title: Immune Reconstitution Syndrome secondary to Rhodococcus equi infection in a patient with HIV and Burkitt's lymphoma.
abstract: Immune Reconstitution Syndrome (IRIS) has been associated with a variety of infections in patients with human immunodeficiency virus (HIV). However, we are reporting the first case of IRIS secondary to Rhodococcus equi (R. equi) in a patient with HIV. We report the case of a 48-year-old male found to have HIV infection in the setting of Burkitt's lymphoma. While on anti-retroviral therapy and chemotherapy, he had developed IRIS secondary to R. equi that manifested as a cavitating pneumonia. This report outlines the successful management of the R. equi infection with the use of a combination of antibiotics, radiographic follow up and suppressive antibiotic while on chemotherapy.
authors.affiliation: Department of Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia; Section of Medical Microbiology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Majid
authors.initials: M
authors.lastname: Darraj
authors.affiliation: Section of General Internal Medicine, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Fainstein
authors.affiliation: Section of Medical Microbiology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Ken
authors.initials: K
authors.lastname: Kasper
authors.affiliation: Section of Medical Microbiology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: keynan@yahoo.com.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Keynan
mesh_terms: D000193:Actinomycetales Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002051:Burkitt Lymphoma / Q000150:complications* / Q000188:drug therapy; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006257:Head / Q000000981:diagnostic imaging; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D013902:Radiography, Thoracic; D016929:Rhodococcus equi / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D044966:Anti-Retroviral Agents; D000970:Antineoplastic Agents
keywords: Burkitt's lymphoma; Cavitating pneumonia; Human immunodeficiency virus; Rhodococcus equi