Rhodococcus equi and Nocardia brasiliensis infection of the brain and liver in a patient with acute nonlymphoblastic leukemia

Resolution of neutropenia is usually followed by resolution of fever in pat ients with febrile neutropenia. However, in some cases fever continues even when the patient is no longer neutropenic. Described here is a case of acu te myeloblastic leukemia complicated by brain abscess, pulmonary nodules, a nd hepatic lesions. The patient's fever had continued after the neutropenia resolved; brain and hepatic cultures grew Rhodococcus equi and Nocardia br asiliensis. Although Rhodococcus infections occur frequently in patients wi th HIV infection, they are uncommon in patients with acute leukemia.