- Email: [email protected]
Stridor and emphysema due to cystic echinococcosis in cattle and buffalo intermediate hosts in Punjab, India
Veterinary Parasitology: Regional Studies and Reports 10 (2017) 51–53
Contents lists available at ScienceDirect
Veterinary Parasitology: Regional Studies and Reports journal homepage: www.elsevier.com/locate/vprsr
Short communication
Stridor and emphysema due to cystic echinococcosis in cattle and buffalo intermediate hosts in Punjab, India
T
V. Chaudharia, A.K. Sharmaa, B.B. Singhb,⁎, C.S. Randhawaa, S.K. Uppala a b
Department of Veterinary Medicine, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
A R T I C L E I N F O
A B S T R A C T
Keywords: Buffalo Cattle Hydatid cyst Stridor Symptoms
The clinical symptoms associated with hydatid disease in the bovine populations remain largely unknown and the disease is usually considered asymptomatic in these intermediate hosts. We report occurrence of symptoms such as sudden onset of continuous stridor, coughing and wheezing due to hydatid cysts present in the lungs of infected cattle and buffalo. Two cattle and one buffalo presented to the Teaching Veterinary Hospital, Guru Angad Dev Veterinary & Animal Sciences University with the complaint of continuous stridor, coughing and wheezing with normal feed and water intake were followed up. The comprehensive clinical examination followed by haematology, radiography of upper and lower respiratory tract, ultrasonography of lungs, liver and reticulum revealed presence of multiple hydatid cysts in the lung parenchyma. There was presence of subcutaneous emphysema in one of the infected animal. Radiography revealed cysts occupying up to 60% of alveolar space in the lungs. Endoscopy up to hilus was carried out to rule out the presence of any other mass/lesion in the respiratory tract. Per cutaneous aspiration (Ultrasound guided) of cystic fluid confirmed the diagnosis and fertile nature of hydatid cysts. The current study reports association of stridor and emphysema with hydatid disease in bovine hosts and it is important that veterinary practitioners in endemic areas consider hydatid disease for differential diagnosis when investigating the etiology of stridor and emphysema in bovine intermediate hosts.
1. Introduction Cystic echinococcosis (CE) occurs due to metacestode stage of the parasite Echinococcus granulosus and is recognized as a major public health problem worldwide. The intermediate hosts, represented by a wide range of mammals, acquire the infection through the ingestion of eggs (Eckert and Thompson, 1995). Adult worm lives in the small intestine of carnivores (definitive host), and the intermediate larval stage (hydatid cyst) develops in the internal organs of a wide range of mammalian species, which acquire the infection through accidental ingestion of the tapeworm eggs (Eckert and Deplazes, 2004). Cystic echinoccosis is an endemic zoonosis in India (Sharma et al., 2013) and the parasite has been recorded from most of the food producing animals in the country (Pednekar et al., 2009; Singh et al., 2012). Presence of stray dogs, lack of meat inspection and free access of dogs to slaughter waste are important risks associated with hydatid disease in the country (Singh et al., 2012). The disease in food producing animals is usually considered asymptomatic and detected at the time of post mortem inspection.
⁎
Corresponding author. E-mail address: [email protected] (B.B. Singh).
http://dx.doi.org/10.1016/j.vprsr.2017.08.001 Received 6 October 2016; Received in revised form 17 July 2017; Accepted 7 August 2017 Available online 09 August 2017 2405-9390/ © 2017 Elsevier B.V. All rights reserved.
However, it causes great economic losses through condemnation of infected offal, in particular liver (Benner et al., 2010; Budke et al., 2005; Torgerson et al., 2000). In India, CE has been reported to cause median economic losses to the amount of Rs. 11.47 billion (approx. US $ 212.35 million) per annum (Singh et al., 2014a) and the occurrence of CE in cattle and buffalo accounted for 93.05% of the total livestock and 88.88% of the total (livestock and human) losses (Singh et al., 2014a). The clinical symptoms occurring due to hydatid disease in intermediate host species have been discussed by Schwabe (1986). The infection may remain asymptomatic or symptoms similar to human disease could occur in the infected intermediate animal hosts (Schwabe, 1986). Despite causing huge production losses in the livestock sector, the clinical effects associated with hydatid disease are poorly understood in bovine intermediate hosts. The current report will benefit clinicians to better understand clinical symptoms associated with the hydatid disease in the bovine intermediate hosts.
Veterinary Parasitology: Regional Studies and Reports 10 (2017) 51–53
V. Chaudhari et al.
2. Materials and methods The current study was performed on two cattle and one buffalo presented to the Teaching Veterinary Hospital, Guru Angad Dev Veterinary & Animal Sciences University with the complaint of continuous stridor, coughing and wheezing with normal feed and water intake. The animals were subjected to comprehensive clinical examination and the detailed history and clinical symptoms were recorded. Blood samples were collected for routine haematological examination(s) to note down any changes associated with the disease. Radiography of upper and lower respiratory tract along with ultrasonography of lungs, liver and abdominal cavity was performed. Additionally, endoscopic examination up to hilus was carried out to detect presence of any obstructive lesion in the respiratory tract. For confirmation and to determine fertility of the cysts, cystic fluid was aspirated using 23 G′ × 4.5 cm long spinal needle injected per cutaneously. The cystic fluid was centrifuged at 5000 rpm for 10 min and microscopic examination (×40) of sediment (sand like material) was carried out. The protoscolices were detected as per the published methods (Singh et al., 2014b). The identity of the hydatid cysts were further confirmed by amplifying a 434 base pair fragment of the cytochrome oxidase-1 gene using PCR (Pednekar et al., 2009; Singh et al., 2012).
Fig. 2. Ultrasonography of lung showing E. granulosus cysts.
More than 60% of lung space in these animals was occupied by hydatid cysts. Endoscopic examination up to hilus ruled out presence of any mass/lesion in the respiratory tract. Ultrasonography of liver revealed presence of hydatid cysts in all the animals. The ultrasonographic examination did not revealed any abnormalities in the abdominal cavity. Cystic echinococcosis was confirmed by carrying out ultrasound guided per-cutaneous aspiration yielding watery mild turbid fluid. Microscopic examination of cyst fluid from all the 3 cases revealed several protoscoleces of E. granulosus (Fig. 3). All the samples of hydatid cysts were found to be positive for E. granulosus cytochrome oxidase-1 gene using PCR.
3. Results The disease history revealed sudden onset of continuous stridor, dyspnoea and open mouth breathing since past 8–10 days. The animals were already treated with regular course of broad spectrum antibiotics and anti-inflammatory agents for 5–8 days without any response. At the time of clinical examination, all the animals were bright, alert and reactive with normal range of temperature, pulse and respiration rate. Clinical presentation of the animals revealed stridor, coughing, wheezing and one of them also had subcutaneous emphysema. Haematological findings viz. haemoglobin-8.6 ± 4.20 g/dl (mean ± SE), total Leukocyte count-10,605 ± 3904.89/μl (mean ± SE), neutrophils–7406 ± 2401/μl (mean ± SE), lymphocytes–3198 ± 863.67/μl (mean ± SE) and platelets–460 ± 151.63 × 103/μl (mean ± SE) indicated mild anemia and neutrophilic leukocytosis with left shift. Radiographic and ultrasonographic examination indicated presence of multiple (3 −10) fluid filled uniform circular structures of varying size (1–8 cm) in lungs and liver in all the three animals (Figs. 1 and 2).
4. Discussion As far as we are aware, this is the first study describing the association of stridor with cystic echinococcosis in cattle and buffalo hosts. Stridor in bovines usually occurs due to involvement of upper respiratory tract with obstructive lesions. Inhalation pneumonia, tuberculosis, multi-centric lymphosarcoma, atypical interstitial pneumonia, or pulmonary embolism from posterior venacava thrombosis are some of the causes of origin of stridor of lower respiratory tract (Smith, 2016). In our study, there was no mass/lesion in the upper respiratory tract up to hilus. The clinical features of CE have not been previously described in
Fig. 3. Mature invaginative protoscoleces detected in cystic fluid aspirated from hydatid cyst present in lung of an infected buffalo (×40).
Fig. 1. Radiograph of lung showing multiple hydatid cysts.
52
Veterinary Parasitology: Regional Studies and Reports 10 (2017) 51–53
V. Chaudhari et al.
Ethics statement
detail in bovine intermediate hosts. The spectrum of symptoms depends upon the involved organs, number and size of cyst (s) and the adjacent organ structures. The disease may remain asymptomatic for many years and cysts may be found in many organs but most commonly present in the liver, lungs or both (Ammann and Eckert, 1995; Pawlowski, 1997; Khanfar, 2004). As previously reported (Singh et al., 2014b), the presence of fertile cysts in these animals re-confirm that bovine hosts are highly adapted to E. granulosus strains cycling among livestock in north India. There was presence of multiple lung cysts of varying size and number occupying up to 60% of area of lungs which was primarily responsible for clinical signs such as dyspnoea, open mouth breathing and stridor. We did not identified strains of E. granulosus prevalent in the infected animals. The recognition of strain variation may prove useful in directing control programs (Thompson and McManus, 2002). The species of Echinococcus with cattle as intermediate host and pulmonary metacestode development is strongly suggestive to be E. ortleppi. According to Thompson and McManus (2002), the form of Echinococcus that is adapted to cattle as its intermediate host also warrants taxonomic recognition. This cattle form is characterized by the nature of its pulmonary metacestode development with the production of predominantly fertile cysts, the unusual strobilar morphology and rapid rate of development of the adult worm. The cattle-adapted form has a widespread geographical distribution that includes parts of central Europe, South Africa, India, Sri Lanka, Nepal and possibly South America (Thompson and McManus, 2002). Another paper by Pednekar et al. (2009) suggests that their molecular, morphological and biological characteristics also support earlier studies suggesting that Echinococcus of cattle origin, designated the G5 genotype, should be recognized as a separate species, viz. Echinococcus ortleppi. Although stridor associated with congenital bronchogenic cyst has been previously described in a child (Jiwane et al., 2001), such observations have not been usually recorded from bovine hosts. It is important that veterinary practitioners in endemic areas consider hydatid disease for differential diagnosis when investigating the etiology of stridor and emphysema in bovine intermediate hosts.
It is submitted that proper consideration has been given to any ethics issue raised. Acknowledgements This study was financially supported by the Department of Veterinary Medicine, Guru Angad Dev Veterinary & Animal Sciences University, Ludhiana, Punjab, India. References Ammann, R.W., Eckert, J., 1995. Clinical diagnosis and treatment of echinococcus in humans. In: Thompson, R.C.A., Lymbery, A.J. (Eds.), Echinococcus and Hydatid Disease. CAB international, Wallingford, Oxon, pp. 411–463. Benner, C., Carabin, H., Serrano, L.P.S., Budke, C.M., Carmena, D., 2010. Analysis of the economic impact of cystic echinococcosis in Spain. Bull. World Health Organ. 88, 49–57. Budke, C.M., Jiamin, Q., Qian, W., Torgerson, P.R., 2005. Economic effectsof echinococcosis in a disease endemic region of the Tibetan Plateau. Am. J. Trop. Med. Hyg. 73 (1), 2–10. Eckert, J., Deplazes, P., 2004. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin. Microbiol. Rev. 17, 107–135. Eckert, J., Thompson, R.C.A., 1995. Echinococcus spp.: biology and strain variation. In: Ruiz, A., Schantz, P., Arámbulo IIIP. (Eds.), Proceedings of Scientific Working Group on the Advances in the Prevention Control Treatment of Hydatidosis. 26–28 October 1994, Montevideo. Pan American Health Organization, Washington, DC, pp. 29–47. Jiwane, A., Kumar, T., Kutumbale, R., Bhusare, D., Kothari, P., Kulkarni, B., 2001. Bronchogenic cyst with stridor and unilateral obstructive emphysema: an unusual presentation. J. Indian. Assoc. Pediatr. Surg. 6, 95–98. Khanfar, N., 2004. Hydatid disease: a review and update. Current Anaesthesia Critical Care 15, 173–183. Pawlowski, Z.S., 1997. Critical points in the clinical managements of cystic echinococcus: a revised review. In: Anderson, F.L., Quhelli, H., Kachani, M. (Eds.), Compendium on Cystic Echinococcus in Africa and in Middle Eastern Countries with Special Reference to Morocco. Brigham Young University, Print Service, Provo Utah, 84602 USA, pp. 119–135. Pednekar, P.R., Gatne, L.M., Thompson, R.C.A., Traub, R.J., 2009. Molecular and morphological characterisation of Echinococcus from food producing animals in India. Vet. Parasitol. 165, 58–65. Schwabe, 1986. Current status of hydatid disease: a zoonosis of increasing importance. In: Thompson, R.C.A. (Ed.), The Biology of Echinococcus and Hydatid Disease. G. Allen & Unwin, London, pp. 81–113. Sharma, M., Sehgal, R., Fomda, B.A., Malhotra, A., Malla, N., 2013. Molecular characterization of Echinococcus granulosus cysts in north Indian patients: identification of G1, G3, G5 and G6 genotypes. PLoS Negl. Trop. Dis. 7 (6), e2262. http://dx.doi.org/ 10.1371/journal.pntd.0002262. (Jun). Singh, B.B., Sharma, J.K., Ghatak, S., Sharma, R., Bal, M.S., Tuli, A., Gill, J.P.S., 2012. Molecular epidemiology of Echinococcosis from food producing animals in north India. Vet. Parasitol. 186 (3–4), 503–506. Singh, B.B., Dhand, N.K., Ghatak, S., Gill, J.P.S., 2014a. Economic losses due to cystic Echinococcosis in India: need for urgent action to control the disease. Prev. Vet. Med. 113 (1), 1–12. Singh, B.B., Sharma, J.K., Tuli, A., Sharma, R., Bal, M.S., Aulakh, R.S., Gill, J.P.S., 2014b. Prevalence and morphological characterization of Echinococcus granulosus from north India. J. Parasit. Dis. 38 (1), 36–40. Smith, B.P., 2016. Large animal internal medicine. In: Diseases of Alimentary Tract. Elsevier Health Sciences, pp. 66–70. Thompson, R.A., McManus, D.P., 2002. Towards a taxonomic revision of the genus Echinococcus. Trends Parasitol. 18 (10), 452–457. Torgerson, P.R., Carmona, C., Bonifacino, R., 2000. Estimating the economiceffects of cystic echinococcosis: Uruguay, a developing country withupper-middle income. Ann. Trop. Med. Parasitol. 94, 703–713.
5. Conclusions Presence of multiple hydatid cysts involving large area of lung lobes result in clinical disease in dairy cattle and buffaloes with symptoms such as coughing, dyspnoea and stridor. These cysts can be effectively diagnosed using radiographic, ultrasonographic and microscopic examination(s) of the cyst fluid. Stridor is commonly associated with lesion in the upper respiratory tract but should be further investigated for hydatid cysts in disease endemic areas. Conflict of interest statement No financial or personal relationships between the authors and other people or organizations have inappropriately influenced (bias) this work.
53
Contents lists available at ScienceDirect
Veterinary Parasitology: Regional Studies and Reports journal homepage: www.elsevier.com/locate/vprsr
Short communication
Stridor and emphysema due to cystic echinococcosis in cattle and buffalo intermediate hosts in Punjab, India
T
V. Chaudharia, A.K. Sharmaa, B.B. Singhb,⁎, C.S. Randhawaa, S.K. Uppala a b
Department of Veterinary Medicine, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India
A R T I C L E I N F O
A B S T R A C T
Keywords: Buffalo Cattle Hydatid cyst Stridor Symptoms
The clinical symptoms associated with hydatid disease in the bovine populations remain largely unknown and the disease is usually considered asymptomatic in these intermediate hosts. We report occurrence of symptoms such as sudden onset of continuous stridor, coughing and wheezing due to hydatid cysts present in the lungs of infected cattle and buffalo. Two cattle and one buffalo presented to the Teaching Veterinary Hospital, Guru Angad Dev Veterinary & Animal Sciences University with the complaint of continuous stridor, coughing and wheezing with normal feed and water intake were followed up. The comprehensive clinical examination followed by haematology, radiography of upper and lower respiratory tract, ultrasonography of lungs, liver and reticulum revealed presence of multiple hydatid cysts in the lung parenchyma. There was presence of subcutaneous emphysema in one of the infected animal. Radiography revealed cysts occupying up to 60% of alveolar space in the lungs. Endoscopy up to hilus was carried out to rule out the presence of any other mass/lesion in the respiratory tract. Per cutaneous aspiration (Ultrasound guided) of cystic fluid confirmed the diagnosis and fertile nature of hydatid cysts. The current study reports association of stridor and emphysema with hydatid disease in bovine hosts and it is important that veterinary practitioners in endemic areas consider hydatid disease for differential diagnosis when investigating the etiology of stridor and emphysema in bovine intermediate hosts.
1. Introduction Cystic echinococcosis (CE) occurs due to metacestode stage of the parasite Echinococcus granulosus and is recognized as a major public health problem worldwide. The intermediate hosts, represented by a wide range of mammals, acquire the infection through the ingestion of eggs (Eckert and Thompson, 1995). Adult worm lives in the small intestine of carnivores (definitive host), and the intermediate larval stage (hydatid cyst) develops in the internal organs of a wide range of mammalian species, which acquire the infection through accidental ingestion of the tapeworm eggs (Eckert and Deplazes, 2004). Cystic echinoccosis is an endemic zoonosis in India (Sharma et al., 2013) and the parasite has been recorded from most of the food producing animals in the country (Pednekar et al., 2009; Singh et al., 2012). Presence of stray dogs, lack of meat inspection and free access of dogs to slaughter waste are important risks associated with hydatid disease in the country (Singh et al., 2012). The disease in food producing animals is usually considered asymptomatic and detected at the time of post mortem inspection.
⁎
Corresponding author. E-mail address: [email protected] (B.B. Singh).
http://dx.doi.org/10.1016/j.vprsr.2017.08.001 Received 6 October 2016; Received in revised form 17 July 2017; Accepted 7 August 2017 Available online 09 August 2017 2405-9390/ © 2017 Elsevier B.V. All rights reserved.
However, it causes great economic losses through condemnation of infected offal, in particular liver (Benner et al., 2010; Budke et al., 2005; Torgerson et al., 2000). In India, CE has been reported to cause median economic losses to the amount of Rs. 11.47 billion (approx. US $ 212.35 million) per annum (Singh et al., 2014a) and the occurrence of CE in cattle and buffalo accounted for 93.05% of the total livestock and 88.88% of the total (livestock and human) losses (Singh et al., 2014a). The clinical symptoms occurring due to hydatid disease in intermediate host species have been discussed by Schwabe (1986). The infection may remain asymptomatic or symptoms similar to human disease could occur in the infected intermediate animal hosts (Schwabe, 1986). Despite causing huge production losses in the livestock sector, the clinical effects associated with hydatid disease are poorly understood in bovine intermediate hosts. The current report will benefit clinicians to better understand clinical symptoms associated with the hydatid disease in the bovine intermediate hosts.
Veterinary Parasitology: Regional Studies and Reports 10 (2017) 51–53
V. Chaudhari et al.
2. Materials and methods The current study was performed on two cattle and one buffalo presented to the Teaching Veterinary Hospital, Guru Angad Dev Veterinary & Animal Sciences University with the complaint of continuous stridor, coughing and wheezing with normal feed and water intake. The animals were subjected to comprehensive clinical examination and the detailed history and clinical symptoms were recorded. Blood samples were collected for routine haematological examination(s) to note down any changes associated with the disease. Radiography of upper and lower respiratory tract along with ultrasonography of lungs, liver and abdominal cavity was performed. Additionally, endoscopic examination up to hilus was carried out to detect presence of any obstructive lesion in the respiratory tract. For confirmation and to determine fertility of the cysts, cystic fluid was aspirated using 23 G′ × 4.5 cm long spinal needle injected per cutaneously. The cystic fluid was centrifuged at 5000 rpm for 10 min and microscopic examination (×40) of sediment (sand like material) was carried out. The protoscolices were detected as per the published methods (Singh et al., 2014b). The identity of the hydatid cysts were further confirmed by amplifying a 434 base pair fragment of the cytochrome oxidase-1 gene using PCR (Pednekar et al., 2009; Singh et al., 2012).
Fig. 2. Ultrasonography of lung showing E. granulosus cysts.
More than 60% of lung space in these animals was occupied by hydatid cysts. Endoscopic examination up to hilus ruled out presence of any mass/lesion in the respiratory tract. Ultrasonography of liver revealed presence of hydatid cysts in all the animals. The ultrasonographic examination did not revealed any abnormalities in the abdominal cavity. Cystic echinococcosis was confirmed by carrying out ultrasound guided per-cutaneous aspiration yielding watery mild turbid fluid. Microscopic examination of cyst fluid from all the 3 cases revealed several protoscoleces of E. granulosus (Fig. 3). All the samples of hydatid cysts were found to be positive for E. granulosus cytochrome oxidase-1 gene using PCR.
3. Results The disease history revealed sudden onset of continuous stridor, dyspnoea and open mouth breathing since past 8–10 days. The animals were already treated with regular course of broad spectrum antibiotics and anti-inflammatory agents for 5–8 days without any response. At the time of clinical examination, all the animals were bright, alert and reactive with normal range of temperature, pulse and respiration rate. Clinical presentation of the animals revealed stridor, coughing, wheezing and one of them also had subcutaneous emphysema. Haematological findings viz. haemoglobin-8.6 ± 4.20 g/dl (mean ± SE), total Leukocyte count-10,605 ± 3904.89/μl (mean ± SE), neutrophils–7406 ± 2401/μl (mean ± SE), lymphocytes–3198 ± 863.67/μl (mean ± SE) and platelets–460 ± 151.63 × 103/μl (mean ± SE) indicated mild anemia and neutrophilic leukocytosis with left shift. Radiographic and ultrasonographic examination indicated presence of multiple (3 −10) fluid filled uniform circular structures of varying size (1–8 cm) in lungs and liver in all the three animals (Figs. 1 and 2).
4. Discussion As far as we are aware, this is the first study describing the association of stridor with cystic echinococcosis in cattle and buffalo hosts. Stridor in bovines usually occurs due to involvement of upper respiratory tract with obstructive lesions. Inhalation pneumonia, tuberculosis, multi-centric lymphosarcoma, atypical interstitial pneumonia, or pulmonary embolism from posterior venacava thrombosis are some of the causes of origin of stridor of lower respiratory tract (Smith, 2016). In our study, there was no mass/lesion in the upper respiratory tract up to hilus. The clinical features of CE have not been previously described in
Fig. 3. Mature invaginative protoscoleces detected in cystic fluid aspirated from hydatid cyst present in lung of an infected buffalo (×40).
Fig. 1. Radiograph of lung showing multiple hydatid cysts.
52
Veterinary Parasitology: Regional Studies and Reports 10 (2017) 51–53
V. Chaudhari et al.
Ethics statement
detail in bovine intermediate hosts. The spectrum of symptoms depends upon the involved organs, number and size of cyst (s) and the adjacent organ structures. The disease may remain asymptomatic for many years and cysts may be found in many organs but most commonly present in the liver, lungs or both (Ammann and Eckert, 1995; Pawlowski, 1997; Khanfar, 2004). As previously reported (Singh et al., 2014b), the presence of fertile cysts in these animals re-confirm that bovine hosts are highly adapted to E. granulosus strains cycling among livestock in north India. There was presence of multiple lung cysts of varying size and number occupying up to 60% of area of lungs which was primarily responsible for clinical signs such as dyspnoea, open mouth breathing and stridor. We did not identified strains of E. granulosus prevalent in the infected animals. The recognition of strain variation may prove useful in directing control programs (Thompson and McManus, 2002). The species of Echinococcus with cattle as intermediate host and pulmonary metacestode development is strongly suggestive to be E. ortleppi. According to Thompson and McManus (2002), the form of Echinococcus that is adapted to cattle as its intermediate host also warrants taxonomic recognition. This cattle form is characterized by the nature of its pulmonary metacestode development with the production of predominantly fertile cysts, the unusual strobilar morphology and rapid rate of development of the adult worm. The cattle-adapted form has a widespread geographical distribution that includes parts of central Europe, South Africa, India, Sri Lanka, Nepal and possibly South America (Thompson and McManus, 2002). Another paper by Pednekar et al. (2009) suggests that their molecular, morphological and biological characteristics also support earlier studies suggesting that Echinococcus of cattle origin, designated the G5 genotype, should be recognized as a separate species, viz. Echinococcus ortleppi. Although stridor associated with congenital bronchogenic cyst has been previously described in a child (Jiwane et al., 2001), such observations have not been usually recorded from bovine hosts. It is important that veterinary practitioners in endemic areas consider hydatid disease for differential diagnosis when investigating the etiology of stridor and emphysema in bovine intermediate hosts.
It is submitted that proper consideration has been given to any ethics issue raised. Acknowledgements This study was financially supported by the Department of Veterinary Medicine, Guru Angad Dev Veterinary & Animal Sciences University, Ludhiana, Punjab, India. References Ammann, R.W., Eckert, J., 1995. Clinical diagnosis and treatment of echinococcus in humans. In: Thompson, R.C.A., Lymbery, A.J. (Eds.), Echinococcus and Hydatid Disease. CAB international, Wallingford, Oxon, pp. 411–463. Benner, C., Carabin, H., Serrano, L.P.S., Budke, C.M., Carmena, D., 2010. Analysis of the economic impact of cystic echinococcosis in Spain. Bull. World Health Organ. 88, 49–57. Budke, C.M., Jiamin, Q., Qian, W., Torgerson, P.R., 2005. Economic effectsof echinococcosis in a disease endemic region of the Tibetan Plateau. Am. J. Trop. Med. Hyg. 73 (1), 2–10. Eckert, J., Deplazes, P., 2004. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin. Microbiol. Rev. 17, 107–135. Eckert, J., Thompson, R.C.A., 1995. Echinococcus spp.: biology and strain variation. In: Ruiz, A., Schantz, P., Arámbulo IIIP. (Eds.), Proceedings of Scientific Working Group on the Advances in the Prevention Control Treatment of Hydatidosis. 26–28 October 1994, Montevideo. Pan American Health Organization, Washington, DC, pp. 29–47. Jiwane, A., Kumar, T., Kutumbale, R., Bhusare, D., Kothari, P., Kulkarni, B., 2001. Bronchogenic cyst with stridor and unilateral obstructive emphysema: an unusual presentation. J. Indian. Assoc. Pediatr. Surg. 6, 95–98. Khanfar, N., 2004. Hydatid disease: a review and update. Current Anaesthesia Critical Care 15, 173–183. Pawlowski, Z.S., 1997. Critical points in the clinical managements of cystic echinococcus: a revised review. In: Anderson, F.L., Quhelli, H., Kachani, M. (Eds.), Compendium on Cystic Echinococcus in Africa and in Middle Eastern Countries with Special Reference to Morocco. Brigham Young University, Print Service, Provo Utah, 84602 USA, pp. 119–135. Pednekar, P.R., Gatne, L.M., Thompson, R.C.A., Traub, R.J., 2009. Molecular and morphological characterisation of Echinococcus from food producing animals in India. Vet. Parasitol. 165, 58–65. Schwabe, 1986. Current status of hydatid disease: a zoonosis of increasing importance. In: Thompson, R.C.A. (Ed.), The Biology of Echinococcus and Hydatid Disease. G. Allen & Unwin, London, pp. 81–113. Sharma, M., Sehgal, R., Fomda, B.A., Malhotra, A., Malla, N., 2013. Molecular characterization of Echinococcus granulosus cysts in north Indian patients: identification of G1, G3, G5 and G6 genotypes. PLoS Negl. Trop. Dis. 7 (6), e2262. http://dx.doi.org/ 10.1371/journal.pntd.0002262. (Jun). Singh, B.B., Sharma, J.K., Ghatak, S., Sharma, R., Bal, M.S., Tuli, A., Gill, J.P.S., 2012. Molecular epidemiology of Echinococcosis from food producing animals in north India. Vet. Parasitol. 186 (3–4), 503–506. Singh, B.B., Dhand, N.K., Ghatak, S., Gill, J.P.S., 2014a. Economic losses due to cystic Echinococcosis in India: need for urgent action to control the disease. Prev. Vet. Med. 113 (1), 1–12. Singh, B.B., Sharma, J.K., Tuli, A., Sharma, R., Bal, M.S., Aulakh, R.S., Gill, J.P.S., 2014b. Prevalence and morphological characterization of Echinococcus granulosus from north India. J. Parasit. Dis. 38 (1), 36–40. Smith, B.P., 2016. Large animal internal medicine. In: Diseases of Alimentary Tract. Elsevier Health Sciences, pp. 66–70. Thompson, R.A., McManus, D.P., 2002. Towards a taxonomic revision of the genus Echinococcus. Trends Parasitol. 18 (10), 452–457. Torgerson, P.R., Carmona, C., Bonifacino, R., 2000. Estimating the economiceffects of cystic echinococcosis: Uruguay, a developing country withupper-middle income. Ann. Trop. Med. Parasitol. 94, 703–713.
5. Conclusions Presence of multiple hydatid cysts involving large area of lung lobes result in clinical disease in dairy cattle and buffaloes with symptoms such as coughing, dyspnoea and stridor. These cysts can be effectively diagnosed using radiographic, ultrasonographic and microscopic examination(s) of the cyst fluid. Stridor is commonly associated with lesion in the upper respiratory tract but should be further investigated for hydatid cysts in disease endemic areas. Conflict of interest statement No financial or personal relationships between the authors and other people or organizations have inappropriately influenced (bias) this work.
53