F. Gallen et al., Pulmonary infection with Rhodococcus equi after renal transplantation. Review of the literature., NEPHROLOGIE, 20(7), 1999, pp. 383-386
Rhodococcus Equi, a stictly aerobic Gram positive cocco-bacillus, is a path
ogen for horses and foals. It may induce opportunistic infections and is de
scribed in AIDS infected patients.
We report the case of a 47-year old man, breeder of horses,with kidney tran
splant who has presented, 8 years after his graft, an impairment of health,
a fever and evidence of pulmonary disease. The pulmonary biopsy under scan
ner guidance and microbiology study, has displayed the diagnosis of Rhodoco
ccus equi infection. The evolution has been favorable with double antibioth
erapy (follow-up 27 months).
Ten comparable observations have been published after organ transplantation
: (kidney: 8; heart: 1; liver: 1). Pulmonary locations are widely predomina
nt. The animal contact is found only in 30% of cases. The presentation of t
he sickness has been compared to pulmonary tuberculosis or to nocardiosis,
pathologies often observed in this context of immunosuppression.
The antibiotic treatment is difficult and should required two bactericidal
antibiotics A surgical lobectomy can be envisaged in case of relapse. The m
ortality is 30%.