title: Clinical findings in 10 foals with bacterial meningoencephalitis.
abstract: BACKGROUND
  Bacterial meningoencephalitis is a severe complication in septic foals and there is scarce and often unclear information in the equine literature.
  
  
  OBJECTIVE
  To report the most frequent clinical signs, clinicopathological findings, causative agents, treatments given and outcome of a group of foals with confirmed bacterial meningoencephalitis.
  
  
  METHODS
  Foals aged < 6 months of age admitted to the Universitat Autonoma de Barcelona (2004-2009) with confirmed bacterial meningoencephalitis were retrospectively included in the study Diagnosis of bacterial meningoencephalitis was made by cerebrospinal fluid (CSF) culture, CSF analysis consistent with bacterial infection, observation of bacteria in CSF cytology or postmortem confirmation.
  
  
  RESULTS
  Nine neonates and one 5-month-old foal were included. The most frequently observed clinical signs were alterations in mental status (10/10), recumbency (8/10), weakness (8/10), abnormal pupillary light reflexes (6/10), decreased suckling-reflex (6/9), seizures and/or nystagmus (4/10). Common clinicopathological alterations included hyperfibrinogenaemia (8/9), hyperlactataemia (7/7), and neutropenia (5/10) or neutrophilia (5/10). Most neonates (8/9) developed bacterial meningoencephalitis despite having a sepsis score near the cut-off value (median = 12). On CSF analysis, pleocytosis (9/9), increased total protein concentration (5/6) and intracellular bacteria (6/9) were detected. The most frequently isolated bacterium was Escherichia coil. Once bacterial meningoencephalitis was diagnosed, antimicrobial therapy was switched to third and fourth generation cephalosporins.
  
  
  CONCLUSIONS
  The diagnosis of bacterial meningoencephalitis is established based on CSF analysis and culture. Clinical recognition of bacterial meningoencephalitis is difficult and can be easily overlooked. Moreover, severe sepsis is not necessary to develop bacterial meningoencephalitis.
  
  
  CONCLUSIONS
  CSF analysis should be considered more often in sick newborn foals with signs indicative of central nervous system (CNS) involvement. Cerebrospinal fluid (CSF) cytology and culture would help to confirm or rule out unnoticed bacterial meningoencephalitis, and to choose appropriate antimicrobial therapy
authors.affiliation: Servei de Medicina Interna Equina, Facultat de Veterinaria, Universitat Aut6noma de Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Viu
authors.forename: L
authors.initials: L
authors.lastname: Monreal
authors.forename: E
authors.initials: E
authors.lastname: Jose-Cunilleras
authors.forename: C
authors.initials: C
authors.lastname: Cesarini
authors.forename: S
authors.initials: S
authors.lastname: Añor
authors.forename: L
authors.initials: L
authors.lastname: Armengou
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004660:Encephalitis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology / Q000662:veterinary*; D006734:Horse Diseases / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D006736:Horses; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*
chemical_list: D000900:Anti-Bacterial Agents