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
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
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
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.
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.
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 ?
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.
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.
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.
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.
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.
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.
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.
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.
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.