CLINCAL AND PATHOLOGICAL DIAGNOSIS OF INTERSTITIAL PNEUMONIA IN CATTLE Alfonso Lopez Dept. Pathology and Microbiology Atlantic Veterinary College University of Prince Edward Island Canada Prince Edward Island Atlantic Veterinary College University of Prince Edward Island 1984 CLASSIFICATION OF PNEUMONIA IN DOMESTIC ANIMALS One of the most controversial topics in Veterinary Medicine • There is no Universal Classification: • Epidemiologic: Enzootic pneumonia, Contagious,. Progressive, etc. • Morphologic Features: Gangrenous, proliferative, exudative, etc. • Etiology: Bacterial pneumonia, viral pneumonia, aspiration pneumonia, etc. • Miscellaneous Criteria: Atypical, Cuffing Pneumonia, calf pneumonia, • BRD Complex (acute undifferentiated bovine respiratory disease In Veterinary Pathology the most popular classifications is based on morphologic features Texture Distribution Gross appearance exudate MORPHOLOGIC TYPES OF PNEUMONIA Bronchopneumonia – Ex. Mannheimia haemolytica Embolic Pneumonia – Ex. Hepatic abscess, endocarditis Granulomatous Pneumonia – Ex. Tuberculosis Interstitial Pneumonia Interstitial Pneumonia • Clinical Practice – Textbooks – Clinical History +++ +/- • Diagnostic Laboratories – Interstitial pneumonia +++ – Bronchointerstitial pneumonia ++ Historically • Interstitial Pneumonia (virus) • Atypical Interstitial Pneumonia – Fog Fever (Tryptophan / 3-MI) – Extrinsic Allergic Alveolitis – Reinfection Syndromes (Dictyocaulus spp or BRSV) – Others… Interstitial Pneumonia • Most difficult type to diagnose in a postmortem examination: – Non- collapsible lung – Fills the thoracic cavity – Costal imprints – Elastic or meaty texture – Diffuse distribution • The type of pneumonia in which is most difficult to reach etiological diagnosis – Virology – Toxicology – CLINICAL HISTORY Objectives: To investigate the CLINICAL and PATHOLOGICAL criteria to diagnose Interstitial Pneumonia in cattle RETROSPECTIVE STUDY AVC Diagnostic Laboratory Electronic data files INTERSTITIAL PNEUMONIA IN CATTLE Selection Criteria: Diagnostic Criteria: • Final Diagnosis • Alveolar thickening • At necropsy • Necrotizing bronchiolitis • Clinical History • Diffuse alveolar damage • Hyaline Membranes 1998-2007 • Virology-Bacteriology INTERSTITIAL PNEUMONIA IN CATTLE RESULTS Data base (1998-2007): INTERSTITIAL PNEUMONIA IN CATTLE Diagnostic Criteria Histopathology Diagnostic Criteria • Postmortem Diagnosis • H&E slides • Alveolar thickening • Histological diagnosis • Special Stains • Necrotizing bronchiolitis • Immunohistochemistry § • Diffuse alveolar damage • Hyaline Membranes • Virology-Bacteriology RESULTS RESULTS Necrotizing Bronchiolitis Virus Identification 27.7% 7.7 % Atypical Interstitial Pneumonia Sepsis Plus Bronchopneumonia 15.5% 55.3% 32.2% CONCLUSIONS • Interstitial Pneumonia is rarely suspected by clinicians • Interstitial pneumonia is the most difficult type of pneumonia to diagnose during a postmortem examination • It has the lowest success rate for etiological diagnosis • Most commonly associated to viral infections (IBR, BRSV, PI-3). Why? • Acute Respiratory Distress Syndrome (ARDS) should be suspected when there is microscopic evidence of diffuse alveolar damage and hyaline membranes in alveoli • Sepsis, particularly in young calves, is often associated but not suspected with Interstitial Pneumonia THANKS FOR YOUR ATTENTION