Percutaneous puncture technique for treating persistent retropharyngeal lymph node infections in seven horses

Between 1999 and 2001, seven horses with fever, dysphagia and a history of chronic upper respiratory tract infection lasting between three weeks and three months were examined. They had been treated unsuccessfully with a variety of antibiotics for three to four weeks. A deep abscess in a retropharyngeal lymph node was diagnosed in each case by clinical examination, endoscopy and echographic examination of the retropharyngeal region. The infected retropharyngeal lymph node of each horse was punctured with a spinal needle under ultrasound guidance. Pus was aspirated from four of the horses, and their abscesses were then rinsed with 0.9 per cent saline solution, and antibiotics (sodium ceftiofur or penicillin) were injected. In the other three horses the pus was too viscous to be aspirated, and the enlarged lymph node was opened along the tract of the needle and rinsed with chlorhexidine. All the horses were treated with penicillin for two weeks and in six of them the clinical signs gradually disappeared. The other horse continued to show fever and the penicillin treatment was continued for another 10 days, after which the signs gradually disappeared over a period of two months.