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Cavitary pneumonia due to Rhodococcus equi in a heart transplant recipient
E J Kwak1, D C Strollo, S M Kulich
1Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania USA.
Summary
Rhodococcus equi, a rare pathogen, caused pneumonia and bacteremia in an immunocompromised heart transplant patient with horse exposure. Successful treatment involved vancomycin, imipenem/cilastin, ciprofloxacin, and minocycline.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Transplant Surgery
Background:
- Rhodococcus equi is an opportunistic pathogen rarely causing human infections, typically in immunocompromised individuals.
- Heart transplant recipients are at increased risk for opportunistic infections due to long-term immunosuppression.
Observation:
- A 68-year-old male heart transplant recipient developed Rhodococcus equi pneumonia and secondary bacteremia 10 months post-transplant.
- The patient had a history of horse breeding, suggesting a potential animal exposure link.
Findings:
- The patient received a 5-month treatment regimen including vancomycin, imipenem/cilastin, ciprofloxacin, and minocycline.
- Complete resolution of the infection was achieved with the prescribed antibiotic therapy.
Implications:
- This case underscores the importance of considering Rhodococcus equi in immunocompromised patients, especially those with animal contact.
- Early diagnosis and appropriate antimicrobial therapy are crucial for managing Rhodococcus equi infections in transplant recipients.