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Rhodococcus Equi


Presentation

  • ADR Presented by Dr. Richard Markell Cellulitis Presented by Dr. Phoebe Smith Foal Diarrhea Presented by Dr. Bonnie Barr Laminitis Presented by Dr. Luis Castro Bone Injury vs Bone Infection Presented by Dr.[stablelab.com]
  • It sometimes affects humans presenting as cavitary pneumonia. Immunocompromised patients, including HIV-infected patients, are more susceptible to R. equi infection.[liebertpub.com]
  • Clinical Case We present the case of a 79-year-old patient with a clinical history of myocardial infarction, heart failure and global respiratory failure.[archbronconeumol.org]
  • Ten (38%) cases had pulmonary involvement at presentation.[nzma.org.nz]
  • Full Text Dear Editor, Infections by Rhodococcus species are very rarely seen in humans. 1,2 We present the case of a 52-year-old Spanish-born male construction worker with a history of hypertension and moderate heart failure and no history of habitual[elsevier.es]
Weight Loss
  • Clinical signs of Rhodococcus equi can include fever, depression, coughing, weight loss, swollen joints, colic and/or diarrhea.[cahosp.com]
  • Luis Castro Weight Loss Work Up Presented by Dr. Phoebe Smith Peritonitis Presented by Dr. Korin Potenza Screening for Rhodococcus Equi Presented by Dr. Jaye McCracken Septic Joints Presented by Dr.[stablelab.com]
  • Foals with abdominal involvement often present with fever, depression, anorexia, weight loss, colic, and diarrhea.[msdvetmanual.com]
Asymptomatic
  • After 16 months of follow-up, the patient was asymptomatic and had neither recurrence nor immunological disturbances.[erj.ersjournals.com]
  • Three months later, the pulmonary mass had disappeared and 12 months later the patient remained asymptomatic with periodic check-ups at the haematology clinic. Discussion The first infection caused by R. equi in man was described in 1967.[archbronconeumol.org]
Fever of Unknown Origin
  • Richard Markell Fever of Unknown Origin Presented by Dr. Phoebe Smith Pending Colitis Presented by Dr. Luis Castro Weight Loss Work Up Presented by Dr. Phoebe Smith Peritonitis Presented by Dr.[stablelab.com]
  • […] of unknown origin.[archbronconeumol.org]
Intravenous Drugs
  • We recently treated a patient with AIDS who had bacteremia and a cavitating pneumonia caused by Rhodococcus equi .AIDS was diagnosed in a 38-year-old white male homosexual and former intravenous drug abuser in July 1984 on the basis of oral candidiasis[nejm.org]
Candidiasis
  • We recently treated a patient with AIDS who had bacteremia and a cavitating pneumonia caused by Rhodococcus equi .AIDS was diagnosed in a 38-year-old white male homosexual and former intravenous drug abuser in July 1984 on the basis of oral candidiasis[nejm.org]
Heart Failure
  • Clinical Case We present the case of a 79-year-old patient with a clinical history of myocardial infarction, heart failure and global respiratory failure.[archbronconeumol.org]
  • Full Text Dear Editor, Infections by Rhodococcus species are very rarely seen in humans. 1,2 We present the case of a 52-year-old Spanish-born male construction worker with a history of hypertension and moderate heart failure and no history of habitual[elsevier.es]
Hypertension
  • Full Text Dear Editor, Infections by Rhodococcus species are very rarely seen in humans. 1,2 We present the case of a 52-year-old Spanish-born male construction worker with a history of hypertension and moderate heart failure and no history of habitual[elsevier.es]
Chronic Abscess
  • abscessating bronchopneumonia of foals up to 3-5 months of age.[vetres.org]
Joint Swelling
  • The most common one is pneumonia, but its other forms include abdominal abscesses, joint swelling or infection, bone infection, and ocular manifestations among others.[cahosp.com]
Asthenia
  • He attended the emergency department due to a decreased level of consciousness, asthenia and drowsiness. Physical examination showed blood pressure 73/47 mmHg, heart rate 120 beats/min, mild fever and basal oxygen saturation of 86%.[archbronconeumol.org]
Confusion
Apathy
  • Physical examination upon admission revealed disorientation in time and space, frank bradypsychia, mild right brachial paresis, motor aphasia, apathy, and aboulia.[elsevier.es]

Workup

Air Bronchogram
  • Chest X-ray showed a rounded high attenuation area in the right hemithorax, with no air bronchogram, measuring 5 cm 4 cm, on the right parahilar region ( Fig. 1 a).[archbronconeumol.org]
Staphylococcus Aureus
  • The radiological differential diagnosis should be made mainly with pneumonia due to Pneumocystis jirovecci or Staphylococcus aureus, central bronchogenic carcinoma and pulmonary tuberculosis.[archbronconeumol.org]

Treatment

  • Antibiotic treatment was the mainstay of treatment while some patients had surgical treatment in combination or as the sole therapy. Antibiotic treatment was described in 24 (92%) patients.[nzma.org.nz]
  • Recent evidence suggests that a high proportion of foals identified via screening methods such as ultrasonographic evaluation of the thorax can recover without treatment, questioning the “trigger” required for treatment of identified cases.[dovepress.com]
  • Prompt diagnosis, early initiation of antiretroviral treatment and combined antimicrobial treatment seem to be effective to eradicate the infection and to improve the outcome.[liebertpub.com]
  • There is no consensus regarding what treatment should be used, or the treatment duration. The most common recommendation 5,8 is to administer erythromycin with vancomycin or rifampicin during at least 3 weeks.[elsevier.es]
  • Blood cultures were drawn and intravenous imipenem treatment was initiated empirically, due to suspected sepsis and pulmonary mass.[archbronconeumol.org]

Prognosis

  • The prognosis for survival for foals with R. equi pneumonia is good, especially in foals mildly or subclinically affected, as is the prognosis for future athletic performance.[dovepress.com]
  • The prognosis for foals with abdominal forms of R equi is less favorable than for those with pulmonary disease. Septic physitis and osteomyelitis are less common extrapulmonary sites of infection.[msdvetmanual.com]
  • With respect to the prognosis, the mortality reaches 50% in HIV patients, 25% in other types of immunosuppression and 11% in immunocompromised patients. 5 It is exceptionally observed in immunocompromised patients who do not have HIV, as in our case,[archbronconeumol.org]
  • We have focused mainly on pulmonary infection as it is the commonest manifestation and has the worst prognosis.[nzma.org.nz]

Epidemiology

  • Compelling epidemiologic data indicate pulmonary infection probably originates within the first week of life. (See also Rhodococcosis .) R equi is a gram-positive, facultative intracellular pathogen that is nearly ubiquitous in soil.[msdvetmanual.com]
Sex distribution
Age distribution

Prevention

  • Management of R. equi infections, in particular on farms with endemic disease, combines appropriate treatment of affected foals with preventative measures targeted at preventing infection and identifying foals before the development of severe disease.[dovepress.com]
  • Administration of hyperimmune plasma might reduce the incidence and severity of R equi within the herd, but it is not completely effective in preventing disease.[msdvetmanual.com]

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