- 期刊
病例報告：犬之Pythium insidiosum誘發化膿性肉芽腫性胃炎
Case Report: Pyogranulomatous Gastritis Caused by Pythium insidiosum in a Dog
摘要
病畜為一隻一歲雌性、已絕育米格魯犬。於就診前二個月有食後性嘔吐、厭食、精神沉鬱及體重下降等症狀。血液學檢查呈現白血球數量略高(17, 300/μL)；血清生化學檢查呈現血糖和總蛋白略高，而鈉鉀氯離子則顯著降低。正造影×光學檢查發現硫酸鋇顯影劑無法正常通過胃幽門部而有阻塞情形。進行開腹探查手術時，於胃幽門部發現其胃壁明顯堅實腫大而造成幽門部狹窄，因此摘除腫大組織並進行胃幽門及十二指腸成形吻合術(gastroduodenostomy)切除的組織團塊之顯微病變結果，於胃肌肉層可見明顯多發局部化膿性肉芽腫一生病灶，且病灶內有疑似黴菌之菌絲。經Periodic Acid Schiff (PAS)及Grocott's methenamine silver (GMS)染色結果，胃化膿性肉芽腫性病灶內可見許多染色陽性之分支而無分節之黴菌菌絲。再者，經由萃取團塊組織之去氧核醣核酸，並進行PCR增幅及其產物核酸序列分析比對，鑑定此黴菌為Pythium insidiosum。根據特徵性組織病理變化及PGR分子檢查，診斷為犬之Pythium insidiosum誘發化膿性肉芽腫性胃炎。
並列摘要
An approximately 1-year-old neutered female beagle was referred to the National Chiayi University Veterinary Hospital with two-month history of vomiting, anorexia, depression and progress weight loss. Blood and serum examinations revealed slightly leukocytosis (17, 300/μL), and slightly increased concentration of glucose and total protein. The dramatically decreased concentration of Na(superscript +), K(superscript +) and Cl(superscript -) was also observed. Abdominal positive-contrast radiograph revealed gastric obstruction around the pylorus. Exploratory celiotomy observed the firm, enlarged pylorus and further affecting its antrum; therefore, pylorectomy and gastroduodenostomy were performed to remove the narrowed gastric lumen. Histopathologically, obviously multifocal pyogranulomatous lesions with hyphae-like organism were observed in the muscularis of stomach from the incised tissue specimens. Periodic acid Sohiff stain and Grocotts methenamine silver stain revealed broad-branching, non-septa hyphae presented in the pyogranulomatous lesions. Moreover, the identification of the Pyt/rium insidiosum was performed on DNA extraction from paraffin-fixed tissue, PCR amplification, and nucleic acid sequencing. The sequences were shown to be highly homologous to previously described P. insidiosum DNA sequences. Based on the characteristically histopathological changes and PCR assay, pyogranulomatous gastritis caused by P. insidiosum is diagnosed in this dog.