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 infect...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 treat-ment.This article reports on the diagnosis and treatment of a renal transplant recipient infected with R.equi 21 mo postoperatively and summarizes the charac-teristics of infection with R.equi after renal transplantation,along with a detailed review of the literature.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 sequen-cing sequencing of the pus were suggestive of R.equi infection.The immunosup-pressive 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.展开更多
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...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.展开更多
Background: Procalcitonin, a precursor protein of the hormone calcitonin, is a sensitive marker for sepsis in human medicine, which is used for diagnosis of bacterial pneumonia in adults and neonates to initiate antib...Background: Procalcitonin, a precursor protein of the hormone calcitonin, is a sensitive marker for sepsis in human medicine, which is used for diagnosis of bacterial pneumonia in adults and neonates to initiate antibiotic therapy. Objectives: In this study, procalcitonin was evaluated as a potential biomarker for Rhodococcus equi associated pneumonia. Methods: In four foals procalcitonin was measured at four time-points (day 0 before antibiotic therapy, day 1, 3 and 5/6 during therapy) in plasma using an equine specific ELISA. Inclusion criteria for the study were a positive sepsis score, ultrasonographic evidence of pulmonary abscesses in addition >8 cm, a positive microbiology out of tracheobronchial secretion and positive response to antibiotic treatment (azithromycin 10 mg/kg BDW 24q PO and rifampicin 10 mg/kg BDW 12q PO) within a weak including improvement of clinical status and reduction of ultrasonographic score Rhodococcus equi.展开更多
Background Rhodococcus equi （R. equl） infection commonly occurs in grazing areas, especially in patients with AIDS or with T-lymphocyte immuno-deficiencies. Literature reviews revealed that cases radiologically and ...Background Rhodococcus equi （R. equl） infection commonly occurs in grazing areas, especially in patients with AIDS or with T-lymphocyte immuno-deficiencies. Literature reviews revealed that cases radiologically and pathologically diagnosed of AIDS complicated by R. equi infection are rare. This study aimed to investigate the imaging features and Datholoqical basis of AIDS complicated by pulmonary R. equi infection.展开更多
Rhodococcus equi is a zoonotic opportunistic pathogen that mainly infects immunodeficient individuals,such as those with HIV infection.In R.equi-infected individuals,serious lung lesions can develop and death may resu...Rhodococcus equi is a zoonotic opportunistic pathogen that mainly infects immunodeficient individuals,such as those with HIV infection.In R.equi-infected individuals,serious lung lesions can develop and death may result without appropriate antiviral treatment.This bacterium is rare in clinic and there is little information regarding its diagnosis and treatment.To improve our understanding,this case report describes the diagnosis and treatment of a patient with HIV complicated with R.equi infection from Ditan Hospital,Beijing,China.展开更多
基金Supported by Science and Technology Project of Guizhou Province,No.ZK[2023]380.
文摘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 treat-ment.This article reports on the diagnosis and treatment of a renal transplant recipient infected with R.equi 21 mo postoperatively and summarizes the charac-teristics of infection with R.equi after renal transplantation,along with a detailed review of the literature.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 sequen-cing sequencing of the pus were suggestive of R.equi infection.The immunosup-pressive 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.
基金Project supported by the National Natural Science Foundation of China (No. 30871130)the Youth Talent Special Fund of the Health Bureau of Zhejiang Province, China (No. 2008QN016)
文摘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.
文摘Background: Procalcitonin, a precursor protein of the hormone calcitonin, is a sensitive marker for sepsis in human medicine, which is used for diagnosis of bacterial pneumonia in adults and neonates to initiate antibiotic therapy. Objectives: In this study, procalcitonin was evaluated as a potential biomarker for Rhodococcus equi associated pneumonia. Methods: In four foals procalcitonin was measured at four time-points (day 0 before antibiotic therapy, day 1, 3 and 5/6 during therapy) in plasma using an equine specific ELISA. Inclusion criteria for the study were a positive sepsis score, ultrasonographic evidence of pulmonary abscesses in addition >8 cm, a positive microbiology out of tracheobronchial secretion and positive response to antibiotic treatment (azithromycin 10 mg/kg BDW 24q PO and rifampicin 10 mg/kg BDW 12q PO) within a weak including improvement of clinical status and reduction of ultrasonographic score Rhodococcus equi.
文摘Background Rhodococcus equi （R. equl） infection commonly occurs in grazing areas, especially in patients with AIDS or with T-lymphocyte immuno-deficiencies. Literature reviews revealed that cases radiologically and pathologically diagnosed of AIDS complicated by R. equi infection are rare. This study aimed to investigate the imaging features and Datholoqical basis of AIDS complicated by pulmonary R. equi infection.
基金supported by the Beijing Municipal Administration of Hospitals’Ascent Plan(DFL20191802)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(ZYLX202126)Beijing high-level public health technical personnel construction project(2022-2-014).
文摘Rhodococcus equi is a zoonotic opportunistic pathogen that mainly infects immunodeficient individuals,such as those with HIV infection.In R.equi-infected individuals,serious lung lesions can develop and death may result without appropriate antiviral treatment.This bacterium is rare in clinic and there is little information regarding its diagnosis and treatment.To improve our understanding,this case report describes the diagnosis and treatment of a patient with HIV complicated with R.equi infection from Ditan Hospital,Beijing,China.
