Frequently the first signs that a cat has HCM are tachypnea/dyspnea due to heart failure or acute pain and paralysis due to systemic thromboembolism. While medication is commonly given to cats with HCM that have no clinical signs, no medication has been shown to be helpful at this stage and it has been shown that an ACE inhibitor is not beneficial until heart failure is present (at which time a diuretic is most beneficial). Diltiazem generally produces no demonstrable benefit. Atenolol is commonly administered when a severe systolic anterior motion of the mitral valve is present.Feline arterial thromboembolism (FATE) is a relatively common and devastating complication of feline HCM and other feline cardiomyopathies. The thrombus generally forms in the left atrium, most commonly the left auricle. The formation is thought to be primarily due to blood flow stasis. Classically, the thromboembolism lodges at the iliac trifurcation of the aorta, occluding either one or both of the common iliac arteries. Because this split is called the saddle, and is the most frequent location for the thrombus, FATE is commonly known as saddle thrombus. Clinically this presents as a cat with complete loss of function in one or both hind limbs. The hind limbs are cold and the cat is in considerable pain. Emboli may, rarely, lodge in other locations, most commonly the right front limb and the renal arteries.Clopidogrel is used to try to prevent left atrial thrombus formation in cats with HCM and a large left atrium.
If the infected person resides in Brazil, it is mandatory that the infection is reported to the health authority so that a proper investigation of the contacts can be completed. This investigation will help to determine the probable source of the infection. Treatment
It is extremely difficult to successfully treat BPF, mainly because of the difficulty obtaining a proper diagnosis. Since the disease starts out with what seems to be a common case of conjunctivitis, H. aegyptius is not susceptible to the antibiotic eye drops that are being used to treat it. This treatment is ineffective because it treats only the local ocular infection, whereas if it progresses to BPF, systemic antibiotic treatment is required. Although BPF is susceptible to many commonly used antibiotics, including ampicillin, cefuroxime, cefotaxime, rifampin, and chloramphenicol, by the time it is diagnosed the disease has progressed too much to be effectively treated. However, with the fast rate of progression of BPF it is unlikely that it will be successfully treated. With antibiotic therapy, the mortality rate of BPF is around 70%. References
Barbosa, S.F.C. ; Hoshino-Shimizu, S.; das Gracas A. Alknin, M.; Goto, H. (2003). "Implications of Haemophilus influenzae Biogroup aegyptius Hemagglutinins in the Pathogenesis of Brazilian Purpuric Fever". Journal of Infectious Diseases. 188 (1): 74–80. doi:10.1086/375739. PMID 12825174. Harrison, L.H. ; Da Silva, G.A. ; Pittman, M.; Fleming, D.W.; Vranjac, A.; Broome, C.V. (1989). "Epidemiology and Clinical Spectrum of Brazilian Purpuric Fever". Journal of Clinical Microbiology. 27 (4): 599–604. doi:10.1128/JCM.27.4.599-604.1989. PMC 267380. PMID 2656737. Harrison, L.H. ; Simonsen, V.; Waldman, E.A. (2008).