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[Pulmonary malacoplakia caused by Rhodococcus equi in AIDS: a case report]
F Goupil1, A Foulet, H Maillard
1Service de Pneumologie, C.H. Le Mans.
Revue De Pneumologie Clinique
|September 16, 1999
Summary
Persistent Rhodococcus equi pneumonia in an AIDS patient led to a diagnosis of pulmonary malacoplakia. This rare condition requires consideration when R. equi pneumonia is refractory to treatment.
Area of Science:
- Infectious Diseases
- Pulmonology
- Pathology
Background:
- Rhodococcus equi (R. equi) can cause severe pneumonia, particularly in immunocompromised individuals.
- Acquired Immunodeficiency Syndrome (AIDS) increases susceptibility to opportunistic infections like R. equi pneumonia.
- Pulmonary malacoplakia is a rare, benign inflammatory condition characterized by the presence of Michaelis-Gutmann bodies.
Observation:
- A case of R. equi pneumonia with cavitation in the right upper lobe of an AIDS patient is presented.
- Initial antimicrobial therapy targeting R. equi proved ineffective, necessitating a right upper lobectomy.
- Histopathology revealed a pseudotumoral mass with macrophages containing Michaelis-Gutmann bodies, confirming R. equi infection.
Findings:
- The patient was diagnosed with pulmonary malacoplakia caused by R. equi.
- The presence of Michaelis-Gutmann bodies in macrophages is a hallmark of malacoplakia.
- Culture of R. equi confirmed its role in the observed pathology.
Implications:
- Pulmonary malacoplakia should be suspected in cases of persistent R. equi pneumonia unresponsive to prolonged antimicrobial therapy.
- This case highlights the importance of considering rare pathologies in immunocompromised patients with refractory infections.
- Early recognition and appropriate management are crucial for improving outcomes in pulmonary malacoplakia associated with R. equi.