Rhodococcus is a rare zoonotic infection causing cavitary pneumonia in immunocompromised humans. There had been very few reported incidences of Rhodococcus osteomyelitis. Our patient is a 27 years old male with human immunodeficiency virus (HIV) infection who was diagnosed with Rhodococcus osteomyelitis and bacteremia. He initially presented with right hip pain and was diagnosed with osteomyelitis and abscess based on a CT scan. IR guided drainage of the abscess was done and culture yielded R. equi. He failed antibiotic treatment multiple times and later was managed with surgical intervention. Although it is a rare case, physicians should keep it in mind especially in immunocompromised patients while deciding on diagnosis and treatment plans.
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