Faecal Occult Blood Test

Case of the Month (Emma Scurrell November 2012)

Fungal keratitis and secondary endophthalmitis in a horse  

 Enucleation of the right eye was performed in a 10-year-old male thoroughbred with persistent corneal ulceration, keratitis and uveitis. The following are H&E sections from the formalin-fixed globe


Fig 1. . The cornea contains a deep stromal abscess that is demarcated in this section by the blue arrows. The green arrows highlight Descemet’s membrane.



Fig 2. Fragments of fungal hyphae (blue arrow) are identified within the degenerate neutrophilic infiltrate in the deep corneal stroma. Low numbers of fungal hyphae also infiltrate Descemet’s membrane (green arrow). Descemet’s membrane is pathologically ruptured in multiple places (not shown in this image).
 

Fig 3. Fungal hyphae (black arrows) are associated with neutrophilic exudate in the anterior chamber of the eye.  







Final Diagnosis

Mycotic keratitis and endophthalmitis 


Discussion

 Fungi are opportunistic pathogens of the equine cornea and usually involve saprophytic fungi that are part of the resident fungal population found around the eye/adnexae. Species most commonly involved include Aspergillus spp, Alternaria spp. Penicillium spp. and Fusarium spp. Corneal injury is a common predisposing cause and apparent increased risk of fungal keratitis is also associated with increasing age, topical corticosteroid treatment and prolonged antibiotic therapy. Corneal abscesses secondary to fungal infection are often deep and therefore superficial corneal scrapes may yield false negative results. Perforation of Descemet’s membrane and secondary mycotic endophthalmitis such as what has occurred in this particular case, is a possible complication.

Previous Monthly Cases

Hypertensive Retinopathy January 2010
FIP in a cat - uncommon presentation February 2010
Phaeohyphomycosis    March 2010 
Scleral Rupture April 2010
Canine and feline epulides May 2010
Erythema multiforme in a labrador retreiver June 2010
Keloidal fibrosarcoma in a labrador retreiver July 2010
Cutaneous epitheliotropic lymphoma  August 2010 
Benign cutaneous histiocytoma  September 2010 
Iridociliary adenoma October 2010
Proliferative thrombovascular necrosis of the pinnae November 2010
Signet-ring cell carcinoma in the stomach of a dog December 2010
Cutaneous infiltrative lipoma in a labrador January 2011

Tonsillar squamous cell carcinoma February 2011
Canine orbital meningioma March 2011
"Lung-digit" syndrome in a cat April 2011
Hepatic amyloidosis in a cat May 2011
Haemophagocytic histiocytic sarcoma June 2011
Alternaria spp. infection in an immunocompromised dog July 2011
Ocular manifestation of lymphoma in a cat  August 2011
Kerion dermatophytosis in a Cocker spaniel September 2011
Subcuticular coenurus in a rabbit  October 2011
Optic nerve glioma in a dog November 2011
Malignant transformation of a viral papilloma in a dog  December 2011
Uveodermatological syndrome in an Akita
January 2012
Cutaneous angiostomatosis in a dog  February 2012
Transitional cell carcinoma in a dog  March 2012
Corneal inclusion cysts in a dog   April 2012
Extraskeletal osteosarcoma in a dog  May 2012
Subungual melanoma in a dog  June 2012
Retrobulbar grass seed in a dog   July 2012
Lungworm infection associated with hypercalcaemia in a dog  August 2012
Conjunctival melanoma in a dog  September 2012
Pneumocystis infection in a Cavalier King Charles Spaniel  October 2012



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Faecal Occult Blood Test