Extrapulmonary disorders associated with Rhodococcus equi infection in foals: 150 cases (1987-2007).
OBJECTIVE
To describe frequency, types, and clinical outcomes of extrapulmonary disorders (EPDs) in foals in which Rhodococcus equi infection was diagnosed, and to identify factors determined at the time of admission that differentiated foals that developed EPDs from foals with R equi infection identified only in the lungs.


METHODS
Retrospective case series.


METHODS
150 foals aged 3 weeks to 6 months with a diagnosis of R equi infection.


METHODS
Medical records were reviewed for information on date of admission, signalment, history, clinical signs, diagnostic testing, treatment, duration of hospitalization, invoice, and outcome. For each EPD identified, further information was collected on the identification, location, treatment, and outcome of the lesion.


RESULTS
Of 150 foals with R equi infections, 111 (74%) had at least 1 of 39 EPDs. Survival was significantly higher among foals without EPDs (32/39 [82%]) than among foals with EPDs (48/111 [43%]), but many EPDs were only recognized after death. Risk factors significantly associated with EPDs included referral status, duration of clinical signs prior to admission, leukocytosis, and neutrophilia. Foals with EPDs also had a higher heart rate and BUN concentration than foals without.


CONCLUSIONS
Practitioners should recognize that extrapulmonary manifestations of R equi occur with high prevalence affecting diverse organ systems, that multiple systems are generally affected when EPDs occur, and that suspicion of R equi infection should prompt evaluation and monitoring of extrapulmonary sites. Improved recognition of the presence of these disorders will help practitioners to better advise their clients in the treatment and outcome of foals with R equi infections.
Reuss
Sarah M
SM
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.
Chaffin
M Keith
MK
Cohen
Noah D
ND
D018784:Abdominal Abscess / Q000150:complications / Q000382:microbiology / Q000662:veterinary; D000193:Actinomycetales Infections / Q000150:complications / Q000382:microbiology / Q000401:mortality / Q000662:veterinary*; D000818:Animals; D002493:Central Nervous System Diseases / Q000150:complications / Q000382:microbiology / Q000662:veterinary; D005767:Gastrointestinal Diseases / Q000150:complications / Q000382:microbiology / Q000662:veterinary; D006402:Hematologic Diseases / Q000150:complications / Q000382:microbiology / Q000662:veterinary; D006520:Hepatitis, Animal / Q000150:complications / Q000382:microbiology; D006734:Horse Diseases / Q000382:microbiology*; D006736:Horses; D008199:Lymphadenitis / Q000150:complications / Q000382:microbiology / Q000662:veterinary; D009140:Musculoskeletal Diseases / Q000150:complications / Q000382:microbiology / Q000662:veterinary; D010538:Peritonitis / Q000150:complications / Q000382:microbiology / Q000662:veterinary; D012189:Retrospective Studies; D016929:Rhodococcus equi; D014605:Uveitis / Q000150:complications / Q000382:microbiology / Q000662:veterinary