title: Acute osteomyelitis of the mandible caused by Rhodococcus equi in an immunocompromised patient: a case report and literature review.
abstract: 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.
authors.affiliation: Department of Oral & Maxillofacial Surgery, General Hospital of Attica KAT, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Rallis
authors.forename: Panayotis
authors.initials: P
authors.lastname: Dais
authors.forename: George
authors.initials: G
authors.lastname: Gkinis
authors.forename: Constantinos
authors.initials: C
authors.lastname: Mourouzis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Papaioannou
authors.forename: Michael
authors.initials: M
authors.lastname: Mezitis
mesh_terms: D000193:Actinomycetales Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D016867:Immunocompromised Host; D008279:Magnetic Resonance Imaging; D008297:Male; D008336:Mandibular Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016929:Rhodococcus equi / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents