Infecção pulmonar por "Rhodococcus equi": relato dos dois primeiros casos brasileiros

Severo, Luiz Carlos; Ritter, Patrícia D.; Petrillo, V.F.; Dias, Cícero Armídio Gomes; Porto, Nelson da Silva

doi:10.1590/s0102-35862001000300007

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…The first case of human infection was reported in 1967 in a patient presenting with a pulmonary abscess. The two first cases that occurred in Brazil were reported by Severo et al (2001). However, with the AIDS epidemic, the number of patients infected by R. equi has grown (Roda et al 2009).…”

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Rhodococcus equi isolation from sputum of patients with suspected tuberculosis

Silva

Miyata²,

Sato

et al. 2010

Mem. Inst. Oswaldo Cruz

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Rhodococcus equi has emerged as an opportunistic pathogen associated with pulmonary, invasive or systemic infections in immunocompromised patients. We report the identification of 51 R. equi isolates found in sputum samples of 546 individuals suspected to have pulmonary tuberculosis in two Public Health Hospital Units in Brazil.The epidemiology of R. equi infection as well as the phenotypic identification and drug susceptibility profile of isolates are described in this paper.Key words: Rhodococcus equi -identification -tuberculosis -antimicrobial profile -epidemiologyThe genus Rhodococcus belongs to the group of nocardioform, Gram-positive rods containing mycolic acids in the cell wall; this group also includes the genera My� cobacterium, Nocardia, Corynebacterium, Dietzia, Gor� donia, Millisia, Segniliparus, Skermania, Tsukamurella and Williamsia (Soddell et al. 2006a, b, Tsitko et al. 2006). The genus Rhodococcus was discovered by Zopf in 1891 (Goodfellow & Alderson 1977) and comprises 30 species, of which Rhodococcus equi is considered the most opportunistic pathogen in mammals, including humans (Meijer & Prescott 2004). The first case of human infection was reported in 1967 in a patient presenting with a pulmonary abscess. The two first cases that occurred in Brazil were reported by Severo et al. (2001). However, with the AIDS epidemic, the number of patients infected by R. equi has grown (Roda et al. 2009). R. equi also causes infection in patients with lymphoma, chronic renal failure, alcoholism, lung cancer, leukaemia, diabetes mellitus and other immunodeficient syndromes. Some cases have been reported in which the infection can also occur in immunocompetent hosts (von Bargen & Haas 2009).When incubated aerobically at 37°C, R. equi grows efficiently in the majority of nonselective culture media, including media used in mycobacteria isolation and produces irregular, smooth and mucoid colonies that turn a shade of salmon pink to yellow after a week of growth (Prescott 1991). R. equi appears coccoid on stained smears of clinical specimens, especially purulent material and tissue (obtained by biopsy, during surgery and upon autopsy). However, long rods have been reported in clinical specimens isolated from blood, sputum and bronchial lavage fluid In general, R. equi is biochemically non-reactive, has no proteolytic activity and fails to oxidize or ferment carbohydrates, with the exception of glucose, which is oxidized by R. equi in 14 days. R. equi is strictly aerobic, catalase positive, oxidase negative and mostly urease positive. R. equi produces soluble "equi factors" that are associated with phospholipase and cholesterol oxidase activity and interact with phospholipase D of Listeria ivanovii to induce complete haemolysis of sheep erythrocytes (Prescott 1991).The Laboratory of Mycobacteriology at the Adolfo Lutz Institute in Ribeirão Preto (SP, Brazil) has frequently isolated partial acid-fast bacteria from sputum of patients suspected to have pulmonary tuberculosis. Considering the emerging clinical im...

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confidence: 99%

Rhodococcus equi isolation from sputum of patients with suspected tuberculosis

Silva

Miyata²,

Sato

et al. 2010

Mem. Inst. Oswaldo Cruz

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“…Rhodococcus equi deve ser suspeitado em pacientes imunocomprometidos ou HIV positivos que apresentam infecção respiratória de curso não-habitual (pneumonia lentamente evolutiva) 9 . É importante o estudo da suscetibilidade aos antimicrobianos para o correto manejo do paciente, visto que, em geral, o tratamento específico desta infecção é prolongado.…”

Section: Discussionunclassified

Bacteremia por Rhodococcus equi em paciente com síndrome da imunodeficiência adquirida: relato de caso

Secchi

Pereira²,

Perez

et al. 2006

Rev. Soc. Bras. Med. Trop.

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RESUMORhodococcus equi é um importante agente de infecções zoonóticas, podendo causar sérias infecções em humanos, principalmente em pacientes imunocomprometidos. Neste estudo, nós relatamos o caso de uma bacteremia fatal devido a Rhodococcus equi em paciente com síndrome da imunodeficiência adquirida (HIV positivo). Palavras-chaves: Rhodococcus equi. Bacteremia. Imunocomprometidos. HIV. ABSTRACTRhodococcus equi is an important agent for zoonotic infections, and may cause serious infections in humans, especially immunocompromised patients. In this study, a case of fatal bacteremia due to Rhodococcus equi in a patient with acquired immunodeficiency syndrome (HIV positive) is reported.

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“…A duração do tratamento deverá ser igual ou superior a 2 meses (6 meses no caso de doentes imunocomprometidos) 1,13 . Em certos casos, nomeadamente quando falha o tratamento médico, alguns autores sugerem o tratamento cirúrgico 1,7 . O prognóstico da infecção humana por R. equi está relacionado com o estado imunológico do doente 2 .…”

Section: Galicia Clínica | Sociedade Galega De Medicina Internaunclassified