Surgical management of Rhodococcus induced anterior mediastinal mass: A case report

Introduction: Rhodococcus is an extremely rare, gram positive, aerobic, coccobacillary organism, usually found in the soil or in dairy and livestock animals. It is most commonly affecting the immunocompromised. Only 15 % of cases have been reported in immunocompetent hosts. Case report: We bring for...

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Main Authors: Rida Wahab, Abdul Ahad, Haseeb Ur Rahman, Asad Saulat Fatimi, Sara Iqbal, Faisal Mahmood, Saulat Hasnain Fatimi
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Respiratory Medicine Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213007124001448
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author Rida Wahab
Abdul Ahad
Haseeb Ur Rahman
Asad Saulat Fatimi
Sara Iqbal
Faisal Mahmood
Saulat Hasnain Fatimi
author_facet Rida Wahab
Abdul Ahad
Haseeb Ur Rahman
Asad Saulat Fatimi
Sara Iqbal
Faisal Mahmood
Saulat Hasnain Fatimi
author_sort Rida Wahab
collection DOAJ
description Introduction: Rhodococcus is an extremely rare, gram positive, aerobic, coccobacillary organism, usually found in the soil or in dairy and livestock animals. It is most commonly affecting the immunocompromised. Only 15 % of cases have been reported in immunocompetent hosts. Case report: We bring forth the unusual case of a 45-year-old gem minor who had already undergone pericardial window due to pericardial effusion. He presented to us with recurrent pericardial effusion and anterior mediastinal mass diagnosed on Computed Tomography Pulmonary Angiogram scan. He was diagnosed with Rhodococcus as being the causative organism of the condition on pericardial fluid cultures. This is an extremely rare manifestation of Rhodococcus infection, which has not yet been reported in literature to the best of our knowledge. Discussion: The first human case of Rhodococcus was reported in a young male upon steroidal therapy for autoimmune hepatitis who developed pneumonia in 1967. Rhodococci infections are usually common in immunocompromised hosts, and only 19 cases have been reported in immunocompetent hosts till now. The usual signs of presentation are cough, pleuritic chest pain, and fever; however, it varies according to the site of infection. The most common manifestation is pneumonia, although other presentations include osteomyelitis, brain abscess, wound infections, etc. Result: The diagnosis and treatment of Rhodococci is very difficult due to the rarity of presentation. Despite that, surgical intervention should be considered as the preferred modality for diagnostic purposes and in infections resistant to medical management.
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spelling doaj-art-d4414f52b1d24c00812296dc57f2d8322025-08-20T02:49:53ZengElsevierRespiratory Medicine Case Reports2213-00712024-01-015210212110.1016/j.rmcr.2024.102121Surgical management of Rhodococcus induced anterior mediastinal mass: A case reportRida Wahab0Abdul Ahad1Haseeb Ur Rahman2Asad Saulat Fatimi3Sara Iqbal4Faisal Mahmood5Saulat Hasnain Fatimi6Aga Khan University Hospital, Karachi, PakistanCorresponding author.; Aga Khan University Hospital, Karachi, PakistanAga Khan University Hospital, Karachi, PakistanAga Khan University Hospital, Karachi, PakistanAga Khan University Hospital, Karachi, PakistanAga Khan University Hospital, Karachi, PakistanAga Khan University Hospital, Karachi, PakistanIntroduction: Rhodococcus is an extremely rare, gram positive, aerobic, coccobacillary organism, usually found in the soil or in dairy and livestock animals. It is most commonly affecting the immunocompromised. Only 15 % of cases have been reported in immunocompetent hosts. Case report: We bring forth the unusual case of a 45-year-old gem minor who had already undergone pericardial window due to pericardial effusion. He presented to us with recurrent pericardial effusion and anterior mediastinal mass diagnosed on Computed Tomography Pulmonary Angiogram scan. He was diagnosed with Rhodococcus as being the causative organism of the condition on pericardial fluid cultures. This is an extremely rare manifestation of Rhodococcus infection, which has not yet been reported in literature to the best of our knowledge. Discussion: The first human case of Rhodococcus was reported in a young male upon steroidal therapy for autoimmune hepatitis who developed pneumonia in 1967. Rhodococci infections are usually common in immunocompromised hosts, and only 19 cases have been reported in immunocompetent hosts till now. The usual signs of presentation are cough, pleuritic chest pain, and fever; however, it varies according to the site of infection. The most common manifestation is pneumonia, although other presentations include osteomyelitis, brain abscess, wound infections, etc. Result: The diagnosis and treatment of Rhodococci is very difficult due to the rarity of presentation. Despite that, surgical intervention should be considered as the preferred modality for diagnostic purposes and in infections resistant to medical management.http://www.sciencedirect.com/science/article/pii/S2213007124001448RhodococcusImmunocompetentAnterior mediastinal massPericardial effusionPericardial window
spellingShingle Rida Wahab
Abdul Ahad
Haseeb Ur Rahman
Asad Saulat Fatimi
Sara Iqbal
Faisal Mahmood
Saulat Hasnain Fatimi
Surgical management of Rhodococcus induced anterior mediastinal mass: A case report
Respiratory Medicine Case Reports
Rhodococcus
Immunocompetent
Anterior mediastinal mass
Pericardial effusion
Pericardial window
title Surgical management of Rhodococcus induced anterior mediastinal mass: A case report
title_full Surgical management of Rhodococcus induced anterior mediastinal mass: A case report
title_fullStr Surgical management of Rhodococcus induced anterior mediastinal mass: A case report
title_full_unstemmed Surgical management of Rhodococcus induced anterior mediastinal mass: A case report
title_short Surgical management of Rhodococcus induced anterior mediastinal mass: A case report
title_sort surgical management of rhodococcus induced anterior mediastinal mass a case report
topic Rhodococcus
Immunocompetent
Anterior mediastinal mass
Pericardial effusion
Pericardial window
url http://www.sciencedirect.com/science/article/pii/S2213007124001448
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AT saraiqbal surgicalmanagementofrhodococcusinducedanteriormediastinalmassacasereport
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