Distinction between porcine circovirus type 2 enteritis and porcine proliferative enteropathy caused by Lawsonia intracellularis

The presence of porcine circovirus type 2 (PCV2) was studied immunohistochemically in formalin-fixed, paraffin wax-embedded samples of intestinal tissue from 80 pigs with a clinical history suggestive of Lawsonia intracellularis-associated diarrhoea. Histopathologically, enteritis of varying intensity was diagnosed in 64 of the pigs. Of these 64 animals, 34 (18%) were infected with both PCV2 and L. intracellularis. Of the remaining 30 cases of enteritis, 23 (77%) were attributed to PCV2 infection alone. The PCV2-associated enteritis cases showed necrotizing ileitis and colitis, indistinguishable macroscopically from proliferative enteritis (PE) due to L. intracellularis. Histopathologically, L. intracellularis-positive intestines showed adenomatous proliferation of crypt enterocytes, whereas PCV2 enteritis was characterized by histiocytosis of varying intensity, with PCV2-positive cells in the submucosa, lamina propria and crypt epithelium, as well as in the lymphoid tissue of the ileum and colon. Multinucleated giant cells, however, were seen in both infections. PCV2 was about three times more likely to be detected in L. intracellularis-negative than in L. intracellularis-positive samples (P<0.001). There was no association between PCV2 and other intestinal bacterial pathogens. The study demonstrated that PCV2 enteritis should be borne in mind in the differential diagnosis of L. intracellularis infection in pigs aged 2-4 months with a clinical history of diarrhoea.