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


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.

Download full-text


Available from: Panayotis Dais,
41 Reads
  • [Show abstract] [Hide abstract]
    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. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
    Transplant Infectious Disease 11/2014; 16(6). DOI:10.1111/tid.12314 · 2.06 Impact Factor