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In the later phases of infection, the disease is characterised by profuse, watery 'pipe-stem' diarrhoea and weight loss despite maintaining a good appetite. The disease is progressive and advanced cases may develop submandibular or ventral oedema due to a protein losing enteropathy.
In the later phases of infection, the disease is characterised by profuse, watery 'pipe-stem' diarrhoea and weight loss despite maintaining a good appetite. The disease is progressive and advanced cases may develop submandibular or ventral oedema due to a protein losing enteropathy.
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The disease is similar in goats and sheep except diarrhoea is not a feature.
==Pathogenesis==
==Pathogenesis==
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==Gross Pathology==
==Gross Pathology==
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The infected host appears emaciated.
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The infected host appears emaciated. Fat is pale and oedematous, and only present in small amounts.
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Signs are confined to the terminal [[Small Intestine - Anatomy & Physiology|small intestine]] (especially the [[Ileum - Anatomy & Physiology|ileum]]) but are characteristic. The mucosal surface is diffusely thickened with transverse, corrugated rugae. Infected animals may also have enlarged mesenteric lymph nodes.
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Fat is pale and oedematous, and only present in small amounts.
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[[Image:johnes disease proliferative ileitis.jpg|thumb|right|150px|Proliferative ileitis in Johnes disease (Courtesy of Bristol BioMed Image Archive)]]
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Signs are confined to the terminal [[Small Intestine - Anatomy & Physiology|small intestine]] (especially the [[Ileum - Anatomy & Physiology|ileum]]) but are characteristic. It has diffusely thickened, velvety mucosa surface and transverse, corrugated ruggae with reddened crests. Infected animals may also have enlarged mesenteric lymph nodes
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[[Image:johnes disease proliferative ileitis.jpg|thumb|right|150px|Proliferative ileitis in Johnes disease (Courtesy of Bristol BioMed Image Archive)]]
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Changes are milder in sheep and goats, than seen in cows, and is symptoms are often missed.
==Histologically==
==Histologically==
There are many large macrophages (epithelioid macrophages) in mucosa, submucosa and lymph nodes.
There are many large macrophages (epithelioid macrophages) in mucosa, submucosa and lymph nodes.
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The mesenteric lymph nodes are pale and enlarged (though not necrotic), and the lamina propria is infiltrated by sheets of macrophages with some lymphocytes.
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The mesenteric lymph nodes are pale and enlarged (though not necrotic), and the lamina propria is infiltrated by sheets of macrophages with some lymphocytes. Acid-fast bacteria are found in the macrophages and giant cells, and this is detected by Ziehl-Neelson stain.
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Acid-fast bacteria are found in the macrophages and giant cells, and this is detected by Ziehl-Neelson stain.
Bacteria act like foreign bodies producing a type IV hypersensitivity reaction.
Bacteria act like foreign bodies producing a type IV hypersensitivity reaction.