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Frontiers in veterinary science2020; 6; 503; doi: 10.3389/fvets.2019.00503

Rhodococcus equi Joint Sepsis and Osteomyelitis Is Associated With a Grave Prognosis in Foals.

Abstract: The most common pathologic manifestation of , a gram-positive, facultative intracellular bacterium, is pyogranulomatous pneumonia in foals and weanlings. Hematogenous spread of bacteria may subsequently occur, resulting in joint sepsis, osteomyelitis, or subcutaneous abscessation. Medical records from horses presenting to the Cornell University Equine Hospital from 1998 to 2018 were reviewed for cases diagnosed with joint and/or bone infection, and information about case progression and outcome were analyzed. We hypothesized that, despite advances in diagnostic imaging, antimicrobials and antimicrobial delivery methods, the prognosis for joint sepsis and osteomyelitis remains grave for athletic activity and poor for survival. The 12 cases that met the review criteria had a mortality rate of 84% (10/12), with one case lost to follow up after discharge and one case discharged with a grave prognosis for athleticism.
Copyright © 2020 Ruocco, Luedke, Fortier, Ducharme and Reesink.
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Publication Date: 2020-01-14 PubMed ID: 31993449PubMed Central: PMC6971166DOI: 10.3389/fvets.2019.00503Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study analyzes cases of Rhodococcus equi joint sepsis and osteomyelitis in foals and identifies an alarmingly high mortality rate and poor prognosis for survival and athleticism, despite improvements in diagnosis and treatment.

Introduction

  • Rhodococcus equi is a Gram-positive bacterium that often leads to pyogranulomatous pneumonia in young horses like foals and weanlings.
  • The bacteria can spread through the bloodstream to different parts of the body, causing joint sepsis, osteomyelitis (an infection in the bone), or subcutaneous abscessation (formation of abscesses under the skin).

Study Methodology

  • For this study, medical records from horses presented to the Cornell University Equine Hospital between the years 1998 to 2018 were reviewed.
  • The aim was to gather information on cases diagnosed with Rhodococcus equi joint sepsis and/or osteomyelitis, and analyze the progression and outcome of each case.
  • The initial hypothesis was that despite advancements in diagnostic imaging techniques, antimicrobials (drugs that kill or stop the growth of bacteria), and antimicrobial delivery methods, the prognosis for both conditions remains daunting, with a poor outlook for athletic activity and survival.

Findings

  • The review of records yielded 12 cases that met the review criteria.
  • Astonishingly, these cases had a mortality rate of 84% (10 out of 12 cases), emphasizing the severity of Rhodococcus equi infections.
  • One case was lost to follow up after the horse was discharged, and another one was discharged but with a grave prognosis for athletic performance.

Conclusion

  • The study results corroborated the initial hypothesis, highlighting the severe implications of Rhodococcus equi joint sepsis and osteomyelitis in foals.
  • Despite advancements in detection and treatment methods, prognosis remains poor.
  • This underlines the urgent need for further research and development in methods of prevention, detection, and treatment of these conditions.

Cite This Article

APA
Ruocco NA, Luedke LK, Fortier LA, Ducharme NG, Reesink HL. (2020). Rhodococcus equi Joint Sepsis and Osteomyelitis Is Associated With a Grave Prognosis in Foals. Front Vet Sci, 6, 503. https://doi.org/10.3389/fvets.2019.00503

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 6
Pages: 503
PII: 503

Researcher Affiliations

Ruocco, Nicholas A
  • Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States.
Luedke, Lauren K
  • Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States.
Fortier, Lisa A
  • Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States.
Ducharme, Norm G
  • Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States.
Reesink, Heidi L
  • Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States.

References

This article includes 20 references
  1. Hepworth-Warren KL, Wong DM, Fulkerson CV, Wang C, Sun Y. Bacterial isolates, antimicrobial susceptibility patterns, and factors associated with infection and outcome in foals with septic arthritis: 83 cases (1998-2013).. J Am Vet Med Assoc 2015 Apr 1;246(7):785-93.
    doi: 10.2460/javma.246.7.785pubmed: 25794129google scholar: lookup
  2. Glass K, Watts AE. Septic Arthritis, Physitis, and Osteomyelitis in Foals.. Vet Clin North Am Equine Pract 2017 Aug;33(2):299-314.
    doi: 10.1016/j.cveq.2017.03.002pubmed: 28687092google scholar: lookup
  3. Paradis MR. Cutaneous and musculoskeletal manifestations of Rhodococcus equi infection in foals.. Equine Vet Educ (1997) 9:266–70.
    doi: 10.1111/j.2042-3292.1997.tb01321.xgoogle scholar: lookup
  4. Ainsworth DM, Eicker SW, Yeagar AE, Sweeney CR, Viel L, Tesarowski D, Lavoie JP, Hoffman A, Paradis MR, Reed SM, Erb HN, Davidow E, Nalevanko M. Associations between physical examination, laboratory, and radiographic findings and outcome and subsequent racing performance of foals with Rhodococcus equi infection: 115 cases (1984-1992).. J Am Vet Med Assoc 1998 Aug 15;213(4):510-5.
    pubmed: 9713534
  5. Burton AJ, Giguère S, Berghaus LJ, Hondalus MK, Arnold RD. Efficacy of liposomal gentamicin against Rhodococcus equi in a mouse infection model and colocalization with R. equi in equine alveolar macrophages.. Vet Microbiol 2015 Apr 17;176(3-4):292-300.
    doi: 10.1016/j.vetmic.2015.01.015pubmed: 25666452google scholar: lookup
  6. Reuss SM, Chaffin MK, Cohen ND. Extrapulmonary disorders associated with Rhodococcus equi infection in foals: 150 cases (1987-2007).. J Am Vet Med Assoc 2009 Oct 1;235(7):855-63.
    doi: 10.2460/javma.235.7.855pubmed: 19793018google scholar: lookup
  7. Vos NJ, Ducharme NG. Analysis of factors influencing prognosis in foals with septic arthritis.. Ir Vet J 2008 Feb 1;61(2):102-6.
    doi: 10.1186/2046-0481-61-2-102pmc: PMC3113883pubmed: 21851707google scholar: lookup
  8. Desjardins MR, Vachon AM. Surgical management of Rhodococcus equi metaphysitis in a foal.. J Am Vet Med Assoc 1990 Sep 1;197(5):608-12.
    pubmed: 2211310
  9. Chaffin MK, Honnas CM, Crabill MR, Schneiter HL, Brumbaugh GW, Briner RP. Cauda equina syndrome, diskospondylitis, and a paravertebral abscess caused by Rhodococcus equi in a foal.. J Am Vet Med Assoc 1995 Jan 15;206(2):215-20.
    pubmed: 7751225
  10. Burton AJ, Giguère S, Sturgill TL, Berghaus LJ, Slovis NM, Whitman JL, Levering C, Kuskie KR, Cohen ND. Macrolide- and rifampin-resistant Rhodococcus equi on a horse breeding farm, Kentucky, USA.. Emerg Infect Dis 2013 Feb;19(2):282-5.
    doi: 10.3201/eid1902.121210pmc: PMC3559061pubmed: 23347878google scholar: lookup
  11. Giguère S, Lee E, Williams E, Cohen ND, Chaffin MK, Halbert N, Martens RJ, Franklin RP, Clark CC, Slovis NM. Determination of the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and treatment outcome in foals infected with antimicrobial-resistant isolates of R equi.. J Am Vet Med Assoc 2010 Jul 1;237(1):74-81.
    doi: 10.2460/javma.237.1.74pubmed: 20590498google scholar: lookup
  12. Fenton CS, Buckley TC. Minimum inhibitory concentrations of erythromycin and rifampin for Rhodococcus equi during the years 2007-2014.. Ir Vet J 2015;68:23.
    doi: 10.1186/s13620-015-0051-4pmc: PMC4594895pubmed: 26445669google scholar: lookup
  13. Giguère S, Jacks S, Roberts GD, Hernandez J, Long MT, Ellis C. Retrospective comparison of azithromycin, clarithromycin, and erythromycin for the treatment of foals with Rhodococcus equi pneumonia.. J Vet Intern Med 2004 Jul-Aug;18(4):568-73.
    doi: 10.1111/j.1939-1676.2004.tb02587.xpubmed: 15320600google scholar: lookup
  14. Landersdorfer CB, Bulitta JB, Kinzig M, Holzgrabe U, Sörgel F. Penetration of antibacterials into bone: pharmacokinetic, pharmacodynamic and bioanalytical considerations.. Clin Pharmacokinet 2009;48(2):89-124.
    doi: 10.2165/00003088-200948020-00002pubmed: 19271782google scholar: lookup
  15. Poyade-Alvarado A, Marcoux M. Haematogenous septic arthritis and osteomyelitis in foals: 39 cases (1985-1989).. Prat Vet Equine (1993) 25:275–80.
  16. Collatos C, Clark ES, Reef VB, Morris DD. Septicemia, atrial fibrillation, cardiomegaly, left atrial mass, and Rhodococcus equi septic osteoarthritis in a foal.. J Am Vet Med Assoc 1990 Oct 15;197(8):1039-42.
    pubmed: 2147021
  17. Kelmer G, Hayes ME. Regional limb perfusion with erythromycin for treatment of septic physitis and arthritis caused by Rhodococcus equi.. Vet Rec 2009 Sep 5;165(10):291-2.
    doi: 10.1136/vr.165.10.291pubmed: 19734562google scholar: lookup
  18. Firth EC, Alley MR, Hodge H. Rhodococcus equi-associated osteomyelitis in foals.. Aust Vet J 1993 Aug;70(8):304-7.
    doi: 10.1111/j.1751-0813.1993.tb07980.xpubmed: 8216097google scholar: lookup
  19. Loesch DA, Bryant JE, Lopez-Martinez A. Case report: septic coxofemoral arthritis with extension into the abdominal cavity in a foal.. Equine Vet Educ (2003) 15:15–8.
    doi: 10.1111/j.2042-3292.2003.tb00204.xgoogle scholar: lookup
  20. Giles C, Vanniasinkam T, Ndi S, Barton MD. Rhodococcus equi (Prescottella equi) vaccines; the future of vaccine development.. Equine Vet J 2015 Sep;47(5):510-8.
    doi: 10.1111/evj.12310pubmed: 24945608google scholar: lookup

Citations

This article has been cited 2 times.
  1. Sting R, Schwabe I, Kieferle M, Münch M, Rau J. Fatal Infection in an Alpaca (Vicugna pacos) Caused by Pathogenic Rhodococcus equi. Animals (Basel) 2022 May 19;12(10).
    doi: 10.3390/ani12101303pubmed: 35625149google scholar: lookup
  2. Zanilabdin M, Ilgekbayeva G, Otarbayev B, Nissanova R, Mussayeva G, Takai S, Suzuki Y, Kakuda T, Kurman S, Kassymov Y, Valiyeva B. Integrated molecular and serological survey of Rhodococcus equi in horses from three regions of Kazakhstan. Front Vet Sci 2025;12:1650186.
    doi: 10.3389/fvets.2025.1650186pubmed: 41195079google scholar: lookup
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