## Overview Guttural pouch empyema is accumulation of pus in one or both guttural pouches, usually after upper-respiratory infection with Streptococcus species (including Streptococcus equi). Signs include purulent nasal discharge (worse when the head is lowered), parotid swelling, and fever. Chronic cases form chondroids. ## Causes Bacterial infection, most often following strangles or other upper-airway disease. ## Diagnosis Endoscopy of the guttural pouches showing purulent material, radiographs demonstrating a fluid line, and culture. ## Treatment Repeated lavage of the pouch plus systemic and local antibiotics. Chondroids may need surgical removal. Systemic antibiotics alone rarely clear the infection. ## Recovery and Prognosis Good with thorough lavage. Nerve damage or chronic chondroids complicate some cases. ## Prevention Prompt treatment of upper-respiratory infections and strangles biosecurity.
purulent nasal discharge (worse with head down); parotid swelling; fever; material visible on endoscopy; possible Horner's syndrome
## Overview Guttural pouch empyema is accumulation of pus in one or both guttural pouches, usually after upper-respiratory infection with Streptococcus species (including Streptococcus equi). Signs include purulent nasal discharge (worse when the head is lowered), parotid swelling, and fever. Chronic cases form chondroids. ## Causes Bacterial infection, most often following strangles or other upper-airway disease. ## Diagnosis Endoscopy of the guttural pouches showing purulent material, radiographs demonstrating a fluid line, and culture. ## Treatment Repeated lavage of the pouch plus systemic and local antibiotics. Chondroids may need surgical removal. Systemic antibiotics alone rarely clear the infection. ## Recovery and Prognosis Good with thorough lavage. Nerve damage or chronic chondroids complicate some cases. ## Prevention Prompt treatment of upper-respiratory infections and strangles biosecurity.
purulent nasal discharge (worse with head down); parotid swelling; fever; material visible on endoscopy; possible Horner's syndrome