╨╧рб▒с>■  #%■   "                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴ ┐м jbjbjкjк ╚╚м      ]ввввввв╥╥╥╥╥ ▐ ╥mъЎЎЎЎЎЎЎЎ*,,,,,,,WЇKnXвЎЎЎЎЎXтввЎЎЎтттЎ╩вЎвЎ*╢─ввввЎ*тHт*вв*ъ -ё╥╢╥╥└"*Group 11 Diagnosis : Bacterial Osteomyelitis Based on the history, clinical signs, cytology, and radiographs the most likely etiology is a hematogenous movement of bacteria from the gastrointestinal tract to the distal physis of metatarsal III. This diagnosis is consistant with hypothesis 3. It is common for clients to present cases of acute osteomyelitis in foals as possible traumatic injuries as seen in this case. Foals with osteomyelitis present with acute lameness and swelling of the affected bone/joint as seen in this case. Young foals are susceptible to bacteria in the blood stream from various routes including umbilicus, lungs, gastrointestinal tract, etc. When the bacteria laden blood enters the small capillary beds in the peripheral tissues, the blood flow slows and the bacteria can attach and begin to proliferate. There is ample blood supply to the physis in foals, so bacteria will commonly deposit in the small terminal sinusoids of the bones near the growth plates and/or the joint capsules. It is common for osteomyelitis to spread from the growth plate to the local joint capsule. Klebsiella pneumoniae was found in the joint tap, and is therefore the most likely etiologic agent. Klebsiella is an enterobacteriaciae so the gastrointestinal tract is the likely source. The bacteria found in the joint are most likely secondary to a primary osteomyelitis. The lack of inflammatory cells in the joint cytology support this theory. Osteomyelitis leads to localized inflammation of the bone and bony lysis. The radiographs support this diagnosis by demonstrating bone lysis and possible pathologic fractures of the distal growth plate of metatarsal III.  1м ¤5Б 12/0%&─ ┼ е ж з и й к л м ¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤ 12/0%&─ ┼ е ж з и й к л м ░╨/ ░р=!░"░#Ра$Ра%░ [4@ё 4NormalCJOJPJQJmH <A@Є б<Default Paragraph Fontм       мм м м  -РЬрцcp╗╚v|&dnoy╚╥┘ыhu┼╥ MRо жзо   Math Emporium=Macintosh HD:Desktop Folder:Student's Folder:3diagnosis_a.txt Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 3diagnosis Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 3diagnosis Math Emporium?Macintosh HD:Desktop Folder:Student's Folder:Word Work File A 4 Math EmporiumBMacintosh HD:Desktop Folder:Student's Folder:Word Work File A 1358 @Ажж|а~жж╞▌м@@GРTimes New Roman5РАSymbol3Р Arial3РTimes"qИ╨hЭcS&!dS&6!е└┤┤А20dX╨  Group 11 Math Emporium Math Emporium■  рЕЯЄ∙OhлС+'│┘0hИРд░╚╘ф № $ 0 <HPX`' Group 11t rouMath EmporiumoathNormalpMath Emporiumo4thMicrosoft Word 8.0d@─0Л@ц:░*л└@╬╨<л└■  ╒═╒Ь.УЧ+,∙о0№ hpИРШа и░╕└ ╚ ▌'Virginia Techp м  Group 11 Title ■    ■   ■    !■   ¤   $■   ■   ■                                                                                                                                                                                                                                                                                                                                                                       Root Entry         └FА,ж-л└&А1Table         WordDocument        SummaryInformation(    DocumentSummaryInformation8            CompObj            X                        ■                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           ■      └FMicrosoft Word Document■   NB6WWord.Document.8