Abstract
IntroductionRhodococcus equi is an animal pathogen that was initially isolated from horses and is being increasingly reported as a cause of infection in humans with impaired cellular immunity. However, this pathogen is underestimated as a challenging antagonist and is frequently considered to be a mere contaminant despite the potential for life-threatening infections. Most case reports have occurred in immunocompromised patients who have received organ transplants (for example kidney, heart, bone marrow) or those with human immunodeficiency virus infection. Infections often manifest as pulmonary involvement or soft tissue abscesses. Bacteremia related to R. equi infections of tunneled central venous catheters has rarely been described.Case presentationWe report the case of a 63-year-old non-transplant recipient, non-HIV infected Caucasian woman with endometrial carcinoma who developed recurrent bloodstream infections and septic shock due to R. equi and ultimately required the removal of her port catheter, a subcutaneous implantable central venous catheter. We also review the medical literature related to human infections with R. equi.ConclusionR. equi should be considered a serious pathogen, not a contaminant, particularly in an immunocompromised patient who presents with a central venous catheter-related bloodstream infection. Counseling patients with central venous catheters who participate in activities involving exposure to domesticated animals is recommended.
Highlights
Rhodococcus equi is an animal pathogen that was initially isolated from horses and is being increasingly reported as a cause of infection in humans with impaired cellular immunity
Case presentation: We report the case of a 63-year-old non-transplant recipient, non-human immunodeficiency virus (HIV) infected Caucasian woman with endometrial carcinoma who developed recurrent bloodstream infections and septic shock due to R. equi and required the removal of her port catheter, a subcutaneous implantable central venous catheter
Counseling patients with central venous catheters who participate in activities involving exposure to domesticated animals is recommended
Summary
Human infection with R. equi should be considered when evaluating immunocompromised patients with a central venous catheter and fever in the setting of exposure to farm animals. Counseling should be provided to immunocompromised patients inclined to participate in activities involving exposure to domesticated animals or their products. Consent Written informed consent was obtained from the patient for publication of this case report. Author details 1Department of Internal Medicine, TTUHSC-Paul L Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX 79905, USA. Authors’ contributions ZN developed the manuscript idea, gathered case details, performed the history, physical exam and the treatment of the patient, and co-wrote and edited the manuscript. RG was a major contributor in writing the manuscript. AB reviewed the literature and contributed to writing the manuscript. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests
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