Nadir bir etken: Rhodococcus equi, immünkompetan hastalarda yumuşak doku enfeksiyonlarına ilişkin bir vaka sunumu ve literatür incelemesi

Year 2023, Volume: 28 Issue: 2, 235 - 241, 23.05.2023

Halime Araz , Aliye Bastug , İpek Mumcuoğlu , Esragül Akınci , Hurrem Bodur

https://doi.org/10.21673/anadoluklin.1168458

Abstract

Rhodococcus equi (R. equi) ilk olarak atlarda tanımlanan ve daha sonra bağışıklığı baskılanmış hastalarda fırsatçı enfeksiyonlara neden olduğu anlaşılan bir mikroorganizmadır. Özellikle bağışıklığı baskılanmış hastalarda akciğer enfeksiyonlarına neden olurken nadiren septik artrit ve yumuşak doku enfeksiyonları gibi hastalıklara neden olur. Hastalığın tanısı için epidemiyolojik risk faktörlerinin sorgulanması önemlidir. Klinisyen-mikrobiyolog ilişkisi de mikroorganizmanın laboratuvar tanısında önemlidir çünkü normal floranın veya kontaminantın bir parçası olarak gözden kaçabilir veya benzer fenotipik özelliklere sahip mikroorganizmalarla (Nocardia türleri veya hızla büyüyen mikobakteriler) karıştırılabilir. Nadiren de olsa bizim olgumuzda olduğu gibi immunkompetan hastalarda da bildirilmeye başlanmıştır. MEDLINE, SCOPUS, Google Akademik ve Cochrane aramaları, 1945’ten Temmuz 2021’e kadar Rhodococcus equi ve Corynebacterium equi anahtar kelimeleri kullanılarak yapıldı. Toplam 582 makale belirlendi. Bu anahtar kelimeleri içeren makaleler daha sonra “insan”, “yumuşak doku enfeksiyonları” ve “selülit” kelimeleri için tarandı ve sonunda toplam 42 makale listelendi. Literatürde R. equi ile ilgili bağışıklığı sağlam hastalarda yumuşak doku enfeksiyonu/selülit ile ilgili toplam 14 vaka raporu tespit edilmiştir. Bizim olgumuzda yumuşak doku enfeksiyonu mevcuttu ve apse kültüründe R. equi saptandı. Enfeksiyonların tedavisinde kültür alınması ve etkenin belirlenmesi çok önemlidir. Bu raporda, bağışıklık sistemi sağlam hastalarda R. equi’nin neden olduğu yumuşak doku enfeksiyonları gözden geçirilmiştir.

Keywords

Bağışıklık yeterliliği, insan, Rhodococcus equi, yumuşak doku enfeksiyonları

Supporting Institution

Herhangi bir destek yoktur.

A rare infectious agent: Rhodococcus equi, a case report and literature review of soft tissue infections in immunocompetent patients

Abstract

Rhodococcus equi (R. equi) is a microorganism that was first identified in horses. Afterward, it was found to cause opportunistic infections in immunosuppressed patients. It causes especially pulmonary infections in immunocompromised patients while it rarely causes diseases such as septic arthritis and soft tissue infections. It is important to question epidemiological risk factors for the diagnosis of the disease. Also, the clinician-microbiologist relationship is important in the laboratory diagnosis of the microorganism because it is possible to be missed as part of normal flora or contaminant or to be confused with microorganisms with similar phenotypic features (Nocardia species or rapidly growing mycobacteria). Rarely, it has been reported in immunocompetent patients, as in our case. MEDLINE, SCOPUS, Google Scholar, and Cochrane searches were performed using the keywords Rhodococcus equi and Corynebacterium equi from 1945 to July 2021. A total of 582 articles were determined. Articles containing these keywords were then scanned for the words “humans”, “soft tissue infections”, and “cellulite” and a total of 42 articles were listed in the end. A total of 14 case reports of soft tissue infection/cellulitis in immunocompetent patients related to R. equi were detected in the literature. In our case, there was a soft tissue infection and R. equi was detected in the abscess culture. Obtaining culture and determining the factor is very important in the treatment of infections. In this report, soft tissue infections caused by R. equi in immunocompetent patients are reviewed.

Keywords

Immunocompetence, human, Rhodococcus equi, soft tissue infections

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