title: Rhodococcus equi infection in non-HIV-infected patients. Two case reports and review.
abstract: OBJECTIVE: To review two recent cases in HIV-negative subjects in the light of literature reports (52 patients without HIV infection till 1994). METHODS: Epidemiology (animal contacts, risk factors, year, country), clinical presentation, diagnostic methods (X-ray, tomography, microbiological techniques), therapeutic approach (antibiotics, surgery) and outcome were evaluated on the basis of clinical literature reports. RESULTS: Tumors constituted an important predisposing factor and less frequently hepatobiliary pathology, rheumatologic diseases, iatrogenic causes, psychiatric pathology and trauma. Exposure to animals was reported by 55% of the patients. Pneumonia and pleurisy, without preferential localization, were detected in 50% of the patients. Etiologic diagnosis was usually obtained after an invasive collection. Combined medical therapy and surgery were required by 27.8% of the patients, and 16.7% of the patients died. CONCLUSIONS: In recent years the number of Rhodococcus equi cases has been rising also in HIV-negative patients. The infection is ubiquitous. Accurate diagnosis and the prompt selection of the most appropriate therapy depend on close cooperation between clinicians and microbiologists.
authors.affiliation: Servizio di Microbiologia.
authors.forename: Claudio
authors.initials: C
authors.lastname: Farina
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferruzzi
authors.forename: Filippo
authors.initials: F
authors.lastname: Mamprin
authors.forename: Francesca
authors.initials: F
authors.lastname: Vailati