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Liang GF, Chao S, Sun Z, Zhu KJ, Chen Q, Jia L, Niu YL. Pleural empyema with endobronchial mass due to Rhodococcus equi infection after renal transplantation: A case report and review of literature. World J Clin Cases 2024; 12:224-231. [PMID: 38292625 PMCID: PMC10824171 DOI: 10.12998/wjcc.v12.i1.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/02/2024] Open
Abstract
BACKGROUND Kidney transplantation is the best option for patients with end-stage renal disease. However, the need for lifelong immunosuppression results in renal transplant recipients being susceptible to various infections. Rhodococcus equi (R. equi) is a rare opportunistic pathogen in humans, and there are limited reports of infection with R. equi in post-renal transplant recipients and no uniform standard of treatment. This article reports on the diagnosis and treatment of a renal transplant recipient infected with R. equi 21 mo postoperatively and summarizes the characteristics of infection with R. equi after renal transplantation, along with a detailed review of the literature. CASE SUMMARY Here, we present the case of a 25-year-old man who was infected with R. equi 21 mo after renal transplantation. Although the clinical features at the time of presentation were not specific, chest computed tomography (CT) showed a large volume of pus in the right thoracic cavity and right middle lung atelectasis, and fiberoptic bronchoscopy showed an endobronchial mass in the right middle and lower lobe orifices. Bacterial culture and metagenomic next-generation sequencing sequencing of the pus were suggestive of R. equi infection. The immunosuppressive drugs were immediately suspended and intravenous vancomycin and azithromycin were administered, along with adequate drainage of the abscess. The endobronchial mass was then resected. After the patient's clinical symptoms and chest CT presentation resolved, he was switched to intravenous ciprofloxacin and azithromycin, followed by oral ciprofloxacin and azithromycin. The patient was re-hospitalized 2 wk after discharge for recurrence of R. equi infection. He recovered after another round of adequate abscess drainage and intravenous ciprofloxacin and azithromycin. CONCLUSION Infection with R. equi in renal transplant recipients is rare and complex, and the clinical presentation lacks specificity. Elaborate antibiotic therapy is required, and adequate abscess drainage and surgical excision are necessary. Given the recurrent nature of R. equi, patients need to be followed-up closely.
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Affiliation(s)
- Guo-Fu Liang
- Department of Organ Transplantation, School of Clinical Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Sheng Chao
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Zhou Sun
- Department of Organ Transplantation, School of Clinical Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Ke-Jing Zhu
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Qian Chen
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Lei Jia
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Yu-Lin Niu
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
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Shah P, Rojas-Moreno C, Alexander J, Vasudevan A, Nguyen V. Rhodococcus equi: Another great masquerader. IDCases 2021; 24:e01144. [PMID: 34012774 DOI: 10.1016/j.idcr.2021.e01144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 11/29/2022] Open
Abstract
Rhodococcosis is a serious infection specially affecting immunocompromised populations. We report a case of disseminated infection by Rhodococcus equi in a renal transplant patient, that was initially diagnosed as histoplasmosis, highlighting the potential for confusion between rhodococcosis and other infections. Clinicians and pathologists should correlate histopathology findings with the clinical and microbiological data.
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Stewart A, Sowden D, Caffery M, Bint M, Broom J. Rhodococcus equi infection: A diverse spectrum of disease. IDCases 2019; 15:e00487. [PMID: 30656137 PMCID: PMC6329319 DOI: 10.1016/j.idcr.2019.e00487] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 12/11/2022] Open
Abstract
Rhodococcus equi is a gram positive bacterium most commonly presenting clinically as pneumonia, however can disseminate to cause disease in virtually any human tissue. Although it is predominantly an opportunistic pathogen, a number of case series have described infection occurring among individuals with a normal immune system. We describe two cases of Rhodococcus equi infection which highlight the diversity of disease presentations of this rare organism.
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Affiliation(s)
- Adam Stewart
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia
| | - David Sowden
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia.,Microbiology Department, Pathology Queensland, Sunshine Coast University Hospital, QLD, Australia
| | - Michael Caffery
- Microbiology Department, Pathology Queensland, Sunshine Coast University Hospital, QLD, Australia
| | - Michael Bint
- Respiratory Medicine, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia
| | - Jennifer Broom
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia.,University of Queensland, School of Medicine, QLD, Australia
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Wilmes D, Coche E, Rodriguez-Villalobos H, Kanaan N. Bacterial pneumonia in kidney transplant recipients. Respir Med 2018; 137:89-94. [PMID: 29605219 DOI: 10.1016/j.rmed.2018.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/06/2018] [Accepted: 02/26/2018] [Indexed: 12/16/2022]
Abstract
Bacterial pathogens are the most frequent cause of pneumonia after transplantation. Early after transplantation, recipients are at higher risk for nosocomial infections. The most commonly encountered pathogens during this period are gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa …), but gram-positive coccus such as Staphylococcus aureus or Streptococcus pneumoniae and anaerobic bacteria can also be found. Empirical antibiotic therapy should be guided by previous colonisation of the recipient and bacterial resistance pattern in the hospital. Six months after transplantation, pneumonias are mostly due to community-acquired bacteria (S. pneumonia, H. influenza, Mycoplasma, Chlamydia and others). Opportunistic pathogens take advantage of the state of immunosuppression which is usually highest from one to six months after transplantation. During this period, but also occurring many years later in the setting of a chronically depressed immune system, bacterial pathogens with low intrinsic virulence can cause pneumonia. The diagnosis of pneumonia caused by opportunistic pathogens can be challenging. The delay in diagnosis preventing the early instauration of adequate treatment in kidney transplant recipients with a depressed immune system, frequently coupled with co-morbid conditions and a state of frailty, will affect prognosis and outcome, increasing morbidity and mortality. This review will focus on the most common opportunistic bacterial pathogens causing pneumonia in kidney transplant recipients: Legionella, Nocardia, Mycobacterium tuberculosis/nontuberculous, and Rhodococcus. Recognition of their specificities in the setting of immunosuppression will allow early diagnosis, crucial for initiation of effective therapy and successful outcome. Interactions with immunosuppressive therapy should be considered as well as reducing immunosuppression if necessary.
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Affiliation(s)
- D Wilmes
- Division of Internal Medicine, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - E Coche
- Division of Radiology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - H Rodriguez-Villalobos
- Division of Microbiology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - N Kanaan
- Division of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
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Ursales A, Klein JA, Beal SG, Koch M, Clement-Kruzel S, Melton LB, Spak CW. Antibiotic failure in a renal transplant patient with Rhodococcus equi infection: an indication for surgical lobectomy. Transpl Infect Dis 2014; 16:1019-23. [PMID: 25412764 DOI: 10.1111/tid.12314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 06/03/2014] [Accepted: 09/11/2014] [Indexed: 12/18/2022]
Abstract
Rhodococcus equi is an animal pathogen that causes infrequent but challenging infections in immunocompromised individuals, few of which have been described in solid organ transplant recipients. Common clinical presentations include indolent cough, fever, and dyspnea, with necrotizing pneumonia and cavitation. We report a case of a dense right upper lung pneumonia with resultant R. equi bacteremia in a renal transplant recipient. Our patient initially responded to antibiotic treatment with resolution of bacteremia and clinical recovery, followed by interval progression in her right upper lobe consolidation on follow-up computed tomography scans. She underwent lobectomy for definitive therapy with resolution of symptoms. Lobectomy can be utilized in isolated infection after antibiotic failure with excellent clinical outcomes.
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Affiliation(s)
- A Ursales
- Department of Medicine, Division of Infectious Diseases, Baylor University Medical Center, Dallas, Texas, USA
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Ramanan P, Deziel P, Razonable R. Rhodococcus globerulusbacteremia in an allogeneic hematopoietic stem cell transplant recipient: report of the first transplant case and review of the literature. Transpl Infect Dis 2014; 16:484-9. [DOI: 10.1111/tid.12220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 12/30/2013] [Accepted: 01/02/2014] [Indexed: 12/11/2022]
Affiliation(s)
- P. Ramanan
- Division of Infectious Diseases and the William J von Liebig Transplant Center; Mayo Clinic College of Medicine; Rochester Minnesota USA
| | - P.J. Deziel
- Division of Infectious Diseases and the William J von Liebig Transplant Center; Mayo Clinic College of Medicine; Rochester Minnesota USA
| | - R.R. Razonable
- Division of Infectious Diseases and the William J von Liebig Transplant Center; Mayo Clinic College of Medicine; Rochester Minnesota USA
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Harrington SM, Bell M, Bernard K, Lagacé-Wiens P, Schuetz AN, Hartman B, McQuiston JR, Wilson D, Lasalvia M, Ng B, Richter S, Taege A. Novel fastidious, partially acid-fast, anaerobic Gram-positive bacillus associated with abscess formation and recovered from multiple medical centers. J Clin Microbiol 2013; 51:3903-7. [PMID: 24025902 DOI: 10.1128/JCM.01497-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a novel anaerobe causing abscess in four patients at three hospitals. In the clinical specimen, bacilli were branching, Gram positive, and acid fast. The organism grew slowly and was not identified by 16S rRNA sequencing. Our findings support the description of a new genus and species of the suborder Corynebacterineae.
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Guo Y, Guo F, Wei C, Qiu J, Liu Y, Fang Y, Gao J. CTLA4 gene polymorphisms influence the incidence of infection after renal transplantation in Chinese recipients. PLoS One 2013; 8:e70824. [PMID: 24015180 PMCID: PMC3754976 DOI: 10.1371/journal.pone.0070824] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 06/22/2013] [Indexed: 01/26/2023] Open
Abstract
Background Immunosuppressive therapy is usually administered following renal transplantation to protect the graft from rejection. However, this often causes complications such as infections to occur. Single nucleotide polymorphisms (SNPs) within the CTLA4 gene, such as −1772T/C (rs733618), +49A/G (rs231775) and +6230 G/A (rs3087243), can affect graft rejection and the long-term clinical outcome of organ transplantation. The role of CTLA4 SNPs in T cell-mediated immunity in renal transplantation and association with infection after transplantation is unknown. Methods In this study, the risk of infection according to CTLA4 SNPs was investigated in 304 patients who received kidney graft transplants between 2008 and 2012. Results The frequency of the rs4553808 GG genotype was significantly higher in recipients with viral infection (14.89%) than in those without infections (3.50%) (Bonferroni-adjusted p = 0.005). A significant difference (p = 0.001) in patients with the rs4553808 GG genotype from those with the AA+AG genotypes was found in the viral cohort using the log-rank test. A significant association was found between the rs4553808 genotype and onset of viral infection in transplant recipients (p = 0.001). The frequencies of the CGTAG and CGCAG haplotypes were significantly higher in the viral infection group (9.6% and 5.3%) than in the non-viral infection group (3.8% and 1.4%) (p = 0.0149 and p = 0.0111). No association between any CTLA4 SNP and bacterial infection was found. Multivariate analyses revealed that one risk factor, the use of antibody induction therapy (p = 0.007), was associated with bacterial infection, and two risk factors, antibody use (p = 0.015) and recipient rs4553808 genotype (p = 0.001), were associated with viral infection. Conclusions The rs4553808 GG genotype may be a risk factor for viral infection in kidney transplantation. The CTLA4 haplotypes CGTAG and CGCAG were partially associated with the development of viral infection in Chinese kidney transplant recipients.
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Affiliation(s)
- Yifeng Guo
- Urological Center and Organ Transplantation Center, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
- * E-mail: (YG); (FG)
| | - Fang Guo
- Lab of Tumor Targeted Therapy, Key Laboratory of Systems Biology, Chinese Academy of Sciences, Shanghai, China
- * E-mail: (YG); (FG)
| | - Chongyang Wei
- Lab of Tumor Targeted Therapy, Key Laboratory of Systems Biology, Chinese Academy of Sciences, Shanghai, China
| | - Jianxin Qiu
- Urological Center and Organ Transplantation Center, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Liu
- Urological Center and Organ Transplantation Center, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Fang
- Urological Center and Organ Transplantation Center, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Junwei Gao
- Department of Pharmacy, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Menon V, Gottlieb T, Gallagher M, Cheong EL. Persistent Rhodococcus equi infection in a renal transplant patient: case report and review of the literature. Transpl Infect Dis 2012; 14:E126-33. [PMID: 23013470 DOI: 10.1111/tid.12008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 04/18/2012] [Accepted: 06/06/2012] [Indexed: 12/14/2022]
Abstract
Rhodococcus equi is a pathogen that mainly causes infection in immunocompromised hosts. We report a case of relapsing R. equi pulmonary infection in a 57-year-old male renal transplant recipient who was treated with 12 months of antibiotics, adjunctive surgery, and a reduction in his immunosuppression. He suffered from relapsing disease, treatment-related complications, and ultimately died of Pneumocystis pneumonia. Case reports in the literature portray a good cure rate for transplant-related R. equi infections, with shorter durations of antibiotics. The case illustrates the difficulties in the management of R. equi infections. Forty cases from the literature were reviewed and compared in terms of epidemiology, location of infection, transplant type, immunosuppression used, treatment used, outcomes, and possible exposures.
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Affiliation(s)
- V Menon
- Department of Microbiology and Infectious Diseases, Concord Hospital, Concord, New South Wales, Australia
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Wong KW, Thevarajah B. Rhodococcal lung abscess in a renal transplant recipient. Am J Case Rep 2012; 13:191-4. [PMID: 23569526 PMCID: PMC3615939 DOI: 10.12659/ajcr.883327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 05/10/2012] [Indexed: 11/11/2022] Open
Abstract
Background: Rhodococcus species are relatively rare human pathogens, but are being increasingly recognized as causes of infection especially in immunosuppressed patients. Case Report: We present a case of Rhodococcus lung abscess in a patient 10 months post-cadaveric renal transplant, successfully treated with a combination of antibiotics. She required a prolonged course of oral antibiotics for 6 months. She did not require surgical intervention. Chest X-rays and CT thorax showed complete resolution of the initial lesion. We also review the medical literature related to Rhodococcus infection in patients with renal transplantation. Rhodococcus infection should be considered as in the differential diagnosis of immunosuppressed patients who present with lung abscess/mass. Conclusions: A literature review indicates this is a potentially fatal condition with disseminated sepsis/abscesses.
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Affiliation(s)
- Koh-Wei Wong
- Nephrology Unit, Department of Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - Bharathan Thevarajah
- Nephrology Unit, Department of Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
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Guerrero R, Bhargava A, Nahleh Z. Rhodococcus equi venous catheter infection: a case report and review of the literature. J Med Case Rep 2011; 5:358. [PMID: 21827681 PMCID: PMC3174126 DOI: 10.1186/1752-1947-5-358] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 08/09/2011] [Indexed: 05/26/2023] Open
Abstract
Introduction Rhodococcus equi is an animal pathogen that was initially isolated from horses and is being increasingly reported as a cause of infection in humans with impaired cellular immunity. However, this pathogen is underestimated as a challenging antagonist and is frequently considered to be a mere contaminant despite the potential for life-threatening infections. Most case reports have occurred in immunocompromised patients who have received organ transplants (for example kidney, heart, bone marrow) or those with human immunodeficiency virus infection. Infections often manifest as pulmonary involvement or soft tissue abscesses. Bacteremia related to R. equi infections of tunneled central venous catheters has rarely been described. Case presentation We report the case of a 63-year-old non-transplant recipient, non-HIV infected Caucasian woman with endometrial carcinoma who developed recurrent bloodstream infections and septic shock due to R. equi and ultimately required the removal of her port catheter, a subcutaneous implantable central venous catheter. We also review the medical literature related to human infections with R. equi. Conclusion R. equi should be considered a serious pathogen, not a contaminant, particularly in an immunocompromised patient who presents with a central venous catheter-related bloodstream infection. Counseling patients with central venous catheters who participate in activities involving exposure to domesticated animals is recommended.
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Affiliation(s)
- Rosalinda Guerrero
- Department of Internal Medicine, TTUHSC-Paul L Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX 79905, USA.
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Affiliation(s)
- Shawn P E Nishi
- Division of Pulmonary and Critical Care Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
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Abstract
The increasing emergence of antimicrobial-resistant organisms, especially methicillin-resistant Staphylococcus aureus (MRSA), has resulted in the increased use of rifampin combination therapy. The data supporting rifampin combination therapy in nonmycobacterial infections are limited by a lack of significantly controlled clinical studies. Therefore, its current use is based upon in vitro or in vivo data or retrospective case series, all with major limitations. A prominent observation from this review is that rifampin combination therapy appears to have improved treatment outcomes in cases in which there is a low organism burden, such as biofilm infections, but is less effective when effective surgery to obtain source control is not performed. The clinical data support rifampin combination therapy for the treatment of prosthetic joint infections due to methicillin-sensitive S. aureus (MSSA) after extensive debridement and for the treatment of prosthetic heart valve infections due to coagulase-negative staphylococci. Importantly, rifampin-vancomycin combination therapy has not shown any benefit over vancomycin monotherapy against MRSA infections either clinically or experimentally. Rifampin combination therapy with daptomycin, fusidic acid, and linezolid needs further exploration for these severe MRSA infections. Lastly, an assessment of the risk-benefits is needed before the addition of rifampin to other antimicrobials is considered to avoid drug interactions or other drug toxicities.
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Abstract
Rhodococcus equi, previously known as Corynebacterium equi, is one of the most important causes of zoonotic infections in grazing animals. Increased cases of human infection with R. equi have been reported, especially in immunocompromised patients, within recent years. We present a case of R. equi bacteremia in a 51-year-old man with diabetes and liver cirrhosis, on long-term corticosteroid therapy after skin-grafting surgery. The patient recovered soon after he was treated with vancomycin. This review focuses on the microbiological characteristics of this organism, and the diagnosis and treatment of this infection.
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Affiliation(s)
- Xi-yuan Chen
- Department of Respiratory Medicine, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
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Rahamat-Langendoen JC, van Meurs M, Zijlstra JG, Lo-Ten-Foe JR. Disseminated Rhodococcus equi infection in a kidney transplant patient without initial pulmonary involvement. Diagn Microbiol Infect Dis 2009; 65:427-30. [DOI: 10.1016/j.diagmicrobio.2009.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Revised: 08/06/2009] [Accepted: 08/08/2009] [Indexed: 11/24/2022]
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Vélez MZ, Greene JN, Vincent AL, Sandin RL. Rhodococcus equi Pulmonary Infections in Patients With Cancer: Three New Cases and Review of the Literature. Infectious Diseases in Clinical Practice 2009; 17:414-22. [DOI: 10.1097/ipc.0b013e31819fe519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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El Karoui K, Guillet C, Sekkal N, Lanternier F, Méchaï F, Hue K, Hiesse C, Mamzer Bruneel MF, Catherinot E, Viard JP, Mainardi JL, Lecuit M, Ferroni A, Lortholary O. Synergistic effect of carbapenem-teicoplanin combination during severeRhodococcus equipneumonia in a kidney transplant recipient. Transpl Infect Dis 2009; 11:359-62. [DOI: 10.1111/j.1399-3062.2009.00405.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Speck D, Koneth I, Diethelm M, Binet I. A pulmonary mass caused by Rhodococcus equi infection in a renal transplant recipient. ACTA ACUST UNITED AC 2008; 4:398-403. [DOI: 10.1038/ncpneph0833] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Accepted: 04/04/2008] [Indexed: 11/08/2022]
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