Antemortem diagnosis and attempted treatment of (Halicephalobus) Micronema deletrix infection in a horse.

eight-year-old, 345 kg, Arabian gelding Medical Teaching Hospital for evaluation of bilateral facial swelling and concurrent weight loss and dysphagia of 30 days duration. The horse was unresponsive to previous treatment with procaine penicillin G and phenylbutazone. On physical examination, the horse was depressed and cachectic. There was bilateral, asymmetric (more pronounced on the left) facial swelling over the maxillary sinuses. Examination of the oral cavity revealed long enamel points on the premolars and molars of both upper and lower dental arcades. Linear erosions were noted on the hard palate, and gingival hypertrophy of the lingual and buccal aspects of the maxillary oral mucosa was apparent. The left submandibular lymph node was enlarged, and skin abra-sions were observed in the area of the throat latch where the halter would normally be located. Neurological examination was unremarkable. Differential diagnosis included facial trauma, neoplasia, hyperparathyroidism, and or bacterial sinusitis. Complete blood count revealed a normocytic normochromic anemia with hyperglobulinemia (5.6 g/dL, normal = 3.1-5.2 g/dL). Serum chemistry and electrolyte evaluations were normal. Strongyle type eggs were found on fecal examination. Radiographs of the skull demonstrated bilateral, lateral displacement of the upper dental arcade and osteopenia of the nasal, incisor, and maxillary bones. Endoscopic examination of the mid-dle and ventral meatus revealed numerous, 3-10 mm in diameter, raised, sessile lesions and grade II lymphoid hyperplasia of the pharynx. The