Department of Oral & Maxillofacial Surgery, General Hospital of Attica KAT, Athens, Greece.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Oct;114(4):e1-5. doi: 10.1016/j.oooo.2011.09.010. Epub 2012 Mar 3.
We present the first case of acute osteomyelitis of the mandible caused by Rhodococcus equi in an immunocompromised patient. A 53-year-old Caucasian man was referred to the outpatient clinic, because of a swelling of the left submental and submandibular spaces. The patient was immunocompromised owing to medication against myasthenia gravis and type II diabetes mellitus. The patient underwent surgical debridement under local anesthesia. Histologic examination showed acute osteomyelitis and both blood and pus cultures isolated Rhodococcus equi. The patient was discharged on linezolid 600 mg orally twice a day for 6 months and remains free of the disease 2 years postoperatively. Most patients with Rhodococcus infection are immunocompromised. Infection with this organism is rare and usually causes a distinct clinical syndrome resembling pulmonary tuberculosis. Diagnosis is frequently missed or delayed. Not only clinicians but also laboratory specialists should be aware of this organism, so as to contribute to prompt diagnosis and treatment of such infections.
我们报告首例免疫抑制患者下颌骨急性马红球菌骨髓炎。一名 53 岁白人男性因左颏下和下颌下间隙肿胀而被转诊至门诊。患者因重症肌无力和 2 型糖尿病的药物治疗而免疫抑制。患者在局部麻醉下接受了手术清创。组织学检查显示急性骨髓炎，血液和脓液培养均分离出马红球菌。患者出院时接受利奈唑胺 600 mg 口服，每日 2 次，疗程 6 个月，术后 2 年无疾病复发。大多数感染马红球菌的患者均免疫抑制。这种病原体的感染很少见，通常引起类似于肺结核的明显临床综合征。诊断经常被遗漏或延迟。不仅临床医生，而且实验室专家都应该了解这种病原体，以便有助于及时诊断和治疗此类感染。
