Rhodococcus equi pneumonia. An unusual early manifestation of the acquired immunodeficiency syndrome (AIDS)

Infection with Rhodococcus equi has been reported as an occasional cause of cavitary pneumonia in severely immunocompromised patients, including those with the acquired immunodeficiency syndrome (AIDS). We report two cases of R equi pneumonia presenting in one month in patients infected with human immunodeficiency virus (HIV) who had not previously had an opportunistic infection. The clinical and radiographic manifestations of the disease are distinctive and should suggest the diagnosis. R equi pneumonia in a person with HIV infection should be considered diagnostic of AIDS. Recognition of this entity is important since antibiotic therapy is different from that conventionally used in pneumonias in AIDS patients and must be prolonged.