Rhodococcus hoagii: Difference between revisions
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Rhodococcus hoagii
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*Facultative intracellular, non-spore-forming, [[Stain::Gram-positive]], weakly acid-fast [[Cellular shape::coccobacillus]] |
*Facultative intracellular, non-spore-forming, [[Stain::Gram-positive]], weakly acid-fast [[Cellular shape::coccobacillus]] |
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| + | *Within the family [[Nocardiaceae]] and order [[Actinomycetes]] |
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| + | *Obligate aerobic and facultatively intracellular |
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*Found in dry and dusty soil |
*Found in dry and dusty soil |
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*Makes red pigment, hence the name |
*Makes red pigment, hence the name |
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| − | *Member of the actinomycetes group |
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===Epidemiology=== |
===Epidemiology=== |
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| − | *Infects domesticated animals |
+ | *Infects domesticated animals: [[Horses]] (and in foals it causes pneumonia), [[Goats]], [[Pigs]], [[Sheep]], and [[Cattle]] |
| + | *Most commonly infects people with cell-mediated immunodeficiency, particularly [[HIV]], with or without a notable infectious exposure |
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| − | **[[Horses]], and in foals it causes pneumonia |
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| + | |||
| − | **[[Goats]] |
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| + | === Risk Factors === |
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| − | **[[Pigs]] |
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| + | |||
| − | **[[Sheep]] |
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| + | * HIV accounts for 65% of cases |
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| − | **[[Cattle]] |
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| + | * Solid organ and hematopoietic stem cell transplantation |
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| − | *Can infect immunocompromised people (HIV, etc) |
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| + | * Diabetes |
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| + | * Alcohol abuse |
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| + | * Chronic renal failure |
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| + | * Leukemia, lymphoma, lung cancer |
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| + | * Sarcoidosis |
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| + | * Preterm infants |
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==Clinical Manifestations== |
==Clinical Manifestations== |
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*[[Necrotizing pneumonia]] is usual presentation, as well as [[Lung nodules|nodules]], [[Cavitary lung disease|cavitation]], [[pleural effusion]], and [[lung abscess]] |
*[[Necrotizing pneumonia]] is usual presentation, as well as [[Lung nodules|nodules]], [[Cavitary lung disease|cavitation]], [[pleural effusion]], and [[lung abscess]] |
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| + | **Typically subacute onset with fever, cough, and fatigue, as well as pleuritic chest pain |
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*Specifically in immunocompromised patients, it can cause a [[cavitary lung disease]] and is on the differential with [[Mycobacterium species|mycobacteria]] and [[nocardiosis]] |
*Specifically in immunocompromised patients, it can cause a [[cavitary lung disease]] and is on the differential with [[Mycobacterium species|mycobacteria]] and [[nocardiosis]] |
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| + | *Extrapulmonary disease can occur with or without pulmonary involvement |
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| + | **In conjunction with other infections, can have abscesses in liver, spleen, thyroid, kidney, psoas, bone, prostate, intraabdominal cavity, and paraspinous tissue |
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| + | *Extrapulmonary disease without pulmonary involvement has three main presentations: |
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| + | **Localized infection following traumatic inoculation, causing wound infection, traumatic septic arthritis, or endophthalmitis |
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| + | **Isolated bacteremia with fever, typically recently after chemotherapy causing neutropenia |
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| + | **Gastrointestional inoculation followed by lymphatic dissemination, causing peritonitis, pelvic masses, and mesenteric adenitis |
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| + | **Others include otitis media with mastoiditis, colonic polyp infection, and osteomyelitis |
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| − | == |
+ | ==Management== |
| − | * |
+ | *Treatment usually 6 months or longer |
{{DISPLAYTITLE:''Rhodococcus equi''}} |
{{DISPLAYTITLE:''Rhodococcus equi''}} |
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[[Category:Gram-positive bacteria]] |
[[Category:Gram-positive bacteria]] |
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Revision as of 20:18, 18 September 2020
Background
Microbiology
- Facultative intracellular, non-spore-forming, Gram-positive, weakly acid-fast coccobacillus
- Within the family Nocardiaceae and order Actinomycetes
- Obligate aerobic and facultatively intracellular
- Found in dry and dusty soil
- Makes red pigment, hence the name
Epidemiology
- Infects domesticated animals: Horses (and in foals it causes pneumonia), Goats, Pigs, Sheep, and Cattle
- Most commonly infects people with cell-mediated immunodeficiency, particularly HIV, with or without a notable infectious exposure
Risk Factors
- HIV accounts for 65% of cases
- Solid organ and hematopoietic stem cell transplantation
- Diabetes
- Alcohol abuse
- Chronic renal failure
- Leukemia, lymphoma, lung cancer
- Sarcoidosis
- Preterm infants
Clinical Manifestations
- Necrotizing pneumonia is usual presentation, as well as nodules, cavitation, pleural effusion, and lung abscess
- Typically subacute onset with fever, cough, and fatigue, as well as pleuritic chest pain
- Specifically in immunocompromised patients, it can cause a cavitary lung disease and is on the differential with mycobacteria and nocardiosis
- Extrapulmonary disease can occur with or without pulmonary involvement
- In conjunction with other infections, can have abscesses in liver, spleen, thyroid, kidney, psoas, bone, prostate, intraabdominal cavity, and paraspinous tissue
- Extrapulmonary disease without pulmonary involvement has three main presentations:
- Localized infection following traumatic inoculation, causing wound infection, traumatic septic arthritis, or endophthalmitis
- Isolated bacteremia with fever, typically recently after chemotherapy causing neutropenia
- Gastrointestional inoculation followed by lymphatic dissemination, causing peritonitis, pelvic masses, and mesenteric adenitis
- Others include otitis media with mastoiditis, colonic polyp infection, and osteomyelitis
Management
- Treatment usually 6 months or longer
