JPC SYSTEMIC PATHOLOGY
SIGNALMENT (JPC #3106248): 4-year old female Santa Gertrudis cow
HISTORY: 2 week duration of illness with appetite changes and scours
HISTOPATHOLOGIC DESCRIPTION: Heart: Diffusely the pericardium and epicardium are thickened up to 1 cm by reactive/hypertrophied fibroblasts separated by fibromyxomatous connective tissue, collagen and many perpendicularly arranged, irregularly spaced, small caliber blood vessels (granulation tissue). Multifocally, and generally more superficially, there are areas of eosinophilic cellular and karyorrhectic debris (necrosis) admixed with viable and degenerate neutrophils, macrophages, erythrocytes, lymphocytes and plasma cells. Adhered to the superficial pericardium is a variably thick mat of pale eosinophilic, homogenous to fibrillar material (fibrin) with multifocal large colonies of 2 µm coccobacilli admixed with numerous viable and degenerate neutrophils, macrophages, erythrocytes and fewer lymphocytes and plasma cells. Multifocally cardiac myocytes within the subepicardial myocardium are separated by neutrophils, lymphocytes, and plasma cells and increased clear space (edema). Diffusely, epicardial adipocytes are separated by variable amounts of fibrous connective tissue and often exhibit variation in cell size (atrophy). Multifocally within the myocardium are single, oval, 40 x 60 µm cysts containing numerous, elongate, 3 x 10 µm basophilic bradyzoites (Sarcocystis spp.).
- Heart: Pericarditis and epicarditis, fibrinosuppurative, diffuse, severe with numerous superficial coccobacilli, Santa Gertrudis, bovine.
- Heart, myocardium: Sarcocysts
CAUSE: Penetrating cardiac trauma
CONDITION: Traumatic pericarditis
SYNONYMS: Hardware disease, traumatic reticuloperitonitis (TRP), fibrinous traumatic reticuloperitonitis, purulent pericarditis, fibrinous pericarditis, traumatic reticulitis
- Traumatic pericarditis result from penetration of pericardial sac resulting in inflammation of the pericardium with accumulation of serous or fibrinous inflammatory products
- Traumatic reticuloperitonitis (TRP), is commonly from the ingestion of long, thin, sharp foreign bodies (wire, needles, nails) that penetrate the reticulum, peritoneum, diaphragm and pericardial sac
- The nonselective ingestive behavior of cattle predisposes them to swallowing metal foreign objects
- The prophylactic use of ingested magnets and the replacement of baling wire with twine, contributed to the decreased incidence of traumatic reticuloperitonitis
- In ruminants: Ingestion of sharp metal foreign body (wire or nail) > penetrates reticulum wall > inoculating the peritoneum, diaphragm, pleural space and/or pericardium with mixed bacteria > acute local peritonitis, pneumonia and pleuritis, fibrinous pericarditis and epicarditis > adhesions between reticulum and adjacent structures > (chronic cases) constrictive pericarditis
- Infections commonly attributed to infiltration and growth of Trueperella (Arcanobacterium) pyogenes and Fusobacterium necrophorum
- Rarely, the perforation of coronary or larger regional arteries can result in sudden death from severe hemorrhage
TYPICAL CLINICAL FINDINGS:
- Sternal edema and distension of the jugular vein
- Cardiac auscultation: loud pericardial friction rub
- Septicemia possible but uncommon
TYPICAL GROSS FINDINGS:
- Heart: Markedly thickened pericardial sac with extensive fibrinous exudate loosely attached to the epicardium, epicardial hemorrhage
- Firm fibrous adhesions that often mineralized
- Pericardial fluid is often fibrinopurulent
- Constrictive pericarditis will result in secondary right-sided heart failure
- Pleural: Fibrinous pleuritis and pyothorax
- Abdominal cavity: Peritonitis with fibrin deposition and firm adhesions
- Reticulum: Serosal ulcerations and/or firm adhesions
- Foreign body rarely found
TYPICAL LIGHT MICROSCOPIC FINDINGS:
- Reactive pericardium and epicardium; expanded by granulation tissue and fibrin
- Fibrinosuppurative infiltrates and large areas of necrosis
- Multifocal large colonies of bacteria through the pericardium and epicardium, extending into the myocardium
ADDITIONAL DIAGNOSTIC TESTS:
- Pericardiocentesis and thoracocentesis
- CBC: Moderate to severe inflammatory leukogram
- Fibrinous pericarditis (cattle):
- Pasteurellosis, blackleg, sporadic bovine encephalomyelitis, contagious bovine pleuropneumonia, clostridial hemoglobinuria
- Neonatal coliform infections that enter via the umbilicus
- TRP is common in all ruminant species
- New World and Old World camelids: Less common due to selective feeding behavior
- Cat, dog and horse: Associated with pyothorax from migrating grass awns “foxtail,” Hordeum glaucum and leparinum
- Cat: Rarely from feline infectious peritonitis
- Swine: Fibrinous pericarditis from Glasser’s disease, pasteurellosis, porcine enzootic pneumonia (Mycoplasma hyopneumoniae) rarely due form salmonellosis
- Sheep: Commonly from pasteurellosis
- Horse: Mycoplasma felis causes pericarditis and pleuritis; streptococcal pericarditis may coexist with polyarthritis; can be associated with the mare reproductive loss syndrome
- Goats: Rarely from contagious caprine pleuropneumonia (CCP)
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