Serviço de Doenças Infecciosas e Parasitárias, Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, MG, Brazi.
Laboratório de Vírus, Departamento de Microbiologia, Universidade Federal de Minas Gerais, MG, Brazil.
J Ayub Med Coll Abbottabad. 2023 Apr-Jun;35(2):337-340. doi: 10.55519/JAMC-02-11715.
Rhodococcus hoagie, previously referred to as R. equi, is a Gram-positive intracellular coccobacillus that belongs to the Nocardiaceae family. This multi-host pathogen causes infections in farm animals, particularly foals, but also in immunosuppressed patients, mainly individuals treated with high doses of corticosteroids, subjected to organ transplant, or infected with human immunodeficiency virus Objectives of the study are to report a bloodstream infection in an immunocompromised patient. Immunocompromised patients with advanced HIV who presented bloodstream infection, residing in an urban setting and having undertaken no trips to the countryside or elsewhere during the COVID-19 pandemic. Blood culture by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was done in order to identify the bacteria. The immunocompromised female patient presented bloodstream infection by Rhodococcus hoagie, which was identified using MALDI-TOF-MS. R. hoagie can cause a severe infection with a high mortality rate if prompt treatment with a combination of antibiotics is not established. A high level of suspicion is required to establish the diagnosis, as it may be misdiagnosed as pulmonary tuberculosis. On gram stain, R. hoagie may appear as beaded to solid staining coccobacilli, which can be dismissed as a "diphtheroid" contaminant. The infection was identified using MALDI-TOF-MS.
罗霍氏球菌，以前称为马红球菌，是一种革兰氏阳性细胞内球杆菌，属于诺卡氏菌科。这种多宿主病原体可引起农场动物感染，特别是幼驹，但也可引起免疫功能低下患者感染，主要是接受大剂量皮质类固醇治疗、接受器官移植或感染人类免疫缺陷病毒的个体。本研究的目的是报告一例免疫功能低下患者的血流感染。在 COVID-19 大流行期间，居住在城市环境中、没有前往农村或其他地方旅行、患有晚期 HIV 的免疫功能低下患者出现血流感染。通过基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF-MS）进行血培养以鉴定细菌。这名免疫功能低下的女性患者患有罗霍氏球菌引起的血流感染，通过 MALDI-TOF-MS 鉴定。如果不及时使用抗生素联合治疗，罗霍氏球菌可引起严重感染，死亡率很高。需要高度怀疑才能建立诊断，因为它可能被误诊为肺结核。在革兰氏染色中，罗霍氏球菌可能表现为呈珠状至固体染色的球杆菌，可能被视为“类白喉”污染物。通过 MALDI-TOF-MS 鉴定了感染。
