Rhodococcus equi pneumonia among patients with AIDS clinical features and treatment

Abstract

To summarize the characteristics of clinical manifestation, chest radiology and microbiology of Rhodococcus equi pneumonia among patients with AIDS. Total 1908 AIDS patients who have therapy in Longtan hospital of Guang Xi province since May 2007 to Nov 2009, 15 patients (0.79%) who were co-infected with Rhodococcus equi, and average age was 35 +/- 13 years, we retrospectively reviewed clinical manifestations, chest radiology and microbiology of nine HIV-infected patients complicated with Rhodococcus equi pneumonia. 14 patients presented with pneumonia or lung abscess, the clinical manifestations included fever (100%), cough and expectoration (93.3%), bellyache (26.7%), etc. And 5 patients Hb lower than 60 g/L, CD(4)(+)T cell count was between (1 - 51) x 10(6)/L, average was (20 +/- 16) x 10(6)/L, Patients presented with consolidation of lung. X-ray, or CT of lung showed large patchy consolidation image, inanition, atelectasis in the lung. Rhodococcus equi could be cultured from sputum, blood, tissue obtained through lung puncture, broncho-alveolar lavage fluid, etc. Though susceptible antibiotics were used, the focus in the lung was absorbed slowly, All of 15 patients begin with HAART, after 33 day to 2 years follow up 4 patients die and alive patients have perfect immune-rebuilt. Rhodococcus equi infection, an unusual disease, can be seen in AIDS patients and can be cured only with long-term effective antibiotic.