2007 Thorax Case 2


Information provided to the candidate


Sg:  2 month old filly

Hx:  Presented for respiratory distress, lethargy, anorexia

Rads:  Left lateral view of the thorax


See image below. Click to enlarge. Click magnifying glass at the bottom of enlarged image for full-sized image.


Candidates received points for:


Dilated fluid and air filled thoracic esophagus with fluid-air interface

Diffuse mixed interstitial and alveolar pulmonary pattern

Poorly defined radiolucencies within the caudo-ventral alveolar pattern


Radiographic Diagnosis:


Megaesophagus:  differentials of idiopathic, ulcers, aerophagia (less likely due to fluid accumulation); probably incidental to pulmonary pathology


Hematogenous pneumonia with possible abscess formation: differentials of bacterial etiologies including  Rodococcus. Aspiration pneumonia possible but less likely given distribution


Outcome:


Foal was euthanized.  A cause of megaesophagus was not determined. Rodococcus was cultured from lungs

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