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Rhodococcus species fatal infection in an immunocompetent host

R P Spark¹, M M McNeil, J M Brown

¹Department of Pathology, Tucson Medical Center, University of Arizona College of Medicine 85733.

Archives of Pathology & Laboratory Medicine

|May 1, 1993

Summary

A fatal case of pneumonia-associated adult respiratory distress syndrome was caused by an uncharacterized Rhodococcus species. This finding highlights the potential for novel Rhodococcus species to cause severe human infections.

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Area of Science:

Medical Microbiology
Infectious Diseases
Pulmonary Medicine

Background:

Rhodococcus species are known to cause infections in humans, though often associated with immunocompromised individuals.
Adult respiratory distress syndrome (ARDS) is a severe lung condition with high mortality.
The genus Rhodococcus includes several species, with varying clinical significance.

Observation:

A 24-year-old woman presented with fatal pneumonia-associated ARDS.
Histological examination of lung biopsy revealed intracellular coccobacillary microorganisms.
The patient's blood isolate demonstrated resistance to clindamycin and norfloxacin but susceptibility to other agents.

Findings:

The Rhodococcus isolate exhibited unique biochemical reactions and RNA gene restriction fragment patterns, differentiating it from 20 recognized species.

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This suggests the causative agent was a previously uncharacterized Rhodococcus species.

Among 17 reported human Rhodococcus infections, nine occurred in immunocompetent individuals, five were disseminated, and four were fatal.

Implications:

This case underscores the potential for novel Rhodococcus species to cause severe, life-threatening infections, even in immunocompetent hosts.
Further genetic and biochemical studies are necessary to definitively classify this Rhodococcus isolate.
Understanding the pathogenicity and antimicrobial resistance of emerging Rhodococcus species is crucial for clinical management.