Acute osteomyelitis of the mandible caused by Rhodococcus equi in an immunocompromised patient: a case report and literature review.

Oral and Maxillofacial Surgeon, Head, Department of Oral & Maxillofacial Surgery, General Hospital of Attica "KAT", Athens, Greece.
Oral surgery, oral medicine, oral pathology and oral radiology 10/2012; 114(4):e1-5. DOI: 10.1016/j.oooo.2011.09.010
Source: PubMed

ABSTRACT We present the first case of acute osteomyelitis of the mandible caused by Rhodococcus equi in an immunocompromised patient. A 53-year-old Caucasian man was referred to the outpatient clinic, because of a swelling of the left submental and submandibular spaces. The patient was immunocompromised owing to medication against myasthenia gravis and type II diabetes mellitus. The patient underwent surgical debridement under local anesthesia. Histologic examination showed acute osteomyelitis and both blood and pus cultures isolated Rhodococcus equi. The patient was discharged on linezolid 600 mg orally twice a day for 6 months and remains free of the disease 2 years postoperatively. Most patients with Rhodococcus infection are immunocompromised. Infection with this organism is rare and usually causes a distinct clinical syndrome resembling pulmonary tuberculosis. Diagnosis is frequently missed or delayed. Not only clinicians but also laboratory specialists should be aware of this organism, so as to contribute to prompt diagnosis and treatment of such infections.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Most patients with Rhodococcus equi infection are immunocompromised by either HIV infection, malignancy, or medication. Diagnosis is frequently missed or delayed because the organisms, resembling diphtheroids on smears, may be regarded as contaminants. Their clinical, pathologic, histochemical, and microbiologic resemblance to mycobacteria can result in misdiagnosis. Two cases were seen recently in our institution. R. equi pericarditis developed in a 29-year-old woman with failed renal transplant and R. equi axillary lymphadenitis developed in an asymptomatic 27-year-old man. These patients are important because the former is the first reported case of R. equi pericarditis, and the second case was unusual because of the absence of immunocompromise.
    The American Journal of the Medical Sciences 08/1995; 310(1):31-3. · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Corynebacterium equi, an aerobic, variably acid-fast, gram-positive "diphtheroid," is an unusual cause of pulmonary infection in immunosuppressed patients. Initially, infection with C. equi may be mistaken for a mycobacterial infection. Two cases in a two-year period were observed and compared with the 10 cases previously reported in the literature. All but one patient had pulmonary involvement, and the presentation of all other patients was typically insidious, with fatigue, fever, and nonproductive cough. Chest roentgenograms showed cavitary lesions in seven of 11 patients. Four of 12 patients had associated bacteremias, and three of 12 had subcutaneous abscesses or lymphadenitis. One of our patients developed multiple brain abscesses. Overall mortality was 25%. The organism is susceptible to vancomycin, erythromycin, aminoglycosides, and chloramphenicol. Optimal duration of antibiotic therapy and the proper role of surgery in treatment is uncertain, but relapses have been common and many weeks of antibiotic therapy have generally been required for cure.
    Reviews of infectious diseases 01/1983; 5(6):1012-8.
  • Annals of internal medicine 07/1967; 66(6):1174-7. · 13.98 Impact Factor


Available from
May 23, 2014