Rhodococcus Equi INFECTION AFTER LIVER TRANSPLANTATION

Sabater, Luís; Andreu, Hernán; Jc, García-Valdecasas; Moreno, Ana; Vila, Jordi; Rimola, A.; Grande, L; Navasa, Miquel; Visa, Josep; Rodés, Joan

doi:10.1097/00007890-199603270-00026

Cited by 22 publications

(21 citation statements)

References 7 publications

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“…In approximately 20% of cases osteomyelitis, purulent pericarditis, subcutaneous abscesses, and multiple brain abscesses also were described. 5 A recent review of the literature has reported a total of 41 cases of R. equi infection in solid-organ transplant patients, 24 of which occurred in kidney transplants, 7 in hearts, 3 in livers and 6 in others. 6 In contrast to the majority of cases in the literature, our patient did not express any pulmonary involvement, instead showing only soft tissue and subcutaneous multiple abscesses.…”

Section: R Equi (Previously Known As Corynebacterium Equi)mentioning

confidence: 99%

Untitled

Varotti

Barabani²,

Dodi³

et al. 2016

Exp Clin Transplant

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Rhodococcus equi is a well-recognized pathogen in veterinary medicine that can also affect immunocompromised human subjects. The most common clinical features in humans include necrotizing pneumonia with subacute pulmonary disease, progressive cough, chest pain and fever. We report a case of a 49-year-old kidney transplant patient who developed a Rhodococcus equi infection characterized by multiple abscesses of the soft tissues and muscles without any respiratory manifestation. Combining specific antibiotic therapy and surgical management of the abscesses without immunosuppression discontinuation led to a complete recovery of both patient and graft.

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Section: R Equi (Previously Known As Corynebacterium Equi)mentioning

confidence: 99%

Untitled

Varotti

Barabani²,

Dodi³

et al. 2016

Exp Clin Transplant

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“…Several cases have been described in patients with immunosuppression due to either human immunodeficiency infection, therapy for neoplastic disorders, or kidney and heart transplantation. 15 patients with a R. equi infection following solid-organ transplantation have been described in the literature [42][43][44][45] . In all patients, rhodococcal infection presented late after transplantation (median, 4 years).…”

Section: Rhodococcus Equi Infection In the Liver Transplant Patientmentioning

confidence: 99%

“…Sabater et al [43] reported the first case of R. equi infection in a liver transplant recipient. The patient was diagnosed with two subcutaneous abscesses on his left arm and an asymptomatic necrotizing bilateral pneumonia 28 mo following transplantation.…”

Section: Rhodococcus Equi Infection In the Liver Transplant Patientmentioning

confidence: 99%

Update and actual trends on bacterial infections following liver transplantation

Pozo

2008

WJG

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Recent advances in effective antimicrobial prophylactic strategies have led to a decline in the incidence of opportunistic infections in liver transplant recipients. However, morbidity and mortality due to infectious diseases remain as major problems. Bacterial infections occurring early after transplant are mainly related to the technical aspects of the procedure. By contrast, after the first postoperative days and beyond, the nature and variety of infectious complications change. Opportunistic bacterial infections are uncommon after 6 mo in patients receiving stable and reduced maintenance doses of immunosuppression with good graft function and little is documented about these cases in the literature. Transplant recipients may be more susceptible to some pathogens, such as the Nocardia species, Legionella species, Listeria monocytogenes , Mycoplasma species, Salmonella species or Rhodococcus equi. Respiratory infections due to capsulated bacteria, such as Streptococcus pneumoniae and Haemophilus influenza , can be lifethreatening if not promptly treated in this population. These late bacterial infections may be very difficult to recognize and treat in this population. In this article, we review what has been described in the literature with regards to late bacterial infections following liver transplantation.

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“…Solid organ transplant recipients may be at risk for R. equi infection because of impaired cell‐mediated immunity owing to immunosuppression directed against T and B lymphocytes. Rhodococcus equi infection in renal, liver, heart, and kidney–pancreas transplant recipients has previously been reported (4–21). We report a case of a pancreas‐alone transplant recipient who developed R. equi pneumonia after receiving multiple courses of anti‐T lymphocyte therapy for the treatment of recurrent acute pancreas allograft rejection.…”

mentioning

confidence: 92%

Rhodococcus equi pulmonary infection in a pancreas‐alone transplant recipient: consequence of intense immunosuppression

Lo¹,

Stratta

Trofe³

et al. 2002

Transplant Infectious Dis

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We report the case of a pancreas-alone transplant recipient who developed Rhodococcus equi pneumonia after receiving multiple courses of antilymphocyte therapy for the treatment of recurrent acute pancreas allograft rejection. We also review and discuss the diagnosis, clinical course, and treatment of 18 cases of R. equi infection reported in solid organ transplant recipients. The lung is the most common primary site of infection, but R. equi infection is difficult to diagnose because of the pleomorphic, gram-positive, and partially acid-fast nature of the organism. Treatment usually involves a combination of antibiotics including rifampin, macrolides, vancomycin, and ciprofloxacin. The optimal duration of therapy is unknown, but relapse is common if the duration of treatment is less than 14 days. The duration of therapy should be guided by clinical recovery, culture results, and radiographic findings. Monitoring levels of immunosuppressive agents-such as tacrolimus and cyclosporine-is needed in order to avoid clinically significant drug interactions with rifampin or the macrolides when these agents are used in order to treat R. equi infection in the transplant population.

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Rhodococcus Equi INFECTION AFTER LIVER TRANSPLANTATION

Cited by 22 publications

References 7 publications

Untitled

Untitled

Update and actual trends on bacterial infections following liver transplantation

Rhodococcus equi pulmonary infection in a pancreas‐alone transplant recipient: consequence of intense immunosuppression

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