title: Rhodococcus equi infection in transplant recipients: case report and review of the literature.
abstract: BACKGROUND
  Rhodococcus equi is an opportunistic pathogen that usually causes infection in immunocompromised hosts, mainly human immunodeficiency virus-positive patients, yet solid organ transplant recipients may be affected as well. Infections in this group of patients have not been sufficiently analyzed.
  
  
  METHODS
  We report an R equi pneumonia in a heart transplant recipient and review another 11 cases.
  
  
  RESULTS
  Infection appeared a mean of 49 months (range 1-180) after transplantation. Lung was primarily involved in 10 cases (83.3%). The remaining two cases presented with a paravertebral abscess and a purulent pericarditis. Invasive techniques were necessary to reach the diagnosis in nine cases. One patient healed with surgical resection of the lesion; the remaining 11 received antimicrobial agents. Six of them required additional surgical treatment. Three patients died.
  
  
  CONCLUSIONS
  Clinicians should consider R equi when evaluating a solid organ recipient with an asymptomatic lung nodule. Microbiology laboratories should be alerted in these cases because it could be mistaken for a contaminant diphtheroid and will not respond to the standard empirical therapy.
authors.affiliation: Department of Clinical Microbiology-Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Muñoz
authors.forename: A
authors.initials: A
authors.lastname: Burillo
authors.forename: J
authors.initials: J
authors.lastname: Palomo
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Créixems
authors.forename: E
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000193:Actinomycetales Infections / Q000175:diagnosis*; D016027:Heart Transplantation; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D011183:Postoperative Complications; D016929:Rhodococcus equi; D014057:Tomography, X-Ray Computed