Management of complicated pleuro pneumonia

Infection of the lower respiratory tract in horses is common, and can range from mild disease of the conducting airways to fulminant and life-threatening infection and necrosis of lung parenchyma with concurrent pleural effusion. Disease with limited involvement of the parenchyma and pleural cavities often resolves with administration of appropriate antimicrobial agents. Conversely, marked infection and tissue damage and/or extensive pleural involvement present considerable challenges for successful resolution of infection and management of complications. Complications include pulmonary abscessation, intrathoracic (intrapleural) fibrin deposition, fluid loculisation and abscessation, pericarditis, cardiovascular dysfunction, thrombophlebitis and laminitis. Consequently, appropriate assessment, including use of ancillary diagnostic methods, targeted treatments and careful patient monitoring are required for the management of horses with complicated (pleuro)pneumonia.