treatment
 Lacrimation, anorexia, coughing, and appearance
of dandruff ---maximum systemic level of iodine
 NaI (70 mg/kg BW) IV 10-20% solution in one
dose
 One dose of potassium iodide or one injection of
sodium iodide is usually sufficient for soft tissue
lesions,
 acute signs in actinobacillosis disappear in 24-48
hours after treatment.
Treatment
 sulfonamides, penicillin, streptomycin, and the
broad spectrum antibiotics
 Streptomycin at 5 gm/day for 3 days IM -- good
results in actinomycosis -- when combined with
iodides and surgical treatment
 Isoniazid at 10 mg/kg BW orally or IM for 3-4
weeks with iodides

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Actinobacillosis (wooden tongue)

  • 2. Definition  infectious disease of ruminants  caused by actinobacillus lignieresii  inflammation of soft tissue of the head especially tongue
  • 3. Etiology  Actinobacillus lignieresii  gram-negative coccibacilli
  • 4. Epidemiology  worldwide in distribution  sporadic occurrence on individual farms  most instances --- occasional cases  sheep flocks a morbidity rate up to 25%  Rare in horses.
  • 5. Source of infection and transmission  Actinobacillus lignieresii --- normal inhabitant of oral cavity and rumen  susceptible to ordinary environmental influences  does not survive -- more than 5 days on hay or straw  Infection in soft tissues --- damage to the oral mucosa.
  • 6. Source of infection and transmission  ulcerating or penetrating lesions to sulcus of tongue  penetrating lesions in the apex  lacerations to the side of the body of the tongue  Actinobacillus granulomas on atypical sites  external nares / jugular furrow  Iatrogenic infection of surgical wound incision  Infection of cheeks---bilateral
  • 7. Pathogenesis  Local infection --- acute inflammatory reaction  development of granulomatous lesions  necrosis and suppuration occur  discharges of pus to the exterior
  • 8. Pathogenesis  Spread to regional lymph nodes  Lingual involvement --- interfere prehension and mastication
  • 9. Clinical Findings  onset of glossal actinobacillosis is usually acute  unable to eat for 48 hours  excessive salivation and gentle chewing of tongue  tongue is swollen and hard---at the base  tip normal  Manipulation of tongue causes pain, resentment  Nodules and ulcers on the side of the tongue
  • 10.
  • 11.
  • 12. Clinical Findings  later stages---acute inflammation --- replaced fibrous tissue--- tongue ---shrunken and immobile  interference with prehension  Lymphadenitis is common  enlargement of sub-maxillary and parotid nodes  Local firm swellings ---- rupture --- discharge of thin, non-odorous pus
  • 13. Clinical Findings  Healing is slow and relapse is common  Enlargement of retropharyngeal nodes --- interfere swallowing --- loud snoring respiration  Cutaneous actinobacillosis --- granulomas --- external nares, cheeks, skin, eyelid, hind limbs  External trauma -- usual initiating cause.
  • 14. Clinical Pathology/Diagnosis  Purulent discharges --- sulfur bodies -- granular in nature  microscopic examination--club-like rosettes with a central mass of bacteria  Examination of smear or culture of pus---A. lignieresii
  • 15. Differential diagnosis  Foreign bodies in the mouth  Rabies  Esophageal obstruction  Tuberculosis  Cutaneous Lymphosarcoma
  • 16. Treatment  Iodides --- standard treatment  Oral or IV dosing of iodides  Potassium iodide, 6-10 gm/day for 7-10 days, given orally  Treatment may continued until iodism develops
  • 17. Treatment  Lacrimation, anorexia, coughing, and appearance of dandruff ---maximum systemic level of iodine  NaI (70 mg/kg BW) IV 10-20% solution in one dose  One dose of potassium iodide or one injection of sodium iodide is usually sufficient for soft tissue lesions,  acute signs in actinobacillosis disappear in 24-48 hours after treatment.
  • 18. Treatment  sulfonamides, penicillin, streptomycin, and the broad spectrum antibiotics  Streptomycin at 5 gm/day for 3 days IM -- good results in actinomycosis -- when combined with iodides and surgical treatment  Isoniazid at 10 mg/kg BW orally or IM for 3-4 weeks with iodides

Notes de l'éditeur

  1. Actinobacillus lignieresii may be recovered in pure culture from the lesions but other pyogenic organisms may also be present. Recent investigations have shown that bacteria with phenotypic similarity to A. Iignieresii isolated from horses are genotypically distinct from those isolated from ruminants and they have been designated as Actinobacillus genomospecies
  2. The disease in cattle is worldwide in distribution and usually of sporadic occurrence on individual farms. In sheep, the disease is common in Scotland but is recorded in most sheep-raising countries. In most instances, only occasional cases occur but in some flocks a morbidity rate of up to 25 % may be encountered. Actinobacillosis also occurs, but is rare, in horses.
  3. Actinobacillus lignieresii is a normal inhabitant of the oral cavity and rumen of ruminants. The organism is susceptible to ordinary environmental influences and does not survive for more than 5 days on hay or straw. Infection in soft tissue results from damage to the oral mucosa.
  4. In cattle, infection most commonly occurs through ulcerating or penetrating lesions to the sulcus of the tongue, penetrating lesions in the apex, and lacerations to the side of the body of the tongue caused by the teeth. AbattOir surveys suggest that subclinical infections are common and have found small actinobacillary granulomas in the draining lymph nodes of the head and approximately 3% of tongues in slaughter cattle. In sheep, the different nature of prehension of food leads to lesions predominantly in the lips and cheeks with occasional extension to the mucous membranes of the turbinates and the soft tissue of the head and neck. Actinobacillosis granulomas may also occur at atypical sites in cattle such as the external nares or the jugular furrow following infection of traumatic lesions caused by nose grips or jugular venepuncture. Iatrogenic infection of surgical incision wounds is also recorded. Infection of the cheeks resulting in bilateral facial enlargement is also recorded ?
  5. Local infection by the organism causes an acute inflammatory reaction and the subsequent development of granulomatous lesions in which necrosis and suppuration occur, often with the discharge of pus to the exterior.
  6. Spread to regional lymph nodes is usual. Lingual involvement in cattle causes interference with prehension and mastication due to acute inflammation in the early stages and distortion of the tongue at a later stage. Visceral involvement is recorded and is identical with that described under actinomycosis.
  7. The onset of glossal actinobacillosis is usually acute, the affected animal being unable to eat for a period of about 48 hours. There is excessive salivation and gentle chewing of the tongue as though a foreign body were present in the mouth. On palpation the tongue is swollen and hard, particularly at the base, the tip often appearing to be normal. Manipulation of the tongue causes pain and resentment. Nodules and ulcers are present on the side of the tongue and there may be an ulcer at the anterior edge of the dorsum.
  8. In the later stages when the acute inflammation is replaced by fibrous tissue, the tongue becomes shrunken and immobile and there is considerable interference with prehension. Lymphadenitis is common and is often independent of lesions in the tongue. There may be visible and palpable enlargement of the submaxillary and parotid nodes. Local, firm swellings develop and often rupture with the discharge of thin, non -odorous pus.
  9. Healing is slow and relapse is common. Enlargement of the retropharyngeal nodes causes interference with swallowing, and loud snoring respiration. Cutaneous actinobacillosis is also recordeds,lO with actinobacillosis granulomas occurring on atypical but visible areas such as the external nares, cheeks, skin or eyelid, and hind limbs. External trauma from abrasive materials in the environment is the usual initiating cause.
  10. Purulent discharges commonly contain 'sulfur' bodies which are granular in nature and, on microscopic examination, consist of club-like rosettes with a central mass of bacteria. These are not pathognomonic for Actinobacillus lignieresii but can also be found in purulent exudate from granulomas associated with Actinomyces bovis, Pseudomonas aeruginosa, and Staphylococcus aureus. Examination of smears or culture of pus for the presence of Actinobacillus lignieresii is advisable. Full-thickness incision biopsies can be of value in diagnosis and show multiple abscessation in the deep dermis with distinct club rosettes.
  11. Iodides are still a standard treatment for both actinomycosis and actinobacillosis. In the former, the results are relatively inefficient, but in actinobacillosis, response is usually dramatic and permanent. Laboratory studies suggest that iodides have little bactericidal effect against Actinobacillus lignieresii and that the sulfonamides are of greater value. It is probable that iodides exert their effect by reducing the severity of the fibrous tissue reaction. Oral or intravenous dosing of iodides may be used. Potassium iodide, 6-10 g/day for 7-10 days, given orally as a drench to cattle, is a time-consuming treatment but effective. Treatment may be continued until iodism develops.
  12. Lacrimation, anorexia, coughing, and the appearance of dandruff indicate that maximum systemic levels of iodine have been reached. Sodium iodide (1 g/12 kg body weight) can be given intravenously as a 10% solution in one dose to both cattle and sheep. One course of potassium iodide or one injection of sodium iodide is usually sufficient for soft-tissue lesions, the acute signs in actinobacillosis disappearing in 24-48 hours after treatment.
  13. The sulfonamides, penicillin, streptomycin, and the broad-spectrum antibiotics are also used. Streptomycin, given by intramuscular injection (5 g/day for 3 days) ffi1d repeated if necessary, has given good results in actinomycosis in cattle when combined with iodides and local surgical treatment. Isoniazid has been used as a treahnent for aCID mycotic infections in humans and it has been reported on favorably as an adjunct to antibiotic or iodide therapy in cattle. The daily dose rate recommended is 10 mg/kg body weight orally or intramuscularly, continued for 3-4 weeks.