Bicavitary septic effusion associated with staphylococcal cholecystitis in a dog.

Clara Mattavelli, Matthew Simpson, Balazs Szladovits, Laura de Los Santos, Richard Meeson, Sarah Tayler, Laura Cole
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Abstract

Objective: To describe a case of concurrent septic pyothorax, peritonitis, and cholecystitis due to Staphylococcus pseudintermedius in a dog.

Case summary: A 10-year-old neutered male, medium-sized, mixed-breed dog presented with an acute abdomen. Initial investigations found the presence of a septic pyothorax, septic peritonitis, and bacterial cholecystitis. Exploratory celiotomy did not identify the source of infection, and no macroscopic communication between pleural and peritoneal space was detected. An abdominal Jackson-Pratt drain and bilateral small-bore thoracostomy tubes were placed for further management, with the dog receiving antimicrobial therapy and intensive supportive care. Subsequently, microbiological cultures confirmed scant growth of S. pseudintermedius in bile, pleural, and peritoneal fluid. The dog was discharged after 1 week of hospitalization. Antimicrobial therapy was discontinued 4 weeks after discharge due to an improvement of clinical signs and normalization of C-reactive protein concentration. A diagnosis of hyperadrenocorticism was made 6 weeks after discharge, and appropriate therapy was initiated.

New or unique information provided: Septic peritonitis and septic pyothorax are both common life-threatening conditions in veterinary medicine. To the authors' knowledge, this is the first report describing septic bicavitary effusion associated with a biliary staphylococcal infection in a dog. The exact mechanism by which the infection spread remains unclear, but hematogenous or lymphatic routes are considered the most probable. However, the presence of microscopic diaphragmatic defects and an anicteric gallbladder rupture cannot completely be excluded. The concurrent hyperadrenocorticism may have also contributed to an immunocompromised state, predisposing the dog to the development of infection.

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一只狗的双腔化脓性渗出与葡萄球菌性胆囊炎有关。
目的:描述一例因假中间葡萄球菌而并发化脓性脓胸、腹膜炎和胆囊炎的病例:描述一例由假中间葡萄球菌引起的犬并发化脓性脓胸、化脓性腹膜炎和胆囊炎的病例。病例摘要:一只 10 岁的雄性中型混种犬在绝育后出现急腹症。初步检查发现存在化脓性脓胸、化脓性腹膜炎和细菌性胆囊炎。探查性开腹手术没有找到感染源,也没有发现胸膜和腹膜间隙有大的沟通。为了进一步治疗,医生为该犬放置了腹腔杰克逊-普拉特引流管和双侧小口径胸腔造口管,并对其进行了抗菌治疗和强化支持治疗。随后,微生物培养证实胆汁、胸腔液和腹腔液中有少量伪中间肠杆菌生长。该犬住院 1 周后出院。出院 4 周后,由于临床症状有所改善,C 反应蛋白浓度恢复正常,抗菌治疗也随之停止。出院 6 周后确诊为肾上腺皮质功能亢进,并开始了适当的治疗:提供的新信息或独特信息:化脓性腹膜炎和化脓性脓胸都是兽医学中常见的危及生命的疾病。据作者所知,这是第一份描述犬胆道葡萄球菌感染引起化脓性双腔积液的报告。感染传播的确切机制仍不清楚,但血源性或淋巴途径被认为是最有可能的途径。不过,也不能完全排除存在微小膈肌缺损和无胆管胆囊破裂的可能性。同时出现的肾上腺皮质功能亢进症也可能导致免疫功能低下,从而使该犬容易发生感染。
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