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Rhodococcus equi
📖 About
- Rhodococcus equi → opportunistic pathogen mainly affecting immunocompromised patients (HIV/AIDS, chronic steroids, malignancy).
- Recognised zoonotic pathogen, also infects foals and other animals.
🔬 Characteristics
- Gram-positive, aerobic, partially acid-fast coccobacillus.
- Can be misidentified as diphtheroids (Corynebacterium-like) in labs → needs careful recognition.
- Intracellular survival in macrophages → contributes to chronicity.
🏠 Source
- Reservoirs: Soil & animal faeces (esp. herbivores 🐎 horses, cattle).
- Transmission: Inhalation of contaminated dust or direct contact with soil/animals (esp. in agricultural settings).
⚠️ Pathogenicity
- Pulmonary disease:
- Cavitating pneumonia (resembles TB) with slow progression.
- Can form lung abscesses & pleural involvement.
- Disseminated infection:
- Brain abscesses 🧠, subcutaneous abscesses, lymphadenitis.
- High mortality if untreated in immunocompromised patients.
💊 Sensitivities
- Generally sensitive to vancomycin, carbapenems, rifampicin, and fluoroquinolones.
- Combination therapy reduces relapse risk.
🧬 Resistance
- Resistance can emerge with prolonged/monotherapy.
- Patterns vary → always perform susceptibility testing.
🩺 Management
- Prolonged combination antibiotic therapy:
- Typical: Rifampicin + (carbapenem / fluoroquinolone / vancomycin).
- Duration: often many weeks to months, tailored to response.
- Surgical intervention: Drainage of abscesses (lung, brain, soft tissue) may be required.
- Close monitoring: Relapse risk is high in HIV/immunosuppressed patients.
⚠️ Exam pearl: Rhodococcus equi causes cavitating pneumonia in HIV patients, mimicking TB, and may be misidentified as diphtheroids in labs. Requires prolonged, multi-drug therapy + sometimes surgery.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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