Successful management of multiple extrapulmonary complications associated with Rhodococcus equi pneumonia in a foal

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Abstract

This report describes the diagnosis and successful treatment of multiple extrapulmonary sequelae of Rhodococcus equi (R. equi) pneumonia in a 3-month-old filly. Bilateral uveitis and hyphaema, haemolytic anaemia and polysynovitis developed in this foal and were likely due to immune-mediated mechanisms. The challenges associated with diagnosis and treatments of these extrapulmonary disorders are discussed. The filly was treated initially with clarithromycin and rifampin; however, a blood transfusion and immunosuppressive therapy with dexamethasone were required due to progressive haemolysis and for treatment of uveitis and polysynovitis. Bilateral hyphaema was successfully treated with intracameral injections of a recombinant tissue plasminogen activator. The development of antimicrobial resistance in R. equi was an additional challenge encountered in the management of this case and emphasises the importance of culture and in vitro antimicrobial susceptibility testing of isolates from foals with R. equi pneumonia.
Original languageEnglish
Pages (from-to)186-192
Number of pages7
JournalEquine Veterinary Education
Volume28
Issue number4
Early online date2015
DOIs
Publication statusPublished - 2016

Fingerprint

Rhodococcus equi
foals
pneumonia
fillies
Pneumonia
Hyphema
Uveitis
clarithromycin
t-plasminogen activator
immunosuppressive agents
hemolytic anemia
rifampicin
blood transfusion
complications (disease)
hemolysis
dexamethasone
antibiotic resistance
Clarithromycin
Hemolytic Anemia
Case Management

Cite this

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title = "Successful management of multiple extrapulmonary complications associated with Rhodococcus equi pneumonia in a foal",
abstract = "This report describes the diagnosis and successful treatment of multiple extrapulmonary sequelae of Rhodococcus equi (R. equi) pneumonia in a 3-month-old filly. Bilateral uveitis and hyphaema, haemolytic anaemia and polysynovitis developed in this foal and were likely due to immune-mediated mechanisms. The challenges associated with diagnosis and treatments of these extrapulmonary disorders are discussed. The filly was treated initially with clarithromycin and rifampin; however, a blood transfusion and immunosuppressive therapy with dexamethasone were required due to progressive haemolysis and for treatment of uveitis and polysynovitis. Bilateral hyphaema was successfully treated with intracameral injections of a recombinant tissue plasminogen activator. The development of antimicrobial resistance in R. equi was an additional challenge encountered in the management of this case and emphasises the importance of culture and in vitro antimicrobial susceptibility testing of isolates from foals with R. equi pneumonia.",
keywords = "Horse, Hyphaema, Immune-mediated haemolytic anaemia, Polysynovitis, Uveitis",
author = "Edwina Wilkes and Kristopher Hughes and Allan Kessell and Sharanne Raidal",
note = "Imported on 12 Apr 2017 - DigiTool details were: month (773h) = April; Journal title (773t) = Equine Veterinary Education. ISSNs: 0957-7734;",
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pages = "186--192",
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TY - JOUR

T1 - Successful management of multiple extrapulmonary complications associated with Rhodococcus equi pneumonia in a foal

AU - Wilkes, Edwina

AU - Hughes, Kristopher

AU - Kessell, Allan

AU - Raidal, Sharanne

N1 - Imported on 12 Apr 2017 - DigiTool details were: month (773h) = April; Journal title (773t) = Equine Veterinary Education. ISSNs: 0957-7734;

PY - 2016

Y1 - 2016

N2 - This report describes the diagnosis and successful treatment of multiple extrapulmonary sequelae of Rhodococcus equi (R. equi) pneumonia in a 3-month-old filly. Bilateral uveitis and hyphaema, haemolytic anaemia and polysynovitis developed in this foal and were likely due to immune-mediated mechanisms. The challenges associated with diagnosis and treatments of these extrapulmonary disorders are discussed. The filly was treated initially with clarithromycin and rifampin; however, a blood transfusion and immunosuppressive therapy with dexamethasone were required due to progressive haemolysis and for treatment of uveitis and polysynovitis. Bilateral hyphaema was successfully treated with intracameral injections of a recombinant tissue plasminogen activator. The development of antimicrobial resistance in R. equi was an additional challenge encountered in the management of this case and emphasises the importance of culture and in vitro antimicrobial susceptibility testing of isolates from foals with R. equi pneumonia.

AB - This report describes the diagnosis and successful treatment of multiple extrapulmonary sequelae of Rhodococcus equi (R. equi) pneumonia in a 3-month-old filly. Bilateral uveitis and hyphaema, haemolytic anaemia and polysynovitis developed in this foal and were likely due to immune-mediated mechanisms. The challenges associated with diagnosis and treatments of these extrapulmonary disorders are discussed. The filly was treated initially with clarithromycin and rifampin; however, a blood transfusion and immunosuppressive therapy with dexamethasone were required due to progressive haemolysis and for treatment of uveitis and polysynovitis. Bilateral hyphaema was successfully treated with intracameral injections of a recombinant tissue plasminogen activator. The development of antimicrobial resistance in R. equi was an additional challenge encountered in the management of this case and emphasises the importance of culture and in vitro antimicrobial susceptibility testing of isolates from foals with R. equi pneumonia.

KW - Horse

KW - Hyphaema

KW - Immune-mediated haemolytic anaemia

KW - Polysynovitis

KW - Uveitis

U2 - 10.1111/eve.12469

DO - 10.1111/eve.12469

M3 - Article

VL - 28

SP - 186

EP - 192

JO - Equine Veterinary Education

JF - Equine Veterinary Education

SN - 0957-7734

IS - 4

ER -