RHODOCOCCUS-EQUI - 1ST CASE IN A HEART-TRANSPLANT RECIPIENT

Rhodococcus equi is a gram-positive diphtheroid that occasionally affe cts immunocompromised patients, usually causing a chronic respiratory infection with cavitating pulmonary opacities on chest radiograph that resemble mycobacterial or fungal disease. Etiologic diagnosis present s a number of pitfalls, because Rhodococcus equi isolates mimic many o f the characteristics of other microorganisms more familiar to the lab oratory staff. The treatment of choice for this disease has not yet be en established, and its mortality rate is greater than 50% in individu als with human immunodeficiency virus and 20% to 25% among the remaini ng patients. We describe here the first case of Rhodococcus equi infec tion in a heart transplant recipient. Clinical presentation was typica l, and treatment with a sensitivity-based combination of antibiotics r esulted in resolution of both the clinical and radiologic picture.