Severe Rhodococcus equi pneumonia: case report and literature review.
Rhodococcus equi is an aerobic, gram-positive, non-motile pleomorphic bacillus infecting immunocompromised patients. Forty-nine cases of Rhodococcus equi infection have been reported, mainly in patients infected with the human immunodeficiency virus (HIV). A case in which Rhodococcus equi caused severe pulmonary infection, the most common presentation, is described. Clinically, patients have symptoms of pneumonia with hemoptysis as a prominent feature. X-ray will often show a cavitating upper-lobe infiltrate, resembling infection with mycobacteria. Rhodococcus equi is easily cultured from blood or sputum on standard media, but is frequently regarded as a contaminant. Mortality from Rhodococcus equi pneumonia is high (25%) and early surgical intervention has been recommended. Based on this review, the benefit of surgery seems dubious, whereas good results have been obtained using long-term antibiotic treatment with erythromycin plus rifampicin, or vancomycin in combination with either of these antibiotics.
Vestbo
J
J
Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark.
Lundgren
J D
JD
Gaub
J
J
Røder
B
B
Gutschik
E
E
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000193:Actinomycetales Infections / Q000382:microbiology*; D000328:Adult; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004917:Erythromycin / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011014:Pneumonia / Q000382:microbiology*; D016929:Rhodococcus equi / Q000302:isolation & purification; D012293:Rifampin / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use
D004917:Erythromycin; D014640:Vancomycin; D012293:Rifampin