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]
Recently, human infestation has been seen in immunocompromised patients, presenting primarily with pulmonary manifestations. [jamanetwork.com]
We present the case of a patient with chronic myeloid leukaemia who had received allogenic stem cell transplant and presented to the hospital with clinical picture of pneumonia. [casereports.bmj.com]
Entire Body System
- Fever
Full Text To the Editor: We report the case of a 59-year-old man who presented in the emergency room with a 48-h history of fever 38.8°C, dyspnea and cough. [archbronconeumol.org]
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]
Clinical signs of Rhodococcus equi can include fever, depression, coughing, weight loss, swollen joints, colic and/or diarrhea. [cahosp.com]
Fever was high grade, insidious in onset, continuous with no variation. No history of vomiting or loose stools was found. She was nondiabetic, nonhypertensive. [ncbi.nlm.nih.gov]
- Inflammation
[…] reduction of ultrasonographic score Freie Schlagwörter: Foal Horse Lung Pneumonia Procalcitonin Rhodococcus equi DDC-Klassifikation: 500 Naturwissenschaften und Mathematik Publikationstyp: Wissenschaftlicher Artikel Auch erschienen in: Modern Research in Inflammation [refubium.fu-berlin.de]
Routine laboratory evaluation of CBC and serum chemistry reveals nonspecific abnormalities consistent with infection and inflammation. [merckvetmanual.com]
Fine needle aspiration was carried out, revealing acute abscessing inflammation associated with a pattern of organizing pneumonia, with no evidence of malignancy. HIV serology was negative. Finally, blood cultures were positive for R. equi. [archbronconeumol.org]
Tracheal lesion biopsy revealed chronic inflammation with intracellular bacteria, malakoplakia and no signs of malignancy. [journalpulmonology.org]
- Weight Loss
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]
Clinical signs of Rhodococcus equi can include fever, depression, coughing, weight loss, swollen joints, colic and/or diarrhea. [cahosp.com]
The respiratory process is insidious, manifesting as high fever, cough, dyspnea, chest pain and weight loss.2 It is identified and diagnosed from the culture of affected tissue samples.4 Blood cultures are positive in 50% of immunocompromised subjects [archbronconeumol.org]
Foals with abdominal involvement often present with fever, depression, anorexia, weight loss, colic, and diarrhea. [merckvetmanual.com]
- Pain
Case 2 A 78-year-old female came to surgical OPD with the complaint of pain abdomen and distension since 1 day and fever since 2 days. The patient was apparently normal when she developed pain in abdomen. [ncbi.nlm.nih.gov]
The respiratory process is insidious, manifesting as high fever, cough, dyspnea, chest pain and weight loss.2 It is identified and diagnosed from the culture of affected tissue samples.4 Blood cultures are positive in 50% of immunocompromised subjects [archbronconeumol.org]
One week later, the patient experienced sudden-onset chest pain, associated dyspnoea, and low oxygen saturation. [elsevier.es]
Prophylactic antiulcer medication is indicated in foals stressed by respiratory difficulty, pain, frequent handling, hospitalization, and transportation. The survival rate of R equi pneumonia is ~70%–90% with appropriate therapy. [msdvetmanual.com]
There was no history of haemoptysis or chest pain. He has clear recollection of exposure to dust that was disturbed whilst he was tiling a laundry, the evening prior to the onset of his symptoms (day 1). [nzma.org.nz]
- High Fever
The respiratory process is insidious, manifesting as high fever, cough, dyspnea, chest pain and weight loss.2 It is identified and diagnosed from the culture of affected tissue samples.4 Blood cultures are positive in 50% of immunocompromised subjects [archbronconeumol.org]
Respiratoric
- Cough
Clinical signs of Rhodococcus equi can include fever, depression, coughing, weight loss, swollen joints, colic and/or diarrhea. [cahosp.com]
Full Text To the Editor: We report the case of a 59-year-old man who presented in the emergency room with a 48-h history of fever 38.8°C, dyspnea and cough. [archbronconeumol.org]
The R. equi bacteria replicates in the lungs, is coughed up and then swallowed by the foal. Replication of the bacteria continues as the bacteria travels thru the gastrointestinal tract. [okfronline.com]
His symptoms however persisted with drenching night sweats, dyspnoea and cough and a computed tomography (CT) scan of his chest was completed on day 15. [nzma.org.nz]
- Dyspnea
Full Text To the Editor: We report the case of a 59-year-old man who presented in the emergency room with a 48-h history of fever 38.8°C, dyspnea and cough. [archbronconeumol.org]
Gastrointestinal
- Diarrhea
Foals with abdominal involvement often present with fever, depression, anorexia, weight loss, colic, and diarrhea. [merckvetmanual.com]
Phoebe Smith Foal Diarrhea Presented by Dr. Bonnie Barr Laminitis Presented by Dr. Luis Castro Bone Injury vs Bone Infection Presented by Dr. Jaye McCracken Septic Foal Presented by Dr. Bonnie Barr Monitoring Infection Presented by Dr. [stablelab.com]
In addition, R. equi can cause several extrapulmonary diseases, including septic arthritis, neonatal diarrhea, abdominal lymphadenitis, abdominal and spinal cord abscesses, hepatitis, and immune-mediated diseases such as polysynovitis. [thehorse.com]
Clinical signs of Rhodococcus equi can include fever, depression, coughing, weight loss, swollen joints, colic and/or diarrhea. [cahosp.com]
Cardiovascular
- Chest Pain
The respiratory process is insidious, manifesting as high fever, cough, dyspnea, chest pain and weight loss.2 It is identified and diagnosed from the culture of affected tissue samples.4 Blood cultures are positive in 50% of immunocompromised subjects [archbronconeumol.org]
One week later, the patient experienced sudden-onset chest pain, associated dyspnoea, and low oxygen saturation. [elsevier.es]
There was no history of haemoptysis or chest pain. He has clear recollection of exposure to dust that was disturbed whilst he was tiling a laundry, the evening prior to the onset of his symptoms (day 1). [nzma.org.nz]
Neurologic
- Meningism
[…] of presentation in immunocompromised patients is cavitated pneumonia of the lower lobes3 (84%), while in immunocompetent patients, infections tend to be localized and extrapulmonary (42%),3,4 generally involving the central nervous system (abscesses, meningitis [archbronconeumol.org]
Four (15%) patients had brain abscesses, 3 (12%) had endocarditis, 2 (8%) had ocular infection and there was 1 patient each, who had meningitis, lymph node infection, infection of the tongue, infection of the soft tissue over the mandible, liver abscess [nzma.org.nz]
- Headache
After 10 days of hospitalization, the patient began to complain of headache and instability, so magnetic resonance imaging (MRI) of the head was performed (Fig. 1B), revealing 8 cortical-subcortical nodular lesions, less than 1cm in size, indicative of [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]
Regarding treatment there are no consensus guidelines. [journalpulmonology.org]
Intravenous treatment was maintained for 2 months, followed by 4 more months of oral azithromycin and trimethoprim-sulfametoxazole. After 2 weeks of treatment, respiratory clinical signs had resolved and chest X-ray was normal. [archbronconeumol.org]
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]
TREATMENT Macrolides: The treatment of choice for R. equi remains a macrolide in combination with rifampin. Erythromycin, azithromycin, and clarithromycin are most commonly used. [dvm360.com]
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. [merckvetmanual.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]
Etiology
He had undergone lower left lobectomy in 2004 for a pulmonary mass, but histology of the operative specimen suggested an infectious etiology and the patient received no further treatment or follow-up. [journalpulmonology.org]
Epidemiology
PMID: 15504593 Rhodococcus equi pneumonia in the foal--part 1: pathogenesis and epidemiology. Muscatello G. Muscatello G. Vet J. 2012 Apr;192(1):20-6. doi: 10.1016/j.tvjl.2011.08.014. Epub 2011 Oct 19. Vet J. 2012. PMID: 22015138 Review. [pubmed.ncbi.nlm.nih.gov]
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. [merckvetmanual.com]
Compelling epidemiologic data indicate pulmonary infection probably originates within the first week of life. ( See also Rhodococcus Infection Rhodococcus Infection .) [msdvetmanual.com]
The medically important aerobic actinomycetes: epidemiology and microbiology. Clin Microbiol Rev, 7 (1994), pp. 357-417 [5] J.M. Brown, M.M. McNeil, E.P. Desmond. [bjid.org.br]
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]
Clinical manifestations, diagnosis, treatment, and prevention of Rhodococcus equi infection in foals. Vet Microbiol 1997;56:313-334. Giguère S, Hernandez J, Gaskin J, et al. [dvm360.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. [merckvetmanual.com]