Rhodococcus equi infection as inaugural manifestation of idiopathic CD4+ lymphopenia: A rare entity and a therapeutic challenge

Pulmonology. 2021 Jan-Feb;27(1):75-77. doi: 10.1016/j.pulmoe.2020.06.002. Epub 2020 Jul 1.

Abstract

We report a case of disseminated infection by Rhodococcus equi as the inaugural manifestation of idiopathic T-CD4+ lymphopenia. We aim to demonstrate our diagnostic and therapeutic approach and focus on the major dilemmas arising from the lack of scientific evidence regarding best clinical practice of this infection in humans.

Keywords: Idiopathic CD4(+) lymphopenia; Rhodococus equi.

Publication types

  • Case Reports

MeSH terms

  • Actinomycetales Infections / complications
  • Actinomycetales Infections / diagnosis
  • Actinomycetales Infections / microbiology*
  • Actinomycetales Infections / pathology
  • Administration, Intravenous
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotics, Antitubercular / administration & dosage
  • Antibiotics, Antitubercular / therapeutic use
  • Biopsy, Needle / methods
  • Bronchoalveolar Lavage / methods
  • Bronchoscopy / methods
  • CD4-Positive T-Lymphocytes
  • Cough / diagnosis
  • Cough / etiology
  • Drug Therapy, Combination
  • Emergency Service, Hospital
  • Fever / diagnosis
  • Fever / etiology
  • Humans
  • Levofloxacin / administration & dosage
  • Levofloxacin / therapeutic use
  • Lymphopenia / diagnosis*
  • Lymphopenia / etiology
  • Male
  • Pneumonia, Necrotizing / diagnosis*
  • Pneumonia, Necrotizing / drug therapy
  • Pneumonia, Necrotizing / etiology
  • Rhodococcus equi / isolation & purification*
  • Rifampin / administration & dosage
  • Rifampin / therapeutic use
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antibiotics, Antitubercular
  • Levofloxacin
  • Rifampin