Chronic cavitary pneumonia by Rhodococcus equi in a highly prevalent tuberculosis country

a diagnosis challenge

Authors

  • Hareton Teixeira Vechi Universidade Federal do Rio Grande do Norte
  • Eduardo Teodoro Gurgel de Oliveira Universidade Federal do Rio Grande do Norte
  • Marise Reis de Freitas Universidade Federal do Rio Grande do Norte
  • Flávia Rossi Universidade de São Paulo, Faculdade de Medicina
  • Maria Helena Marques Fonseca de Britto Centro de Patologia Clínica
  • Manoella do Monte Alves Universidade Federal do Rio Grande do Norte

Keywords:

Rhodococcus equi, AIDS, HIV, Tuberculosis, Necrotizing pneumonia

Abstract

Rhodococcus equi is a facultative aerobic, intracellular, non-motile, non-spore-forming, Gram-positive, weakly acid-fast coccobacillus belonging to the group of nocardioform actinomycetes. R. equi infections are rare opportunistic illnesses in patients with Acquired Immunodeficiency Syndrome (AIDS), associated with a high mortality rate. The most common clinical presentation of R. equi infections is a chronic cavitary pneumonia. Due to its acid-fastness, R. equi can be mistaken for others acid-fast organisms, as Mycobacterium tuberculosis. In turn, R. equi is also a gram-positive pleomorphic bacteria and can be mistaken for diphtheroids or Micrococcus organisms, being accidentally disregarded as oral contaminants in sputum cultures. Therefore, in Brazil, a highly prevalent tuberculosis (TB) country, pulmonary infections caused by R. equi may mimic pulmonary TB and represent a diagnostic challenge. Here, we report on a case of chronic cavitary pneumonia by R. equi in a Human Immunodeficiency Virus (HIV)-infected patient, focusing on diagnostic aspects.

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Published

2018-11-08

Issue

Section

Case Report

How to Cite

Vechi, H. T., Oliveira, E. T. G. de, Freitas, M. R. de, Rossi, F., Britto, M. H. M. F. de, & Alves, M. do M. (2018). Chronic cavitary pneumonia by Rhodococcus equi in a highly prevalent tuberculosis country: a diagnosis challenge. Revista Do Instituto De Medicina Tropical De São Paulo, 60, e74. https://revistas.usp.br/rimtsp/article/view/151624