RADIOLOGIC FEATURES OF RHODOCOCCUS-EQUI PNEUMONIA IN AIDS

This report outlines the radiological features observed in three cases of Rhodococcus equi (R. equi) pneumonia in AIDS (acquired immunodefic iency syndrome) and reviews another 45 radiological reports published of this emerging opportunistic pneumonia in Human Immunodeficiency Vir us (HIV) infected patients, The clinical signs in our three patients c onsisted in a subacute onset of respiratory symptoms and fever. A low lymphocyte count (<200 cells/mm(3)), pulmonary infiltrates, and pleura l effusion was present in all three cases. Cavitary pneumonia was obse rved in two patients, and pericardial effusion in another, In this ser ies CD4 lymphocyte count <200/mm(3) was seen in 29 of the 48 patients (60.4%). All 48 patients had abnormal findings on chest radiogrpahs. A bnormalities involved the upper lobes in 26 of the 48 patients (55%). Cavitation was reported in 37 of the 48 cases (77%). it equi pneumonia may not be as rare as the paucity of case reports suggest. Consequent ly, a cavitary pneumonia in HIV infected patients with a low CD4 lymph ocyte count (<200 mm(3)) with a subacute onset, an upper lobe predilec tion, and/or a poor response to conventional antibiotic therapy should be considered as suspect of R. equi infection.