Rhodococcus equi infection in HIV-infected individuals: case reports and review of the literature.
Rhodococcus equi is a gram-positive, coryneform bacterium that causes zoonotic infection mainly in horses and foals. It sometimes affects humans presenting as cavitary pneumonia. Immunocompromised patients, including HIV-infected patients, are more susceptible to R. equi infection. We present 10 cases of R. equi infection in HIV-positive patients admitted to our institute from 1991 to June 2008. Moreover, we have reviewed 272 cases of R. equi infection in HIV-infected persons, published from 1986 through 2008. With respect to the literature data, the R. equi strains isolated in our case series showed lower sensitivity to ceftriaxone, amoxicillin/clavulanic acid, and cotrimoxazole. Prompt diagnosis, early initiation of antiretroviral treatment and combined antimicrobial treatment seem to be effective to eradicate the infection and to improve the outcome.
Topino
Simone
S
2nd Infectious Diseases Division, National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy. topino@inmi.it
Galati
Vincenzo
V
Grilli
Elisabetta
E
Petrosillo
Nicola
N
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy*; D000193:Actinomycetales Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D016929:Rhodococcus equi / Q000187:drug effects / Q000302:isolation & purification*; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents