Home Rhodococcus equi and Brucella pulmonary mass in immunocompetent: A case report and literature review
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Rhodococcus equi and Brucella pulmonary mass in immunocompetent: A case report and literature review

  • Pengfei Li , Lifang Zhang , Xicheng Li and Xuejuan Zhang EMAIL logo
Published/Copyright: June 18, 2024
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Open Life Sciences
From the journal Open Life Sciences Volume 19 Issue 1

Abstract

Rhodococcus equi, predominantly recognized as an opportunistic pathogen affecting immunocompromised hosts, and Brucella, a widespread zoonotic bacterium, infrequently co-infect immunocompetent adults, thereby posing a distinctive diagnostic challenge. Here, we describe a case involving a 53-year-old male with a history of goat farming, who presented with persistent chest tightness, cough, and notable weight loss, absent fever. Radiological and bronchoscopic assessments showed a right hilar mass, extensive vertebral destruction, and bronchial lesions, deviating from the typical symptoms associated with either pathogen. Laboratory analyses confirmed a co-infection involving R. equi and Brucella. Initial therapy with levofloxacin and vancomycin proved ineffective; however, a subsequent treatment regimen comprising azithromycin, etimicin, minocycline, and moxifloxacin resulted in substantial clinical improvement. This case accentuates the intricacies involved in diagnosing and managing atypical co-infections in immunocompetent individuals and underscores the importance of careful microbiological testing to inform effective therapeutic strategies.

Keywords: Rhodococcus equi ; Brucella ; pulmonary occupancy; Brucellar spondylitis

1 Introduction

Rhodococcus equi, an infrequently encountered opportunistic pathogen, predominantly afflicts neonatal foals, resulting in chronic pyogenic bronchopneumonia [1]. This infection predominantly manifests in immunocompromised hosts, such as individuals with HIV, characterized by pulmonary consolidation and multiple cavitations, yet remains unusual in immunocompetent persons [2]. Conversely, Brucellosis, a zoonotic disease caused by the Brucella species, primarily Brucella melitensis and Brucella abortus, manifests in a diverse array of clinical symptoms, including fever, night sweats, myalgia, arthralgia, and general malaise [3]. In this case study, an immunocompetent individual distinctively presented with coexisting infections of R. equi and Brucella. The patient demonstrated radiological evidence of an isolated pulmonary mass at the hilum, extensive vertebral destruction, and bronchial lesions evident on bronchoscopy. Notably, the patient lacked the cardinal symptom of brucellosis: fever. These multifocal presentations highlight the diagnostic challenge and the need for comprehensive investigation in atypical infectious cases.

2 Case presentation

A 53-year-old male presented at the Affiliated Hospital of Qingdao University reporting a 2-month history of persistent chest tightness and cough, sporadically accompanied by chest and significant back pain. Notably, he denied any fever or hemoptysis. Since the initial manifestation of symptoms, the patient has retained full consciousness and demonstrated stable mental acuity, alongside a normal appetite, adequate sleep quality, and consistent bowel and urinary functions; importantly, he has experienced a significant weight reduction of approximately 10 kg over the past month. Prior to this illness, the patient reported a history of generally good health, with brief engagement in goat farming and an incident where he was bitten by a goat.

2.1 Physical examination

During the examination, the patient remained alert and mentally stable. Pronounced coarse breath sounds were observed in both the upper and lower regions of the right lung. Audible dry and moist rales were present, with a predominance of moist rales in the lower lobes. The cardiac rhythm was regular, and no abnormal murmurs were detected upon auscultation of any heart valve areas, indicating normal cardiac function. The abdomen was soft and non-tender with no rebound tenderness. No masses were palpable, and neither the liver nor spleen was felt below the ribs, suggesting an absence of significant abdominal pathology. Additionally, bowel sounds were audible at a normal rate of four per minute, with no shifting dullness, indicative of normal gastrointestinal activity. Finally, no edema was observed in the lower extremities, and muscle tone in all limbs was normal, suggesting no significant neuromuscular or vascular complications.

  1. Informed consent: Informed consent has been obtained from all individuals included in this study.

  2. Ethical approval: The research related to human use has been complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration and has been approved by the Ethics Committee of the Affiliated Hospital of Qingdao University.

2.2 Laboratory test

Blood routine results: Hemoglobin 101 g/L (130–175 g/L); C-reactive Protein: 19.61 mg/L (0–5 mg/L); Procalcitonin: 0.072 ng/mL (<0.05 ng/mL); CD4 Absolute Count: 427.00 cells/µL (544–1,212 cells/µL); Creatinine 219 µmol/L (79–133 µmol/L); Sputum Culture and Identification: Candida glabrata; Brucella Coombs Test: Brucella IgG Antibody: Positive, Brucellosis Tests: Tube Agglutination Test: 1:200 (++++), Tiger Red Plate Method: Positive; Tests for ANCA, ENA Antibody Spectrum, ANA, and Tumor Marker Screening revealed no significant abnormalities.

2.3 Imaging examination

Initial high-resolution computed tomography (CT) scan of the chest at admission revealed right hilar occupation, extensive mediastinal lymphadenopathy, minimal bilateral pleural effusions, coronary artery calcification, and slight pericardial effusion, along with a high-density shadow localized to approximately the T7 vertebra (Figure 1a). Pre-discharge CT re-evaluation demonstrated marked improvement relative to prior findings (Figure 1b). During the initial bronchoscopy, examination of the lower tracheal segment revealed notable findings including fish-scale-like alterations on the mucosa, a blunted carina, and infiltrative changes, suggesting extensive mucosal involvement. An abnormal growth completely obstructed the lumen at the opening of the right main bronchus, while another lesion was identified on the wall of the left main bronchus, with its distal end remaining patent. Electric loop excision was performed on the right main bronchus to remove the obstructing lesion. This procedure revealed extensive abnormal extension to the distal end of the bronchus, obscuring the openings of the upper and lower lobes. Subsequent irrigation of the bronchus was performed to ensure cleanliness and assess clearance (Figure 2a). A follow-up bronchoscopy conducted a week later revealed polypoid hyperplasia on the inner wall of the left main bronchus and a spherical lesion at the opening of the right main bronchus. Following snare excision of the right bronchial lesion, further examination observed that the growth extended to the terminal end of the bronchus (Figure 2b). Lumbar spine MRI findings: Abnormal signal in L3–L5 vertebrae, suggesting infectious lesions, with posterior spondylolisthesis of L3 and L4 vertebrae (Grade I) and degenerative changes in the lumbar spine (Figure 3).

Figure 1 (a) CT scan showing a right hilar mass with features indicative of obstructive pneumonia. (b) Follow-up CT scan exhibits decreased size of the right hilar mass and improved lung consolidation, indicative of treatment response.
Figure 1

(a) CT scan showing a right hilar mass with features indicative of obstructive pneumonia. (b) Follow-up CT scan exhibits decreased size of the right hilar mass and improved lung consolidation, indicative of treatment response.

Figure 2 (a) The initial bronchoscopy reveals lesions in both the left and right bronchi and that electrocautery was performed. 1. Tracheal carina, 2. Left Main Bronchus, 3. Distal Left Main Bronchus, 4. Electrocautery in Progress, 5. Distal Right Main Bronchus, 6. Right Main Bronchus Opening Under Treatment. (b) The follow-up bronchoscopy shows that despite the intervention, there are still lesions present. 1. Tracheal carina, 2. Left Main Bronchus, 3. Distal Left Main Bronchus, 4. Left Upper Lobe Bronchus Opening, 5. Left Lower Lobe Bronchus Opening, 6. Right Main Bronchus Opening, 7. Right Main Bronchus Opening Under Treatment.
Figure 2

(a) The initial bronchoscopy reveals lesions in both the left and right bronchi and that electrocautery was performed. 1. Tracheal carina, 2. Left Main Bronchus, 3. Distal Left Main Bronchus, 4. Electrocautery in Progress, 5. Distal Right Main Bronchus, 6. Right Main Bronchus Opening Under Treatment. (b) The follow-up bronchoscopy shows that despite the intervention, there are still lesions present. 1. Tracheal carina, 2. Left Main Bronchus, 3. Distal Left Main Bronchus, 4. Left Upper Lobe Bronchus Opening, 5. Left Lower Lobe Bronchus Opening, 6. Right Main Bronchus Opening, 7. Right Main Bronchus Opening Under Treatment.

Figure 3 Lumbar spine MRI indicates abnormal signal intensity in the L3–L5 vertebral bodies with low signal on T1-weighted images (a) and high signal on T2-weighted images (b), suggestive of an infectious lesion.
Figure 3

Lumbar spine MRI indicates abnormal signal intensity in the L3–L5 vertebral bodies with low signal on T1-weighted images (a) and high signal on T2-weighted images (b), suggestive of an infectious lesion.

2.4 Diagnosis

Bronchoscopic biopsy of the right main bronchus revealed extensive inflammatory granulation tissue containing a mixture of histiocytes, lymphocytes, plasma cells, and neutrophils. This suggests a robust inflammatory response. Immunohistochemical analysis and special staining, including positive Silver and PAS reactions, supported the presence of an infection, strongly suggestive of R. equi, corroborated by spore observation. A CT-guided lung biopsy confirmed chronic inflammation along with alveolar epithelial hyperplasia. Next-generation sequencing of bronchoalveolar lavage fluid definitively identified R. equi with high read counts. Concurrent serological testing yielded positive results for Brucella, consistent with the patient’s history and clinical manifestations.

2.5 Treatment and prognosis

Initially, the patient was treated with a regimen comprising levofloxacin and vancomycin, which yielded a negligible therapeutic response. Subsequently, treatment was transitioned to a combination of azithromycin and etimicin. The final therapeutic strategy comprised minocycline and moxifloxacin, augmented by adjunct treatments including antitussives, mucolytics, and bronchodilators for symptomatic relief. Budesonide inhalation therapy was utilized to suppress airway granulomatous proliferation. Concurrently, the patient received calcitriol and cholecalciferol for calcium supplementation. Upon discharge, the patient demonstrated significant amelioration of cough symptoms and substantial improvement in chest CT imaging (Figure 1b).

3 Discussion

R. equi, classified as an aerobic actinomycete within the Nocardiaceae family, is a pleomorphic Gram-positive bacterium that exhibits partial acid-fast staining and is encountered in soil, human feces, and the feces of herbivorous animals. R. equi acts as a pathogen primarily affecting animals like horses and cows, typically inducing purulent bronchopneumonia in foals aged 1–6 months, while in humans, it is recognized as an opportunistic pathogen predominantly affecting individuals with compromised immune systems, with the incidence of infections escalating particularly in the context of widespread HIV/AIDS [4,5,6]. R. equi infections are primarily contracted through inhalation, leading to pulmonary afflictions, or via wounds, resulting in subcutaneous infections and potentially bacteremia or sepsis. Although primarily responsible for pulmonary infections, R. equi occasionally manifests in other organs including the liver, brain, and small intestine [7,8,9]. Its pathogenesis is characterized by the disruption of host cell phagosome maturation, facilitating survival and replication within host macrophages [10,11,12]. These infections often manifest covertly as chronic or subacute illnesses, characterized by non-specific symptoms such as fever and cough, and are frequently misdiagnosed due to their symptom overlap with fungal, actinomycete, or tubercular infections. Often, by the time a precise diagnosis is established, significant pulmonary lesions, typically evidenced by pulmonary consolidation with multiple cavities, have already become apparent [13]. In this case, the patient initially exhibited an isolated pulmonary mass, radiologically indicative of malignancy, and a bronchoscopic granulomatous growth, both of which are considered atypical manifestations. Conventionally, the identification of R. equi has relied on bacterial culturing and PCR-based detection of plasmid genes or the choE gene [14,15]. However, recent advancements in the application of microbial-targeted next-generation sequencing (tNGS) to biopsy tissues from infectious lesions have demonstrated significant diagnostic potential [16]. This case exemplifies a rare instance of successfully identifying R. equi in bronchoalveolar lavage fluid through tNGS, highlighting the evolving landscape of diagnostic microbiology. In the treatment of immunocompromised hosts, a regimen involving a combination of two or more antibiotics, tailored based on susceptibility testing – including agents such as vancomycin, linezolid, carbapenems, fluoroquinolones, aminoglycosides, macrolides, and rifampin – is preferred to address the complex microbial environment [17]. Conversely, for immunocompetent hosts, monotherapy employing broad-spectrum macrolides or fluoroquinolones is generally sufficient. Moreover, for infections affecting the central nervous system, the selection of multiple drugs, known for their robust CNS penetration capabilities, is recommended to ensure effective therapeutic concentrations at the site of infection [18,19,20,21]. Nevertheless, this patient presented with co-infections of Brucella and fungi, necessitating a sequential treatment regimen. The treatment commenced with levofloxacin combined with vancomycin, followed by azithromycin with etimicin, and concluded with minocycline with moxifloxacin. This comprehensive approach resulted in a marked improvement in both symptoms and radiological findings, demonstrating the effectiveness of a carefully tailored therapy plan in managing complex infectious diseases.

Brucellosis, attributable to the Gram-negative Brucella bacterium, exhibits widespread prevalence across diverse regions including the Middle East, the Mediterranean, Central Asia, and Latin America. Transmission of the disease to humans occurs primarily through direct contact with infected animals or via consumption of contaminated animal products, particularly unpasteurized milk and cheeses [22]. As the disease progresses, clinical manifestations of brucellosis vary, initially presenting with symptoms such as fever, muscular pain, arthralgia, and fatigue. In more severe cases, the infection may affect visceral organs such as the liver, spleen, and CNS, with the spine predominantly involved, leading to brucellar spondylitis [23]. This condition is characterized by typical clinical presentations, including persistent, intense lower back pain, fever accompanied by profuse sweating, and evident signs of infection in the spinal intervertebral discs and vertebral bodies [24]. Regarding treatment, it generally entails a prolonged regimen of combined antibiotics to prevent relapse [25]. From a diagnostic perspective, radiologically, it is crucial to differentiate vertebral lesions caused by brucellosis from those due to spinal tuberculosis and pyogenic spondylitis. Patients diagnosed with brucellar spondylitis typically exhibit low signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging [26], aligning with the MRI findings observed in this case. According to the World Health Organization, a regimen of doxycycline with rifampin or doxycycline with streptomycin is recommended for treating Brucella, supplemented by ceftriaxone or levofloxacin in refractory or severe cases, alongside hepatoprotective and supportive therapies. In instances where conservative treatments fail, surgical intervention may be warranted for cases exhibiting spinal cord or nerve root compression, vertebral instability, or a risk of paralysis.

Co-infections involving R. equi and Brucella in immunocompetent individuals represent an extremely uncommon phenomenon, with scant reports documented in the literature. Predominantly, the majority of reported cases affect immunocompromised populations. Given this atypical presentation, further exploration into the immunological dynamics between these pathogens and the host’s immune system is necessitated, potentially offering novel insights into pathogen behavior and host resistance mechanisms. The diagnosis of this co-infection presented considerable challenges, due to symptom overlap with more prevalent diseases. Consequently, the deployment of next-generation sequencing (tNGS) in this instance enabled a swift and precise diagnosis, highlighting its essential role as a diagnostic tool in complex infectious cases. This aligns with recent research findings advocating for the broader adoption of genomic diagnostics to identify atypical pathogens [16]. In response to these diagnostic insights, our therapeutic strategy comprised a regimen of antibiotics customized according to the resistance profiles of the identified pathogens, in line with prevailing guidelines yet modified to address the specifics of this case. This methodology correlates with the scholarly consensus that personalized therapies, predicated on comprehensive microbial analysis, can enhance outcomes in infections attributable to resistant or uncommon pathogens [21,25,27]. Looking forward, future research should concentrate on the integration of genomic diagnostics into standard clinical practice and investigate the immune responses in co-infected immunocompetent hosts to elucidate the underlying mechanisms facilitating such infections.

4 Conclusion

In this case, the treatment regimen for the patient was rendered particularly complex due to concurrent infections with R. equi and Brucella. Such co-infections are exceptionally rare in medical literature, such that definitive guidelines for the pharmacotherapy of this unique scenario are absent. This case demonstrates that, even in individuals with normal immune function, multiple infections may manifest, presenting with atypical clinical and radiological features. This necessitates a comprehensive consideration and a thorough historical investigation by physicians when diagnosing and treating complex infectious cases. Consequently, the medical team was compelled to rely on existing literature and their clinical experience to formulate a treatment plan.

  1. Funding information: Authors state no funding involved.

  2. Author contributions: Conception and design of the research: Pengfei Li and Lifang Zhang; acquisition of data: Pengfei Li, Lifang Zhang, and Xicheng Li; critical revision of the manuscript for intellectual content: Xuejuan Zhang; and all authors read and approved the final draft.

  3. Conflict of interest: Authors state no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2024-02-28
Revised: 2024-04-24
Accepted: 2024-05-09
Published Online: 2024-06-18

© 2024 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  116. Electroacupuncture on GB acupoints improves osteoporosis via the estradiol–PI3K–Akt signaling pathway
  117. Renalase protects against podocyte injury by inhibiting oxidative stress and apoptosis in diabetic nephropathy
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  120. Renal microangiopathy and immune complex glomerulonephritis induced by anti-tumour agents: A case report
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  124. Exploring the effects of culture conditions on Yapsin (YPS) gene expression in Nakaseomyces glabratus
  125. Screening of prognostic core genes based on cell–cell interaction in the peripheral blood of patients with sepsis
  126. Coagulation factor II thrombin receptor as a promising biomarker in breast cancer management
  127. Ileocecal mucinous carcinoma misdiagnosed as incarcerated hernia: A case report
  128. Methyltransferase like 13 promotes malignant behaviors of bladder cancer cells through targeting PI3K/ATK signaling pathway
  129. The debate between electricity and heat, efficacy and safety of irreversible electroporation and radiofrequency ablation in the treatment of liver cancer: A meta-analysis
  130. ZAG promotes colorectal cancer cell proliferation and epithelial–mesenchymal transition by promoting lipid synthesis
  131. Baicalein inhibits NLRP3 inflammasome activation and mitigates placental inflammation and oxidative stress in gestational diabetes mellitus
  132. Impact of SWCNT-conjugated senna leaf extract on breast cancer cells: A potential apoptotic therapeutic strategy
  133. MFAP5 inhibits the malignant progression of endometrial cancer cells in vitro
  134. Major ozonated autohemotherapy promoted functional recovery following spinal cord injury in adult rats via the inhibition of oxidative stress and inflammation
  135. Axodendritic targeting of TAU and MAP2 and microtubule polarization in iPSC-derived versus SH-SY5Y-derived human neurons
  136. Differential expression of phosphoinositide 3-kinase/protein kinase B and Toll-like receptor/nuclear factor kappa B signaling pathways in experimental obesity Wistar rat model
  137. The therapeutic potential of targeting Oncostatin M and the interleukin-6 family in retinal diseases: A comprehensive review
  138. BA inhibits LPS-stimulated inflammatory response and apoptosis in human middle ear epithelial cells by regulating the Nf-Kb/Iκbα axis
  139. Role of circRMRP and circRPL27 in chronic obstructive pulmonary disease
  140. Investigating the role of hyperexpressed HCN1 in inducing myocardial infarction through activation of the NF-κB signaling pathway
  141. Characterization of phenolic compounds and evaluation of anti-diabetic potential in Cannabis sativa L. seeds: In vivo, in vitro, and in silico studies
  142. Quantitative immunohistochemistry analysis of breast Ki67 based on artificial intelligence
  143. Ecology and Environmental Science
  144. Screening of different growth conditions of Bacillus subtilis isolated from membrane-less microbial fuel cell toward antimicrobial activity profiling
  145. Degradation of a mixture of 13 polycyclic aromatic hydrocarbons by commercial effective microorganisms
  146. Evaluation of the impact of two citrus plants on the variation of Panonychus citri (Acari: Tetranychidae) and beneficial phytoseiid mites
  147. Prediction of present and future distribution areas of Juniperus drupacea Labill and determination of ethnobotany properties in Antalya Province, Türkiye
  148. Population genetics of Todarodes pacificus (Cephalopoda: Ommastrephidae) in the northwest Pacific Ocean via GBS sequencing
  149. A comparative analysis of dendrometric, macromorphological, and micromorphological characteristics of Pistacia atlantica subsp. atlantica and Pistacia terebinthus in the middle Atlas region of Morocco
  150. Macrofungal sporocarp community in the lichen Scots pine forests
  151. Assessing the proximate compositions of indigenous forage species in Yemen’s pastoral rangelands
  152. Food Science
  153. Gut microbiota changes associated with low-carbohydrate diet intervention for obesity
  154. Reexamination of Aspergillus cristatus phylogeny in dark tea: Characteristics of the mitochondrial genome
  155. Differences in the flavonoid composition of the leaves, fruits, and branches of mulberry are distinguished based on a plant metabolomics approach
  156. Investigating the impact of wet rendering (solventless method) on PUFA-rich oil from catfish (Clarias magur) viscera
  157. Non-linear associations between cardiovascular metabolic indices and metabolic-associated fatty liver disease: A cross-sectional study in the US population (2017–2020)
  158. Knockdown of USP7 alleviates atherosclerosis in ApoE-deficient mice by regulating EZH2 expression
  159. Utility of dairy microbiome as a tool for authentication and traceability
  160. Agriculture
  161. Enhancing faba bean (Vicia faba L.) productivity through establishing the area-specific fertilizer rate recommendation in southwest Ethiopia
  162. Impact of novel herbicide based on synthetic auxins and ALS inhibitor on weed control
  163. Perspectives of pteridophytes microbiome for bioremediation in agricultural applications
  164. Fertilizer application parameters for drip-irrigated peanut based on the fertilizer effect function established from a “3414” field trial
  165. Improving the productivity and profitability of maize (Zea mays L.) using optimum blended inorganic fertilization
  166. Application of leaf multispectral analyzer in comparison to hyperspectral device to assess the diversity of spectral reflectance indices in wheat genotypes
  167. Animal Sciences
  168. Knockdown of ANP32E inhibits colorectal cancer cell growth and glycolysis by regulating the AKT/mTOR pathway
  169. Development of a detection chip for major pathogenic drug-resistant genes and drug targets in bovine respiratory system diseases
  170. Exploration of the genetic influence of MYOT and MB genes on the plumage coloration of Muscovy ducks
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  172. Comparison of nutritional value of the wild and cultivated spiny loaches at three growth stages
  173. Transcriptomic analysis of liver immune response in Chinese spiny frog (Quasipaa spinosa) infected with Proteus mirabilis
  174. Disruption of BCAA degradation is a critical characteristic of diabetic cardiomyopathy revealed by integrated transcriptome and metabolome analysis
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  176. Effect of long-term in-row branch covering on soil microorganisms in pear orchards
  177. Photosynthetic physiological characteristics, growth performance, and element concentrations reveal the calcicole–calcifuge behaviors of three Camellia species
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  179. Bioinformatics, expression analysis, and functional verification of allene oxide synthase gene HvnAOS1 and HvnAOS2 in qingke
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  184. Combined effects of nitrogen fertilizer and biochar on the growth, yield, and quality of pepper
  185. Comprehensive phytochemical and toxicological analysis of Chenopodium ambrosioides (L.) fractions
  186. Impact of “3414” fertilization on the yield and quality of greenhouse tomatoes
  187. Exploring the coupling mode of water and fertilizer for improving growth, fruit quality, and yield of the pear in the arid region
  188. Metagenomic analysis of endophytic bacteria in seed potato (Solanum tuberosum)
  189. Antibacterial, antifungal, and phytochemical properties of Salsola kali ethanolic extract
  190. Exploring the hepatoprotective properties of citronellol: In vitro and in silico studies on ethanol-induced damage in HepG2 cells
  191. Enhanced osmotic dehydration of watermelon rind using honey–sucrose solutions: A study on pre-treatment efficacy and mass transfer kinetics
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  196. Antioxidant and antimicrobial activities of Salsola imbricata methanolic extract and its phytochemical characterization
  197. Bioengineering and Biotechnology
  198. Absorbable calcium and phosphorus bioactive membranes promote bone marrow mesenchymal stem cells osteogenic differentiation for bone regeneration
  199. New advances in protein engineering for industrial applications: Key takeaways
  200. An overview of the production and use of Bacillus thuringiensis toxin
  201. Research progress of nanoparticles in diagnosis and treatment of hepatocellular carcinoma
  202. Bioelectrochemical biosensors for water quality assessment and wastewater monitoring
  203. PEI/MMNs@LNA-542 nanoparticles alleviate ICU-acquired weakness through targeted autophagy inhibition and mitochondrial protection
  204. Unleashing of cytotoxic effects of thymoquinone-bovine serum albumin nanoparticles on A549 lung cancer cells
  205. Erratum
  206. Erratum to “Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM”
  207. Erratum to “Activation of hypermethylated P2RY1 mitigates gastric cancer by promoting apoptosis and inhibiting proliferation”
  208. Retraction
  209. Retraction to “MiR-223-3p regulates cell viability, migration, invasion, and apoptosis of non-small cell lung cancer cells by targeting RHOB”
  210. Retraction to “A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis”
  211. Special Issue on Advances in Neurodegenerative Disease Research and Treatment
  212. Transplantation of human neural stem cell prevents symptomatic motor behavior disability in a rat model of Parkinson’s disease
  213. Special Issue on Multi-omics
  214. Inflammasome complex genes with clinical relevance suggest potential as therapeutic targets for anti-tumor drugs in clear cell renal cell carcinoma
  215. Gastroesophageal varices in primary biliary cholangitis with anti-centromere antibody positivity: Early onset?
https://doi.org/10.1515/biol-2022-0888
Keywords for this article
Rhodococcus equi; Brucella; pulmonary occupancy; Brucellar spondylitis
Creative Commons
BY 4.0

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  105. The expression and clinical significance of syncytin-1 in serum exosomes of hepatocellular carcinoma patients
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  120. Renal microangiopathy and immune complex glomerulonephritis induced by anti-tumour agents: A case report
  121. Correlation analysis of AVPR1a and AVPR2 with abnormal water and sodium and potassium metabolism in rats
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  130. ZAG promotes colorectal cancer cell proliferation and epithelial–mesenchymal transition by promoting lipid synthesis
  131. Baicalein inhibits NLRP3 inflammasome activation and mitigates placental inflammation and oxidative stress in gestational diabetes mellitus
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  136. Differential expression of phosphoinositide 3-kinase/protein kinase B and Toll-like receptor/nuclear factor kappa B signaling pathways in experimental obesity Wistar rat model
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  139. Role of circRMRP and circRPL27 in chronic obstructive pulmonary disease
  140. Investigating the role of hyperexpressed HCN1 in inducing myocardial infarction through activation of the NF-κB signaling pathway
  141. Characterization of phenolic compounds and evaluation of anti-diabetic potential in Cannabis sativa L. seeds: In vivo, in vitro, and in silico studies
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  145. Degradation of a mixture of 13 polycyclic aromatic hydrocarbons by commercial effective microorganisms
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  148. Population genetics of Todarodes pacificus (Cephalopoda: Ommastrephidae) in the northwest Pacific Ocean via GBS sequencing
  149. A comparative analysis of dendrometric, macromorphological, and micromorphological characteristics of Pistacia atlantica subsp. atlantica and Pistacia terebinthus in the middle Atlas region of Morocco
  150. Macrofungal sporocarp community in the lichen Scots pine forests
  151. Assessing the proximate compositions of indigenous forage species in Yemen’s pastoral rangelands
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  153. Gut microbiota changes associated with low-carbohydrate diet intervention for obesity
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  155. Differences in the flavonoid composition of the leaves, fruits, and branches of mulberry are distinguished based on a plant metabolomics approach
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  158. Knockdown of USP7 alleviates atherosclerosis in ApoE-deficient mice by regulating EZH2 expression
  159. Utility of dairy microbiome as a tool for authentication and traceability
  160. Agriculture
  161. Enhancing faba bean (Vicia faba L.) productivity through establishing the area-specific fertilizer rate recommendation in southwest Ethiopia
  162. Impact of novel herbicide based on synthetic auxins and ALS inhibitor on weed control
  163. Perspectives of pteridophytes microbiome for bioremediation in agricultural applications
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  169. Development of a detection chip for major pathogenic drug-resistant genes and drug targets in bovine respiratory system diseases
  170. Exploration of the genetic influence of MYOT and MB genes on the plumage coloration of Muscovy ducks
  171. Transcriptome analysis of adipose tissue in grazing cattle: Identifying key regulators of fat metabolism
  172. Comparison of nutritional value of the wild and cultivated spiny loaches at three growth stages
  173. Transcriptomic analysis of liver immune response in Chinese spiny frog (Quasipaa spinosa) infected with Proteus mirabilis
  174. Disruption of BCAA degradation is a critical characteristic of diabetic cardiomyopathy revealed by integrated transcriptome and metabolome analysis
  175. Plant Sciences
  176. Effect of long-term in-row branch covering on soil microorganisms in pear orchards
  177. Photosynthetic physiological characteristics, growth performance, and element concentrations reveal the calcicole–calcifuge behaviors of three Camellia species
  178. Transcriptome analysis reveals the mechanism of NaHCO3 promoting tobacco leaf maturation
  179. Bioinformatics, expression analysis, and functional verification of allene oxide synthase gene HvnAOS1 and HvnAOS2 in qingke
  180. Water, nitrogen, and phosphorus coupling improves gray jujube fruit quality and yield
  181. Improving grape fruit quality through soil conditioner: Insights from RNA-seq analysis of Cabernet Sauvignon roots
  182. Role of Embinin in the reabsorption of nucleus pulposus in lumbar disc herniation: Promotion of nucleus pulposus neovascularization and apoptosis of nucleus pulposus cells
  183. Revealing the effects of amino acid, organic acid, and phytohormones on the germination of tomato seeds under salinity stress
  184. Combined effects of nitrogen fertilizer and biochar on the growth, yield, and quality of pepper
  185. Comprehensive phytochemical and toxicological analysis of Chenopodium ambrosioides (L.) fractions
  186. Impact of “3414” fertilization on the yield and quality of greenhouse tomatoes
  187. Exploring the coupling mode of water and fertilizer for improving growth, fruit quality, and yield of the pear in the arid region
  188. Metagenomic analysis of endophytic bacteria in seed potato (Solanum tuberosum)
  189. Antibacterial, antifungal, and phytochemical properties of Salsola kali ethanolic extract
  190. Exploring the hepatoprotective properties of citronellol: In vitro and in silico studies on ethanol-induced damage in HepG2 cells
  191. Enhanced osmotic dehydration of watermelon rind using honey–sucrose solutions: A study on pre-treatment efficacy and mass transfer kinetics
  192. Effects of exogenous 2,4-epibrassinolide on photosynthetic traits of 53 cowpea varieties under NaCl stress
  193. Comparative transcriptome analysis of maize (Zea mays L.) seedlings in response to copper stress
  194. An optimization method for measuring the stomata in cassava (Manihot esculenta Crantz) under multiple abiotic stresses
  195. Fosinopril inhibits Ang II-induced VSMC proliferation, phenotype transformation, migration, and oxidative stress through the TGF-β1/Smad signaling pathway
  196. Antioxidant and antimicrobial activities of Salsola imbricata methanolic extract and its phytochemical characterization
  197. Bioengineering and Biotechnology
  198. Absorbable calcium and phosphorus bioactive membranes promote bone marrow mesenchymal stem cells osteogenic differentiation for bone regeneration
  199. New advances in protein engineering for industrial applications: Key takeaways
  200. An overview of the production and use of Bacillus thuringiensis toxin
  201. Research progress of nanoparticles in diagnosis and treatment of hepatocellular carcinoma
  202. Bioelectrochemical biosensors for water quality assessment and wastewater monitoring
  203. PEI/MMNs@LNA-542 nanoparticles alleviate ICU-acquired weakness through targeted autophagy inhibition and mitochondrial protection
  204. Unleashing of cytotoxic effects of thymoquinone-bovine serum albumin nanoparticles on A549 lung cancer cells
  205. Erratum
  206. Erratum to “Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM”
  207. Erratum to “Activation of hypermethylated P2RY1 mitigates gastric cancer by promoting apoptosis and inhibiting proliferation”
  208. Retraction
  209. Retraction to “MiR-223-3p regulates cell viability, migration, invasion, and apoptosis of non-small cell lung cancer cells by targeting RHOB”
  210. Retraction to “A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis”
  211. Special Issue on Advances in Neurodegenerative Disease Research and Treatment
  212. Transplantation of human neural stem cell prevents symptomatic motor behavior disability in a rat model of Parkinson’s disease
  213. Special Issue on Multi-omics
  214. Inflammasome complex genes with clinical relevance suggest potential as therapeutic targets for anti-tumor drugs in clear cell renal cell carcinoma
  215. Gastroesophageal varices in primary biliary cholangitis with anti-centromere antibody positivity: Early onset?
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