engleski

Septic synovitis of unknown origin in adult horse – a case report

Septic synovitis affects synovial joints, tendon sheaths and bursas. In adult horses, the most frequent causes of synovial sepsis are penetrating trauma and iatrogenic contamination, although reports of septic synovitis of unknown origin are described. A Warmblood mare, 27 years old, was admitted with a history of lameness and swelling of a hind limb lasting for three weeks. The mare had been treated with antibiotics and NSAIDs with deterioration of clinical signs. Two years earlier, a part of an intravenous catheter remained in her jugular vein, without causing any clinical manifestation. At admission, the mare was apathetic, but responsive. The rectal temperature was 37.6 °C, and the heart rate 60/min. Gluteal muscles atrophy and 5/5 grade lameness in the right hind limb were noted. The right tarsal and metatarsal regions were warm and oedematous, with the swelling most pronounced in the medial plantar region. An ultrasound examination revealed a distention of the tarsal tendon sheath with hypoechoic fluid and a pronounced adhesion formation. By performing synoviocentesis, a yellow-pinkish fluid was obtained. Microbial culture identified Streptococcus equi subsp. zooepidemicus. An X-ray examination did not reveal any abnormalities. The mare was treated with daily standing multi-needle lavage, intrasynovial and intravenous antimicrobial medication (ceftiofur 2.2 mg/kg IV BID). After 10 days, the mare’s attitude improved and the lameness score changed to 4/5. On ultrasound, a regression of the process was evident, but X-ray revealed osteomyelitis of the calcaneal bone. In the following months, the clinical status of the mare remained constant, although there was an obvious radiological progression of the pathological process. The present case emphasises the need to consider septic synovitis in adult horses even in cases where there is no evident perforation of synovial structures or a possibility of iatrogenic contamination. It remains speculative if the described corpus alienum could have been the culprit behind synovial sepsis.

septic synovitis, tarsal joint, tarsometatatsal joint, horse

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