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== Introduction  ==

== Introduction  ==

[[Image:Pyogranulomatous lungs due to Rhodococcus Equi.jpg|thumb|right|100px|<small><center>Pyogranulomatous lesions due to Rhodococcus equi (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]  

[[Image:Pyogranulomatous lungs due to Rhodococcus Equi.jpg|thumb|right|200px|<small><center>Pyogranulomatous lesions due to Rhodococcus equi (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]  

''Rhodococcus equi'' is a gram-positive aerobic, intracellular, saprophyte found worldwide in the soil and in the intestinal tract of animals. It replicates at warm temperatures in soils contaminated by faeces of herbivores and is an opportunistic respiratory pathogen of foals under 6 months causing suppurative [[Bronchopneumonia|bronchoneumonia]].  

''Rhodococcus equi'' is a gram-positive aerobic, intracellular, saprophyte found worldwide in the soil and in the intestinal tract of animals. It replicates at warm temperatures in soils contaminated by faeces of herbivores and is an opportunistic respiratory pathogen of foals under 6 months causing suppurative [[Bronchopneumonia|bronchoneumonia]].  

== Clinical Signs ==

== Clinical Signs ==

Bronchoneumonia and lung abscessation in foals less than 4 months old. Acute disease in 1 month-old foals with signs such as acute fever, anorexia, bronchopneumonia. In older foals, 2- 4 months the disease is more insidious with signs such as coughing, dyspnoea, weight loss, exercise intolerance, loud, moist rattles on lung auscultation. There is occasionally diarrhoea seen, due to granulomatous ulcerative enterocolitis, mesenteric lymphadenitis and [[Peritonitis|peritonitis]] in some foals following ingestion of contaminated sputum.

Bronchoneumonia and lung abscessation in foals less than 4 months old. Acute disease in 1 month-old foals with signs such as acute fever, anorexia, [[bronchopneumonia]]. In older foals, 2 - 4 months the disease is more insidious with signs such as coughing, dyspnoea, weight loss, exercise intolerance, loud, moist rattles on lung auscultation. There is occasionally diarrhoea seen, due to granulomatous ulcerative enterocolitis, mesenteric lymphadenitis and [[Peritonitis|peritonitis]] in some foals following ingestion of contaminated sputum.

Foals over 6 months are refractory to pulmonary infection, but superficial abscesses may occur.

Foals over 6 months are refractory to pulmonary infection, but superficial abscesses may occur.

== Diagnosis  ==

== Diagnosis  ==

History of the disease on the farm, age of foals and clinical signs are used to make a presumptive diagnosis. Auscultation and radiography of thorax confirms pulmonary disease. Sonography of the lung shows small abscesses close to pleura in a very early stage, even before clinical signs can be seen. WBC is rising in an early stage, too.  

History of the disease on the farm, age of foals and clinical signs are used to make a presumptive diagnosis. Auscultation and radiography of thorax confirms pulmonary disease. Sonography of the lung shows small abscesses close to the pleura in a very early stage, even before clinical signs can be seen. White blood cell cound (WBC) is rising in an early stage, too.  

Samples of tracheal aspirates and pus from lesions need to be taken and cultured aerobically on blood and MacConkey agar for 24-48 hours. Characteristic salmon-pink mucoid colonies grow, due to capsule and pigment production. 

Samples of tracheal aspirates and pus from lesions need to be taken and cultured aerobically on blood and MacConkey agar for 24-48 hours. Characteristic salmon-pink mucoid colonies grow, due to capsule and pigment production. 

PCR from the tracheobronchial mucus is a save diagnose.

PCR from the tracheobronchial mucus is a safe method to confirm diagnosis.

== Treatment and Control  ==

== Treatment and Control  ==

Starting the treatment in an early stage is important for the succsess!  

Starting the treatment in an early stage is important for the success!  

Affected farms should be screened regulary. Clinical examiation, WBC and sonography of the lung are effective tools to catch the disease early.  

Affected farms should be screened regularly. Clinical examination, WBC and sonography of the lung are effective tools to catch the disease early.

 

Oral rifampin and erythromycin for 4-10 weeks is the treatment of choice for this disease. In Germany the treatment of choice is Tulathromycin (Draxxin by Pfizer), which is given i.m. every week for 4-8 weeks.  

Rehydration therapy if diarrhoea is involved may be needed. Bronchodilators and expectorants should be used supportively.

Rehydration therapy if diarrhoea is involved may be needed. Bronchodilators and expectorants should be used supportively.

Sonography of the lung and clinical examination are the best control for treatment´s sucsess.  

Sonography of the lung and clinical examination are the best control for treatment´s success.  

Control measures include preventing build-up of bacteria in environment by removing manure from pastures regularly and rotating foals and mares onto clean pastures regularly. Dusty conditions in paddocks should be avoided. In sickly looking foals, hyperimmune serum from the dam may be given to the foal in the first month of life. 

Control measures include preventing build-up of bacteria in environment by removing manure from pastures often and rotating foals and mares onto clean pastures regularly. Dusty conditions in paddocks should be avoided. In sickly looking foals, hyperimmune serum from the dam may be given to the foal in the first month of life. 

== Literature Search  ==

== Literature Search  ==

[http://www.cabi.org/cabdirect/FullTextPDF/2008/20083097718.pdf '''Review of the epidemiology and ecology of ''Rhodococcus equi.''''' Muscatello, G.; Lowe, J. M.; Flash, M. L.; McBride, K. L.; Browning, G. F.; Gilkerson, J. R.; Green, E. M.&nbsp;; American Association of Equine Practitioners (AAEP), Lexington, USA, Proceedings of the 53rd Annual Convention of the American Association of Equine Practitioners, Orlando, Florida, USA, 1-5 December, 2007, 2007, pp 214-217, 27 ref. - '''Full text article''']

[http://www.cabi.org/cabdirect/FullTextPDF/2008/20083097718.pdf '''Review of the epidemiology and ecology of ''Rhodococcus equi.''''' Muscatello, G.; Lowe, J. M.; Flash, M. L.; McBride, K. L.; Browning, G. F.; Gilkerson, J. R.; Green, E. M.&nbsp;; American Association of Equine Practitioners (AAEP), Lexington, USA, Proceedings of the 53rd Annual Convention of the American Association of Equine Practitioners, Orlando, Florida, USA, 1-5 December, 2007, 2007, pp 214-217, 27 ref. - '''Full text article''']

There are many dissertations from Hannover (summary in English):

There are many dissertations from Hannover University (summary in English):

http://elib.tiho-hannover.de/dissertations/heyersp_ss05.html

 

:[http://elib.tiho-hannover.de/dissertations/heyersp_ss05.html Comparison of the detection of Rhodococcus equi by microbiological culture and the polymerase chain reaction in tracheobronchial fluid from foals]

== References  ==

== References  ==

Brown, C.M, Bertone, J.J. (2002) The 5-Minute Veterinary Consult- Equine', Lippincott, Williams & Wilkins  

Brown, C.M, Bertone, J.J. (2002) The 5-Minute Veterinary Consult- Equine', Lippincott, Williams & Wilkins  

Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) Equine Internal Medicine (Third Edition), Saunders.

Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) Equine Internal Medicine (Third Edition), Saunders.

Rose, R. J. and Hodgson, D. R. (2000) Manual of Equine Practice (Second Edition) Sauders.  

Rose, R. J. and Hodgson, D. R. (2000) Manual of Equine Practice (Second Edition) Sauders.  

 

 

[[Category:Bacteria_miscellaneous]] [[Category:Gram_positive_bacteria]] [[Category:Cocci]] [[Category:Rods]] [[Category:Horse_Bacteria]] [[Category:Expert_Review]] [[Category:Respiratory_Bacterial_Infections]] [[Category:Respiratory_Diseases_-_Horse]]

[[Category:Bacteria_miscellaneous]] [[Category:Gram_positive_bacteria]] [[Category:Cocci]] [[Category:Rods]] [[Category:Horse_Bacteria]] [[Category:Expert_Review]] [[Category:Respiratory_Bacterial_Infections]] [[Category:Respiratory_Diseases_-_Horse]]