Purulent meningitis caused by Rhodococcus equi

Abstract

Rationale:Purulent meningitis refers infection of the subarachnoid space by various purulent bacteria and the corresponding inflammation of the leptomeninges. However, purulent meningitis due to Rhodococcus equi is extremely rare.Patient concerns:A 40-year-old man presented with fever and intermittent headache for 6 days. Two hours prior to admission, he developed epileptic seizures.Diagnoses:Brain computed tomography and magnetic resonance imaging showed intracerebral malacic lesions. Bacterial culture of cerebrospinal fluid revealed the presence of R. equi. A diagnosis of purulent meningitis caused by R. equi was made.Interventions:The patient was treated with intravenous meropenem (1000 mg every 8 hours) for 19 days; then he was discharged and instructed to continue the intravenous meropenem for two weeks. After a follow-up period of 2 months, the patient had recovered completely.Outcomes:After a follow-up period of 2 months, the patient had recovered completely.Lessons:Central nervous system infection caused by R. equi is rare. Early bacterial culture of CSF is important for timely diagnosis. With sufficient antibiotic therapy, the prognosis can be favorable.

Rhodococcus equi bacteremia with necrotizing pneumonia and brain abscess in a newly diagnosed HIV patient in Saudi Arabia: A case report and review of literature

“… After 20 weeks > relapse: IV VAN, CRO and CPX for 3 weeks. Survived for years with no other relapses 2 [ 10 ] 52/M Hypertension Moderate heart failure Frontal-temporal mass Bacteremia and brain abscess Brain lesion biopsy and culture IV AMK and MEM Died in few days 3 [ 11 ] 48/M SLE ITP DM Immunosuppressant drugs Multiple aggregated enhancing lesions and later enhancement of the meninges Necrotizing pneumonia, brain abscess, three times relapses as recurrent meningitis CSF culture grew Rhodococcus on fourth admission (no growth initially) Multiple regimens used last episode treated with: IV & IT VAN, IT AMK that shifted later to AZM, oral RIF, oral DOX (different time frames for each) Survived after 4 months of last relapse > no further relapses recorded 4 [ 12 ] 40/M Post trauma CNS rhinorrhea Normal Purulent meningitis CSF culture IV MEM for 33 days Survived after 2 months with no relapse 5 Our case 41/M HIV (CD4 count 29) Depression Ring enhancement lesions Necrotizing pneumonia, bacteremia, relapsed as brain abscesses Previous bacteremia, imaging and clinical response to anti-rodococcal regimen IV VAN and MEM for 4 Survived after 9 months > no relapse weeks maintained on AZM and trimethoprim- sulfamethoxazole …”

High-Starch Diet Consumption Impaired Intestinal Barriers of Juvenile Largemouth Bass (Micropterus Salmoides)

“…As emerging opportunistic pathogens, rhodcoccus have been shown to cause infections in human, animals and sh (Majidzadeh et al, 2018;Olsen et al, 2006). rhodcoccus is the most important causes of diseases such as: fulminating bacteremia in American alligator (Alligator missippiensis), pneumonia in pig and purulent meningitis in human (Cui et al, 2018;Jasmin et al, 1969;Woodroofe et al, 1950). Similar to mycoplasma, the relative abundance of rhodcoccus was positively correlated with apoptosis and in ammatory related genes, indicating rhodcoccus may act antigenic stimulus stimulate intestinal cells and cause intestinal in ammation and apoptosis.…”