Rhodococcus equi infection in transplant recipients: case report and review of the literature.
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.
Muñoz
P
P
Department of Clinical Microbiology-Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Burillo
A
A
Palomo
J
J
Rodríguez-Créixems
M
M
Bouza
E
E
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