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Rhodococcus equi lung abscess complicating Evan's syndrome treated with corticosteroid
1University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam, Hong Kong.
Respiration; International Review of Thoracic Diseases
|September 8, 1998
Summary
Rhodococcus equi caused a lung abscess in an immunocompromised patient with Evan's syndrome. Successful treatment involved a combination of antibiotics, including clarithromycin and vancomycin.
Area of Science:
- Infectious Diseases
- Pulmonology
- Immunology
Background:
- Evan's syndrome is an autoimmune disorder characterized by autoimmune hemolytic anemia and immune thrombocytopenia.
- High-dose corticosteroid therapy is often used to manage Evan's syndrome, but it can lead to immunosuppression.
- Rhodococcus equi is an opportunistic pathogen typically associated with infections in immunocompromised individuals.
Observation:
- A patient with Evan's syndrome undergoing high-dose corticosteroid therapy developed a right upper lobe lung abscess.
- The causative agent was identified as Rhodococcus equi, an uncommon cause of lung abscess.
Findings:
- The lung abscess was successfully treated with a combination of clarithromycin, vancomycin, ciprofloxacin, and imipenem.
- This antibiotic regimen demonstrated efficacy against Rhodococcus equi in this complex clinical scenario.
Implications:
- This case highlights the importance of considering unusual pathogens like Rhodococcus equi in immunocompromised patients presenting with lung infections.
- The successful treatment suggests a potential effective antibiotic combination for Rhodococcus equi lung abscess, addressing a previously controversial treatment regimen.