Rhodococcus equi: first case in a heart transplant recipient.
Rhodococcus equi is a gram-positive diphtheroid that occasionally affects immunocompromised patients, usually causing a chronic respiratory infection with cavitating pulmonary opacities on chest radiograph that resemble mycobacterial or fungal disease. Etiologic diagnosis presents a number of pitfalls, because Rhodococcus equi isolates mimic many of the characteristics of other microorganisms more familiar to the laboratory staff. The treatment of choice for this disease has not yet been established, and its mortality rate is greater than 50% in individuals with human immunodeficiency virus and 20% to 25% among the remaining patients. We describe here the first case of Rhodococcus equi infection in a heart transplant recipient. Clinical presentation was typical, and treatment with a sensitivity-based combination of antibiotics resulted in resolution of both the clinical and radiologic picture.
Heart Transplant Unit, Clínica Puerta de Hierro, Madrid, Spain.
J
J
Segovia
L A
LA
Pulpón
M G
MG
Crespo
R
R
Daza
J C
JC
Rodríguez
A
A
Rubio
S
S
Serrano
M C
MC
Carreño
A
A
Varela
R
R
Arangüena
D000328:Adult; D000900:Anti-Bacterial Agents; D009202:Cardiomyopathies / Q000276:immunology / Q000601:surgery*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008826:Microbial Sensitivity Tests; D009894:Opportunistic Infections / Q000188:drug therapy / Q000276:immunology*; D011014:Pneumonia / Q000276:immunology*; D011183:Postoperative Complications / Q000188:drug therapy / Q000276:immunology*; D016929:Rhodococcus equi / Q000187:drug effects / Q000276:immunology*; D018805:Sepsis / Q000276:immunology*
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents