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Processing of Bronchoalveolar Lavage Fluid and Matched Blood for Alveolar Macrophage and CD4+ T-cell Immunophenotyping and HIV Reservoir Assessment
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VapB-positive Rhodococcus equi infection in an HIV-infected patient in Japan

Yasutaka Mizuno1, Fumiya Sato, Mitsuo Sakamoto

  • 1Division of Infection Control, Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan. mizuno@jikei.ac.jp

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|February 25, 2005
PubMed

Insights

Rhodococcus equi causes pneumonia in foals and can infect immunocompromised humans. This report details the first VapB-positive Rhodococcus equi pneumonia case in an HIV-infected patient in Japan, successfully treated with antibiotics.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Rhodococcus equi is a soil bacterium causing foal pneumonia and opportunistic infections in immunocompromised humans.
  • Human R. equi infections are rare in Japan, with only one prior report in a laboratory worker.
  • VapB-positive R. equi strains are associated with severe infections.

Observation:

  • A case of VapB-positive R. equi pneumonia occurred in an HIV-infected patient in urban Japan.
  • The patient had a low CD4+ lymphocyte count (10/microl) at diagnosis.
  • Dogs were suspected as a potential source, but R. equi was not isolated from canine specimens.

Findings:

  • Successful treatment of VapB-positive R. equi pneumonia was achieved using rifampicin and tosufloxacin.
  • This case represents the first documented human infection with VapB-positive R. equi in Japan.
  • The patient's immunocompromised status (HIV) was a significant factor.

Implications:

  • This case highlights the potential for R. equi to cause severe pneumonia in immunocompromised individuals in Japan.
  • The increasing prevalence of R. equi infections in dogs warrants further epidemiological investigation.
  • Understanding the transmission dynamics, including potential zoonotic transmission from companion animals, is crucial for prevention.

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