Cranial osteomyelitis caused by a nematode parasite

Abstract

SummaryA 6‐year‐old horse was presented to a referral hospital in England for assessment of a rapidly expanding, hard swelling of the incisive region. Clinical and ancillary examinations revealed that the disease had spread beyond the incisive region, and advanced diagnostic imaging including computed tomography (CT) was recommended. Histopathology of biopsy samples taken from the lesions led to a diagnosis of a parasitic osteomyelitis caused by Halicephlobus gingivalis. The disease continued to progress rapidly, with neurological signs appearing soon after discharge from the hospital, and the horse was humanely destroyed. This report describes the computed tomographic changes associated with the lesions, treatment and clinical progression of this rare disease, which was ultimately fatal. Given the rapid progression in this case, it remains unclear if the prognosis is better if it is diagnosed early in the pathogenesis and medical and surgical treatments started earlier. CT revealed distinctive, very unusual changes that contributed to the ultimate histopathological diagnosis.