<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1409-1429</journal-id>
<journal-title><![CDATA[Revista Costarricense de Salud Pública]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. costarric. salud pública]]></abbrev-journal-title>
<issn>1409-1429</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Salud Pública]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-14292018000200106</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Absceso glúteo por Rhodococcus Equi: presentación atípica de enfermedad emergente]]></article-title>
<article-title xml:lang="en"><![CDATA[Gluteus abscess due to RhodococcusEqui: atypical presentation of emerging disease]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Flores Sandí]]></surname>
<given-names><![CDATA[Grettchen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Costa Rica Escuela de Medicina Legal Departamento Clínico de Medicina Legal]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>27</volume>
<numero>2</numero>
<fpage>106</fpage>
<lpage>117</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-14292018000200106&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-14292018000200106&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-14292018000200106&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Rhodococcusequi, bacteria aislada principalmente en potros, se considera en la actualidad un patógeno zoonótico emergente en seres humanos, la mayoría inmunocomprometidos, coincidiendo con la epidemia de VIH y los avances en la medicina de trasplantes y la quimioterapia del cáncer, lo que justifica la revisión sobre su patogenia, características clínicas, diagnóstico y tratamiento. Más frecuente en hombres que en mujeres, el inicio de las infecciones es generalmente insidioso y los síntomas que presentan varían según el sitio de la infección, la enfermedad respiratoria, caracterizada por neumonía necrosante es la manifestación más común, y tiende a seguir un curso subagudo, mientras las personas inmunocompetentes son afectadas con baja frecuencia y suelen presentarse con enfermedad localizada. Las infecciones de la piel o partes blandas, incluyendo abscesos, son poco frecuentes incluso en huéspedes inmunocomprometidos y están usualmente relacionadas con contaminación ambiental. El laboratorio de microbiología juega un papel clave en la identificación del organismo, ya que este puede confundirse con flora normal de la piel. El caso que se presenta corresponde a una paciente adulta inmunocompetente, con infección de herida quirúrgica por R equiluego de una cirugía estética, requirió tratamiento antibiótico, múltiples lavados quirúrgicos y debridamientos, más drenaje de absceso, con mejoría del proceso infeccioso. Este caso sugiere la importancia clínica de la identificación precisa de patógenos inusuales, capaces de entorpecer la evolución normal de un proceso quirúrgico y de producir un alto costo de atención de salud y el alcance medidas preventivas relacionadas con la vigilancia de la salud.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Rhodococcusequi, a bacterium isolated mainly in foals, is currently considered an emerging zoonotic pathogen in humans, most of them immunocompromised, coinciding with the HIV epidemic and advances in transplant medicine and cancer chemotherapy, which justifies the review on its pathogenesis, clinical characteristics, diagnosis and treatment. More frequent in men than in women, the onset of infections is usually insidious and the symptoms they present vary according to the site of infection, the respiratory disease, characterized by necrotizing pneumonia is the most common manifestation, and tends to follow a subacute course , while immunocompetent people are affected with low frequency and usually have localized disease. Infections of the skin or soft tissues, including abscesses, are rare even in immunocompromised hosts and are usually related to environmental contamination. The microbiology laboratory plays a key role in the identification of the organism, since it can be confused with normal flora of the skin. The case presented corresponds to an adult immunocompetent patient, with surgical wound infection by R equiafter cosmetic surgery, required antibiotic treatment, multiple surgical washes and debridements, and abscess drainage, with improvement of the infectious process. This case suggests the clinical importance of the precise identification of unusual pathogens, capable of obstructing the normal evolution of a surgical process and of producing a high cost of health care and the scope of preventive measures related to health surveillance.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Rhodococcusequi]]></kwd>
<kwd lng="es"><![CDATA[Paciente Inmunocompetente]]></kwd>
<kwd lng="es"><![CDATA[Absceso Glúteo]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad Emergente]]></kwd>
<kwd lng="en"><![CDATA[Rhodococcusequi]]></kwd>
<kwd lng="en"><![CDATA[Immunocompetent Patient]]></kwd>
<kwd lng="en"><![CDATA[Gluteus abscess]]></kwd>
<kwd lng="en"><![CDATA[Emerging disease]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gundelly]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Suzuki]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Ribes]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Thornton]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Differences in Rhodococcusequi Infections Based on Immune Status and Antibiotic Susceptibility of Clinical Isolates in a Case Series of 12 Patients and Cases in the Literature,]]></article-title>
<source><![CDATA[Biomed Res Int]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Khurana]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Current understanding of Rhodococcusequi infection and its zoonotic implications]]></article-title>
<source><![CDATA[Adv Anim Vet Sci]]></source>
<year>2015</year>
<volume>3</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-10</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lim]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ab Rahman]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Abdullah]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An experience of successful treatment of Rhodococcusequi infective endocarditis in a non-HIV patient with linezolid]]></article-title>
<source><![CDATA[Clin Case Rep Rev]]></source>
<year>2017</year>
<volume>3</volume>
<numero>8</numero>
<issue>8</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rahman]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rhodococcusequi An emerging zoonotic pathogen]]></article-title>
<source><![CDATA[Ann Vet Anim Sci]]></source>
<year>2015</year>
<volume>2</volume>
<page-range>3-10</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yamshchikov]]></surname>
<given-names><![CDATA[AV]]></given-names>
</name>
<name>
<surname><![CDATA[Schuetz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Lyon]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rhodococcusequi infection]]></article-title>
<source><![CDATA[Lancet Infect Dis]]></source>
<year>2010</year>
<volume>10</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>350-9</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<collab>Dalal P1.Dalal T.Shah G</collab>
<article-title xml:lang=""><![CDATA[Hemodialysis catheter related rhodococcus bacteremia in immunocompetent host]]></article-title>
<source><![CDATA[Saudi J Kidney Dis Transpl]]></source>
<year>2011</year>
<volume>22</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>761-3</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sandkovsky]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Sandkovsky]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Sordillo]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Polsky]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rhodococcusequi infection after reduction mammaplasty in an immunocompetent patient.]]></article-title>
<source><![CDATA[Rev Inst Med Trop Sao Paulo]]></source>
<year>2011</year>
<volume>53</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>291-4</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Savini]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Salutari]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Sborgia]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mancini]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Masciarelli]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Catavitello]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Brief Tale of a Bacteraemia by Rhodococcusequi, With Concomitant Lung Mass What Came First, the Chicken or The Egg?]]></article-title>
<source><![CDATA[Mediterr J Hematol Infect Dis]]></source>
<year>2011</year>
<volume>3</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nath]]></surname>
<given-names><![CDATA[SR1]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rhodococcusequi granulomatous mastitis in an immunocompetent patient]]></article-title>
<source><![CDATA[J Med Microbiol]]></source>
<year>2013</year>
<volume>62</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1253-5</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Varotti]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Barabani]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Dodi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Bertocchi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mondello]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cupo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Unusual Extrapulmonary RhodococcusEqui Infection in a Kidney Transplant Patient]]></article-title>
<source><![CDATA[Exp Clin Transplant]]></source>
<year>2016</year>
<volume>14</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>676-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bryan]]></surname>
<given-names><![CDATA[LK]]></given-names>
</name>
<name>
<surname><![CDATA[Alexander]]></surname>
<given-names><![CDATA[ER]]></given-names>
</name>
<name>
<surname><![CDATA[Lawhon]]></surname>
<given-names><![CDATA[SD]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[ND]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Detection of vapN in Rhodococcusequi isolates cultured from humans]]></article-title>
<source><![CDATA[PLoS ONE]]></source>
<year>2018</year>
<page-range>13</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[MacArthur]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Anastasi]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Alvarez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Scortti]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vázquez-Boland]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparative Genomics of Rhodococcusequi Virulence Plasmids Indicates Host-Driven Evolution of the vap Pathogenicity Island]]></article-title>
<source><![CDATA[Genome Biol Evol]]></source>
<year>2017</year>
<volume>9</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1241-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
