## Overview Bursal inflammation at the poll (poll evil when it becomes chronic and fistulous) is inflammation of the cranial nuchal bursa that lies between the nuchal ligament and the atlas. Early disease produces painful swelling at the poll; if the bursa ruptures or becomes infected, draining tracts develop. Historically the condition was linked to Brucella abortus, although other bacteria and trauma are now more commonly implicated. ## Causes Direct trauma, penetrating wounds, and extension of infection from adjacent tissues are the usual modern causes. Brucella species remain a concern in endemic areas and pose a zoonotic risk. The evidence is limited on the current prevalence of Brucella-associated cases in many countries. ## Diagnosis Painful swelling at the poll, reluctance to flex the neck, and, in advanced cases, draining tracts are characteristic. Ultrasound and fluid analysis confirm bursal involvement and infection. Culture, including specific testing for Brucella when indicated, guides therapy. ## Treatment Early aseptic cases may respond to rest, anti-inflammatories, and drainage. Septic or fistulous disease requires prolonged antibiotics, surgical debridement, and sometimes removal of necrotic nuchal ligament. Brucella-positive horses need special public-health precautions. ## Recovery and Prognosis Prognosis is fair for early, non-infected cases and guarded once fistulas and bone involvement develop. Significant scarring can remain. ## Prevention Avoidance of poll trauma and prompt wound care reduce risk. Biosecurity measures limit Brucella exposure in endemic regions.
painful swelling at the poll; reluctance to lower or flex the neck; heat; draining tracts in chronic cases; fever if septic
## Overview Bursal inflammation at the poll (poll evil when it becomes chronic and fistulous) is inflammation of the cranial nuchal bursa that lies between the nuchal ligament and the atlas. Early disease produces painful swelling at the poll; if the bursa ruptures or becomes infected, draining tracts develop. Historically the condition was linked to Brucella abortus, although other bacteria and trauma are now more commonly implicated. ## Causes Direct trauma, penetrating wounds, and extension of infection from adjacent tissues are the usual modern causes. Brucella species remain a concern in endemic areas and pose a zoonotic risk. The evidence is limited on the current prevalence of Brucella-associated cases in many countries. ## Diagnosis Painful swelling at the poll, reluctance to flex the neck, and, in advanced cases, draining tracts are characteristic. Ultrasound and fluid analysis confirm bursal involvement and infection. Culture, including specific testing for Brucella when indicated, guides therapy. ## Treatment Early aseptic cases may respond to rest, anti-inflammatories, and drainage. Septic or fistulous disease requires prolonged antibiotics, surgical debridement, and sometimes removal of necrotic nuchal ligament. Brucella-positive horses need special public-health precautions. ## Recovery and Prognosis Prognosis is fair for early, non-infected cases and guarded once fistulas and bone involvement develop. Significant scarring can remain. ## Prevention Avoidance of poll trauma and prompt wound care reduce risk. Biosecurity measures limit Brucella exposure in endemic regions.
painful swelling at the poll; reluctance to lower or flex the neck; heat; draining tracts in chronic cases; fever if septic