Rhodococcus equiInfection in HIV-Infected Individuals: Case Reports and Review of the Literature

Abstract

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.

Pseudotumor of the Tracheal-Laryngeal Junction with Unusual Morphologic Features Caused by Rhodococcus equi Infection

“…When the pseudotumor was cultured, it grew Rhodococcus equi, an opportunistic pathogen of immunocompromised hosts [2]. In HIV-infected patients, R. equi infection usually presents as cavitary pneumonia with hilar lymphadenopathy [3], but in the case of our patient, it uncharacteristically produced an intraluminal mass. Rare cases of endobronchial infectious pseudotumors have been reported in HIV-infected patients [4].…”

“…He was found to be HIV-positive with a CD4 count of 32 cells/ mm 3 . On radiologic imaging, an exophytic endotracheal mass that almost completely occluded the airway was detected approximately 5 cm below the vocal cords (Fig.…”

HIV-Associated Bacterial Pneumonia

“…cavitation) mimicking those of pulmonary (TB) [1,51,65]. For the treatment of both these infections, early initiation of antiretroviral therapy and the use of combination antimicrobial agents is recommended, which needs tapering according to the antimicrobial sensitivity patterns of the cultured isolates [1,65].…”

In Vitro Potential of Equine DEFA1 and eCATH1 as Alternative Antimicrobial Drugs in Rhodococcosis Treatment

“…In humans, the infection is rare in immunocompetent patients (15,27), but more than 300 cases have been reported in immunocompromised subjects (41,46). Since the first human case report was described in 1967, reports of the infection have increased substantially, with more than 200 cases in the last 3 decades (23,41,46).…”