Rhodococcus equi lung infection in an allogeneic hematopoietic stem cell transplant recipient.
In this report, we describe a case of Rhodococcus equi lung infection diagnosed in an allogeneic hematopoietic stem cell transplant with oral graft-versus-host disease 3 months after stem cell infusion. The lung lesion persisted despite an approximate 3 months of vancomycin therapy, but then responded favorably to a combination of intravenous ertapenem at 1 g daily and oral rifampin at 600 mg daily for 1 month. An overview of Rhodococcus infection in transplant recipients is presented. This case and the discussed literature suggest that combination antibiotic therapy is warranted in patients with decreased humoral and cellular immunity.
Cronin
S M
SM
Bone Marrow Transplantation Service, Department of Pharmacy, Karmanos Cancer Hospital, Detroit, Michigan, Wayne State University, Detroit, Michigan 48201, USA. cronins@karmanos.org
Abidi
M H
MH
Shearer
C J
CJ
Chandrasekar
P H
PH
Ibrahim
R B
RB
D000193:Actinomycetales Infections / Q000000981:diagnostic imaging / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000077727:Ertapenem; D006086:Graft vs Host Disease / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016929:Rhodococcus equi / Q000302:isolation & purification*; D012293:Rifampin / Q000627:therapeutic use; D014184:Transplantation, Homologous / Q000009:adverse effects; D047090:beta-Lactams / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D000077727:Ertapenem; D012293:Rifampin