title: Successful treatment and polymerase chain reaction (PCR) confirmation of Tyzzer's disease in a foal and clinical and pathologic characteristics of 6 additional foals (1986-2005).
abstract: BACKGROUND
  Tyzzer's disease is a rapidly progressive and highly fatal hepatitis of foals caused by Clostridium piliforme. Survival of a confirmed case has not been reported previously.
  
  
  OBJECTIVE
  Successful therapy of C. piliforme infection in foals is possible. Polymerase chain reaction (PCR) can be used to diagnose Tyzzer's disease antemortem or postmortem.
  
  
  METHODS
  Seven foals were included in the study.
  
  
  METHODS
  Retrospective study was made to evaluate the clinical and pathologic characteristics of foals with Tyzzer's disease. Medical records of the Veterinary Medical Teaching Hospital at University of California Davis were reviewed. Foals <3 months old were included in the study if typical clinical signs were present and histologic examination identified multifocal coagulative necrosis and hepatitis with intracytoplasmic filamentous bacilli, consistent with C. piliforme. A real-time TaqMan assay was developed to detect C. piliforme gene sequences in liver tissue from affected foals.
  
  
  RESULTS
  Median survival time from onset of disease in nonsurviving foals was 30 hours (mean 34.5 +/- 20.1; range, 16-62 hours). Common clinical findings included lethargy, recumbency, seizures, and fever. Laboratory findings included metabolic acidosis, hypoglycemia and increased activity of hepatobiliary enzymes. Treatment consisted of IV fluids, antimicrobial and antiinflammatory drugs, and parenteral nutrition. One filly survived, whereas 6 died. Postmortem examination of the 6 foals that died disclosed hepatomegaly with multifocal necrosis. Liver tissue from 4 foals was positive for C. piliforme gene sequences using PCR.
  
  
  CONCLUSIONS
  Although the mortality rate of Tyzzer's disease is high, successful outcome is possible if intensive care is initiated promptly. PCR can be used for early and specific diagnosis.
authors.affiliation: Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Borchers
authors.forename: K Gary
authors.initials: KG
authors.lastname: Magdesian
authors.forename: Spring
authors.initials: S
authors.lastname: Halland
authors.forename: Nicola
authors.initials: N
authors.lastname: Pusterla
authors.forename: W David
authors.initials: WD
authors.lastname: Wilson
mesh_terms: D000818:Animals; D003013:Clostridium / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000662:veterinary*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D005260:Female; D006520:Hepatitis, Animal / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006734:Horse Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006736:Horses; D008297:Male; D016133:Polymerase Chain Reaction / Q000662:veterinary; D012189:Retrospective Studies
chemical_list: D004269:DNA, Bacterial