The facultative human oral pathogen Prevotella histicola in equine cheek tooth apical/ periapical infection: a case report.
Authors: Kau Silvio, Mansfeld Michael D, Šoba Alexandra, Zwick Timo, Staszyk Carsten
Journal: BMC veterinary research
Summary
# Editorial Summary: *Prevotella histicola* in Equine Dental Disease A 12-year-old Tinker mare presenting with intractable nasal discharge and quidding unresponsive to standard medical management was diagnosed with severe apical/periapical infection of the upper right cheek tooth (209), complicated by unilateral sinusitis and conchal necrosis; computed tomography revealed extensive infundibular cemental hypoplasia, caries, and an occlusal fissure fracture. Bacteriological culture and matrix-assisted laser desorption ionisation-time of flight mass spectrometry identified *Prevotella histicola*, a facultative anaerobic pathogen previously documented only in human oral pathology, representing the first documented case of this organism causing dental infection in the horse. Successful treatment combined intraoral tooth extraction with mechanical debridement of the carious infundibulum and transendoscopic management of sinusitis, alongside targeted antibiotic therapy, resulting in uncomplicated healing. This case highlights the need for rigorous microbiological identification in equine dental infections, particularly when clinical response to empirical antibiotics is poor, as species-specific treatment significantly improves outcomes. The findings suggest broader cross-species distribution of *Prevotella* spp. than previously recognised and underscore the value of culture-based diagnostics over presumptive antimicrobial protocols in equine dental practice.
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Practical Takeaways
- •Persistent nasal discharge and quidding unresponsive to initial antibiotics warrant advanced imaging (CT) and microbiological culture of affected teeth to identify causative organisms and guide treatment.
- •Infundibular hypoplasia and caries create conditions for opportunistic pathogenic bacteria; extraction combined with sinusitis management offers better outcomes than conservative therapy alone in severe cases.
- •MALDI-TOF or similar microbial identification should be considered in complex dental infections to enable targeted antibiotic selection rather than empirical broad-spectrum therapy.
Key Findings
- •Prevotella histicola, a facultative human oral pathogen, identified for the first time in equine dental infection causing severe apical/periapical disease of upper cheek tooth 209.
- •The infected tooth exhibited extensive subocclusal mesial infundibular cemental hypoplasia, caries, and occlusal fissure fracture with accompanying unilateral sinonasal inflammation and conchal necrosis.
- •Surgical extraction combined with transendoscopic sinusitis treatment and targeted antibiotic therapy resulted in normal healing without complications.
- •Case demonstrates necessity for microbiological culture and MALDI-TOF identification in equine dental infections to enable targeted antimicrobial therapy.