Diagnostic Approach to Infectious Respiratory Disorders

Nicola Pusterla DVM, DACVIM, Johanna L. Watson DVM, PhD, DACVIM, W. David Wilson BVMS, MS
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引用次数: 18

Abstract

Infectious respiratory tract diseases in horses have been identified as one of the most common medical entities by veterinarians nationwide. Because of the contagious nature of certain pathogens involved in these diseases, early diagnosis is important to allow proper management and reduce the risk of exposure to other horses. The combination of general clinical signs, such as fever, anorexia, and depression, with specific respiratory signs such as tachypnea, nasal discharge, coughing, submandibular lymphadenopathy, and adventitial lung sounds should alert the veterinarian to a respiratory tract infection. The individual, herd, and farm histories are important in determining the contagious nature of the disease. Once the patient’s problems have been assessed and the differential diagnosis considered, a diagnostic workup is instituted. There are several diagnostic tools available to investigate a respiratory tract infection to achieve an accurate diagnosis in a timely manner. Generally, imaging techniques are performed at referral clinics, whereas samples of the respiratory tract can easily be collected in the field. Samples such as nasopharyngeal swab, transtracheal wash fluid, bronchoalveolar lavage fluid, or pleural fluid are routinely used for cytology and culture to detect the inciting pathogen(s). Molecular biological methods based on antigen (ELISA) or nucleic acid (PCR) detection have become more widespread in recent years, increasing the sensitivity and speed for detection of specific respiratory tract pathogens.

传染性呼吸系统疾病的诊断方法
马的传染性呼吸道疾病已被全国兽医确定为最常见的医疗实体之一。由于这些疾病中涉及的某些病原体具有传染性,因此早期诊断对于进行适当管理和减少与其他马匹接触的风险非常重要。一般的临床症状,如发热、厌食和抑郁,结合特殊的呼吸症状,如呼吸急促、流鼻水、咳嗽、下颌下淋巴结病和肺外音,应提醒兽医注意呼吸道感染。个体、畜群和农场的历史在确定疾病的传染性方面是重要的。一旦病人的问题已经评估和鉴别诊断考虑,诊断工作是建立。有几种诊断工具可用于调查呼吸道感染,以实现及时准确的诊断。通常,成像技术是在转诊诊所进行的,而呼吸道样本可以很容易地在现场收集。常规使用鼻咽拭子、经气管冲洗液、支气管肺泡灌洗液或胸膜液等样本进行细胞学和培养,以检测诱发病原体。近年来,基于抗原(ELISA)或核酸(PCR)检测的分子生物学方法越来越普遍,提高了特异性呼吸道病原体检测的灵敏度和速度。
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