Medica Jadertina, Vol. 51 No. 3, 2021.
Professional paper
Pulmonary Rhodococcus equi infection in a renal transplant patient: case report with review of literature
Ivana Krajina
; University Hospital Osijek, Department of Dermatology and Venerology, Osijek, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine Osijek, Osijek, Croatia
Jakov Milić
; University of Zagreb, Catholic Faculty of Theology, Zagreb, Croatia
Dubravka Vuković
; Institute of Public Health of Osijek-Baranja County, Osijek, Croatia
Marko Jakić
; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine Osijek, Osijek, Croatia
Lada Zibar
; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine Osijek, Osijek, Croatia; University Hospital Merkur, Internal Clinic, Department of Nephrology, Zagreb, Croatia
Abstract
Aim: Rhodococcus equi (R. equi) is an opportunistic, Gram-positive coccobacillus, largely unknown and whose infections are often misdiagnosed in transplant patients. The aim of this article is to acquaint the medical public with R. equi infections in order to include them in the differential diagnosis of pneumonia in transplanted and immunocompromised patients.
Case report: We report a case of a renal transplant patient with a productive cough. Chest X-ray showed pulmonary infiltrate. Three months into the disease R. equi was identified in the sputum. Treatment with vancomycin, azithromycin and levofloxacin rendered the improvement in a few months. To the authors' knowledge, this is the first case of R. equi infection in a renal transplant patient in Croatia.
Conclusion: Since the clinical presentation and diagnostic results can be unspecific and misleading, R. equi infections are often misdiagnosed and might be more frequent than usually thought. There is a need for establishing treatment guidelines, as inconsistent antimicrobial combinations of various duration were reported in literature.
Keywords
Rhodococcus equi; pneumonia; kidney transplantation; immunosuppression; opportunistic infections
Hrčak ID:
263223
URI
Publication date:
6.10.2021.
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