Guttural Pouch Fungal Infection Resolved!!

Back in January, a gelding presented for a history of recurrent nasal discharge. Endoscopic exam revealed the presence of a fungal infection within one of the guttural pouches (Figures 1 and 2) . A bacterial and fungal culture was performed on fluid/debris collected from the pouch. The bacterial culture was negative however the fungal culture was positive for Cladosporium spp. This species of fungi is very common in the environment, especially in the presence of moist or wet wood. In humans, it is a big player in fungi induced allergies. Interestingly, this species of fungi has not been described in the guttural pouch of a horse previously!

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The gelding was treated with a specific anti-fungal medication given by mouth daily. After 4 weeks of treatment, there was a 50% reduction in the size of the fungal plaque and the degree of inflammation (Figures 3 and 4).

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After 2 months of treatment there has been complete resolution of the fungal infection and inflammation (Figures 5 and 6). The stylohyoid bone remains slightly thickened compared to the opposite stylohyoid bone (Figure 7) however this will like resolve over the next 3-6 months. This case is unusual in several ways. First, the species of fungi has not been described before in the guttural pouch of a horse, secondly, most guttural pouch fungal infections include bleeding (epistaxis) thirdly, there are few reports of successful treatment of guttural pouch fungal infections in horses with JUST systemic anti-fungals.

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Figure 7