title: [Rhodococcus equi infections in AIDS: personal cases].
abstract: We report on the occurrence of an uncommon pathogen, Rhodococcus equi (R.e.) in HIV infection. In the period february 1990-July 1991 we performed the diagnosis of R.e. infection (lung, lung-central nervous system) in two infected patients, aged 27 and 31 years, both males, drug addicts, classified as CDC IV. In the first of them an cavitating right bronchopneumonia (bpm) was diagnosed as of tuberculous origin, on the ground of the microscopic demonstration of an acid-fast, gram-positive strain in b.a.l.. A standard antituberculous regimen was uneffective and R.e. was eventually isolated in three blood culture taken shortly before the exitus and at post-mortem examination of the lungs. In the second patient a subclavian right bpm developed without microbiological evidence of any common pathogen. A third-generation cephalosporin course was only partially successful (clinical amelioration, incomplete clearing of radiological findings). After 3 months the patient relapsed and an aseptic meningitis developed. Cultures of blood and csf yielded a R.e. strain; post-mortem examination revealed a diffuse, cavitating bpm. Our personal experience underlines the difficulty in recognizing R.e. infections in compromised host, because of similarity to other entities (i.e. tuberculosis) and the absence of pathognomonic hints.
authors: Divisione Malattie Infettive, Ospedali Galliera di Genova.
authors: N
authors: N
authors: Piersantelli
authors: M
authors: M
authors: Casini-Lemmi
authors: E
authors: E
authors: Cavanna
authors: G
authors: G
authors: Cassola
authors: M P
authors: MP
authors: Crisalli
authors: B
authors: B
authors: Guida
authors: M
authors: M
authors: Paladino
authors: G
authors: G
authors: Penco
authors: R
authors: R
authors: Piscopo
authors: A
authors: A
authors: Torresin
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000193:Actinomycetales Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D001996:Bronchopneumonia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000134:cerebrospinal fluid / Q000382:microbiology; D016929:Rhodococcus equi / Q000302:isolation & purification*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Sepsi da Rhodococcus equi in corso di AIDS: osservazioni personali.