Caseous Lymphadenitis

Todayโ€™s path rounds are on ๐œ๐š๐ฌ๐ž๐จ๐ฎ๐ฌ ๐ฅ๐ฒ๐ฆ๐ฉ๐ก๐š๐๐ž๐ง๐ข๐ญ๐ข๐ฌ!

๐–๐ก๐š๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐‚๐š๐ฌ๐ž๐จ๐ฎ๐ฌ ๐ฅ๐ฒ๐ฆ๐ฉ๐ก๐š๐๐ž๐ง๐ข๐ญ๐ข๐ฌ is an extremely common disease, caused by a bacterial infection. In this disease, the lymph nodes become infected (lymphadenitis) and turn cheesy (caseous). Yum ๐Ÿคฎ

๐–๐ก๐จ ๐ ๐ž๐ญ๐ฌ ๐ข๐ญ?
This disease is most commonly seen in sheep and goats, however other species, including humans, can also be affected.

๐–๐ก๐š๐ญ ๐œ๐š๐ฎ๐ฌ๐ž๐ฌ ๐ข๐ญ?
Caseous lymphadenitis is caused by ๐‚๐จ๐ซ๐ฒ๐ง๐ž๐›๐š๐œ๐ญ๐ž๐ซ๐ข๐ฎ๐ฆ ๐ฉ๐ฌ๐ž๐ฎ๐๐จ๐ญ๐ฎ๐›๐ž๐ซ๐œ๐ฎ๐ฅ๐จ๐ฌ๐ข๐ฌ. This bacteria often enters the sheep or goat through a skin wound, which allows it to access nearby lymph nodes. Once in the lymph node, the bacteria causes ๐š๐›๐ฌ๐œ๐ž๐ฌ๐ฌ๐ž๐ฌ (accumulations of dead white blood cells and bacteria) to form. To try and control the abscess, the body produces a ๐œ๐š๐ฉ๐ฌ๐ฎ๐ฅ๐ž out of fibrous tissue, to prevent the bacteria from spreading. However, encapsulating the abscess doesnโ€™t prevent more pus from accumulating! As the abscess continues to grow, the capsule ruptures, and a new capsule is formed. Over time, this produces a characteristic pattern called ๐œ๐จ๐ง๐œ๐ž๐ง๐ญ๐ซ๐ข๐œ ๐ฅ๐š๐ฆ๐ž๐ฅ๐ฅ๐š๐ญ๐ข๐จ๐ง๐ฌ, which look like tree rings. Neat!

๐–๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐š ๐ฉ๐ซ๐จ๐›๐ฅ๐ž๐ฆ?
Caseous lymphadenitis usually isnโ€™t fatal, however it does leave the animal with very large, swollen and ugly looking lymph nodes. These animals often will be condemned at slaughter, reducing the income for the farmer. In some cases, the bacteria may spread to lymph nodes in the lungs, hindering breathing, or to the mammary gland, causing mastitis (infection of the mammary gland) and reduced milk production.

๐‡๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐š๐ ๐ง๐จ๐ฌ๐ž๐?
Often, the appearance of multiple enlarged lymph nodes on a sheep or goat is sufficient to make the diagnosis. If needed, a sample from the lymph node can be sent for bacterial culture, to confirm the diagnosis.

๐‡๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐ž๐š๐ญ๐ž๐? ๐‡๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ฉ๐ซ๐ž๐ฏ๐ž๐ง๐ญ๐ž๐?
Unfortunately, the capsule around the abscesses makes caseous lymphadenitis difficult to treat, as antibiotics often cannot penetrate into the capsule. It is also very common for animals to have internal lymph nodes affected, meaning that direct injection of antibiotics into the accessible, external lymph nodes or other external treatments does not actually resolve the issue. For this reason, caseous lymphadenitis is considered โ€œincurableโ€, and often these animals are culled.

Prevention usually involves quarantining affected animals, testing any animals introduced to the farm for the bacteria, and preventing external wounds to the animal through safe fencing and proper wool shearing protocols. There are also vaccines available to prevent the disease, however they are not 100% effective.

๐๐ก๐จ๐ญ๐จ๐ฌ
1) A sheep with a swollen lymph node under its jaw.
2-6) Examples of the lamellations characteristic of this disease! So satisfying ๐Ÿ˜

๐’๐จ๐ฎ๐ซ๐œ๐ž๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโ€™s Pathology of Domestic Animals, Volume 3. Sixth Edition.
Washburn K. Caseous lymphadenitis of sheep and goats. Merck Veterinary Manual 2020.

Photos 1-6 ยฉ Noahโ€™s Arkive contributors Leathers, King, Reece licensed under CC BY-SA 4.0.

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