Chronic Osteitis Due to Rhodococcus equi in an Immunocompetent Patient

Bouchou, K; Cathébras, P.; Dumollard, Jean‐Marc; Poulard, G; Michel, Vanessa; Seguin, Pierre; Rousset, H.

doi:10.1093/clinids/20.3.718

Cited by 12 publications

(4 citation statements)

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“…En pacientes con SIDA la infección por R. equi se presenta en un estadio avanzado de la infección por VIH; de hecho, en un reporte español que incluyó 67 pacientes, el recuento promedio de linfocitos CD4(+) era de 35 cel/mm³ 9 . En individuos inmunocompetentes se han reportado a la fecha alrededor de veinticinco casos [10][11][12][13][14][15][16][17][18][19][20] . La mortalidad asociada a la infección varía según la condición del hospedero, siendo de aproximadamente 11% en inmunocompetentes, 20-25% en pacientes inmunodeprimidos no-VIH y hasta 50-55% en pacientes con SIDA 20,21 .…”

Section: Discussionunclassified

Neumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana: Caso clínico y revisión

et al. 2005

Rev. chil. infectol.

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Rev Chil Infect 2005; 22 (2): 155-160 CASO CLÍNICONeumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana. Caso clínico y revisión RICARDO RABAGLIATI B., ARTURO MORALES S., RENÉ BAUDRAND B., JORGE JORQUERA A., DAVID ODDÓ B., PATRICIA GARCÍA C., M. CECILIA CARMONA P., MARCELA CISTERNAS M. y ÁLVARO HUETE G. Necrotizing pneumonia due to Rhodococcus equi in non HIV immunocompromised host. Case report and reviewRhodococcus equi, is a grampositive intracellular bacillus, that causes infection mainly in immunocompromised hosts. We report the case of a 52 years old woman, with a systemic lupus erythematosus and a progressive 10 months evolution with cough, dyspnea, mucous-purulent sputum, occasionally hemoptysis, intermittent fever, and weight loss of 10%. With partial response to antibiotic treatment, radiological evolution of thoracic scanners evidenced the development of multiple bilateral areas of consolidation, some of them nodular. Percutaneous thoracic biopsy showed characteristic histology and microbiological analysis yielded the identification of Rhodococcus equi in both bronchoalveolar lavage and pulmonary biopsy. She received prolonged bi-associated antibiotic treatment with good clinical and radiological response. This agent must be considered in the study of immunocompromised patients that present with a prolonged evolution of pneumonia.

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Section: Discussionunclassified

Neumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana: Caso clínico y revisión

et al. 2005

Rev. chil. infectol.

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“…In agreement with the importance of the protective immunity to control R. equi in animal models, immunocompetent patients with R. equi infection treated with antibiotics have better outcomes in general when compared to infected immunocompromised individuals [15, 26–29]. However, there are case reports of deaths in immunocompetent patients diagnosed with R. equi pneumonia [30, 31].…”

Section: Discussionmentioning

confidence: 84%

Differences inRhodococcus equiInfections Based on Immune Status and Antibiotic Susceptibility of Clinical Isolates in a Case Series of 12 Patients and Cases in the Literature

Gundelly

Suzuki

Ribes

et al. 2016

BioMed Research International

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Rhodococcus equi is an unusual zoonotic pathogen that can cause life-threatening diseases in susceptible hosts. Twelve patients with R. equi infection in Kentucky were compared to 137 cases reported in the literature. Although lungs were the primary sites of infection in immunocompromised patients, extrapulmonary involvement only was more common in immunocompetent patients (P < 0.0001). Mortality in R. equi-infected HIV patients was lower in the HAART era (8%) than in pre-HAART era (56%) (P < 0.0001), suggesting that HAART improves prognosis in these patients. Most (85–100%) of clinical isolates were susceptible to vancomycin, clarithromycin, rifampin, aminoglycosides, ciprofloxacin, and imipenem. Interestingly, there was a marked difference in susceptibility of the isolates to cotrimoxazole between Europe (35/76) and the US (15/15) (P < 0.0001). Empiric treatment of R. equi infection should include a combination of two antibiotics, preferably selected from vancomycin, imipenem, clarithromycin/azithromycin, ciprofloxacin, rifampin, or cotrimoxazole. Local antibiograms should be checked prior to using cotrimoxazole due to developing resistance.

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“…In contrast, granulomas have previously been found in immunocompetent patients during chronic infection with R. equi (4,14). These granulomas exhibited caseating necrosis.…”

Section: Case Reportmentioning

confidence: 75%

“…In our case, no caseating granulomas were observed, but granuloma formation was a manifestation of the immune response to this chronic infection. In the other cases reported with granulomas (4,14), no investigations of a potential CD8 deficit were carried out. The search for this type of deficit is not performed routinely, and it might therefore be present but go unrecognized.…”

Section: Case Reportmentioning

confidence: 99%

Nonhealing Wound Due toRhodococcus equiin an Apparently Immunocompetent Patient, Revealing CD8⁺T-Lymphocyte Deficiency

Denès

Peignon-Orsoni²,

Terrade³

2010

J Clin Microbiol

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Chronic Osteitis Due to Rhodococcus equi in an Immunocompetent Patient

Cited by 12 publications

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Neumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana: Caso clínico y revisión

Neumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana: Caso clínico y revisión

Differences inRhodococcus equiInfections Based on Immune Status and Antibiotic Susceptibility of Clinical Isolates in a Case Series of 12 Patients and Cases in the Literature

Nonhealing Wound Due toRhodococcus equiin an Apparently Immunocompetent Patient, Revealing CD8⁺T-Lymphocyte Deficiency

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Chronic Osteitis Due to Rhodococcus equi in an Immunocompetent Patient

Cited by 12 publications

References 0 publications

Neumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana: Caso clínico y revisión

Neumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana: Caso clínico y revisión

Differences inRhodococcus equiInfections Based on Immune Status and Antibiotic Susceptibility of Clinical Isolates in a Case Series of 12 Patients and Cases in the Literature

Nonhealing Wound Due toRhodococcus equiin an Apparently Immunocompetent Patient, Revealing CD8+T-Lymphocyte Deficiency

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Nonhealing Wound Due toRhodococcus equiin an Apparently Immunocompetent Patient, Revealing CD8⁺T-Lymphocyte Deficiency