Antibiotic failure in a renal transplant patient with Rhodococcus equi infection: an indication for surgical lobectomy

Rhodococcus equi is an animal pathogen that causes infrequent but challenging infections in immunocompromised individuals, few of which have been described in solid organ transplant recipients. Common clinical presentations include indolent cough, fever, and dyspnea, with necrotizing pneumonia and c...

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Bibliographic Details
Published in:Transplant infectious disease 2014-12, Vol.16 (6), p.1019-1023
Main Authors: Ursales, A., Klein, J.A., Beal, S.G., Koch, M., Clement‐Kruzel, S., Melton, L.B., Spak, C.W.
Format: Article
Language:English
Subjects:
Actinomycetales Infections - drug therapy
Actinomycetales Infections - microbiology
Anti-Bacterial Agents - therapeutic use
antibiotic therapy
Female
Humans
Kidney Transplantation - adverse effects
lobectomy
Lung - microbiology
Lung - pathology
Lung - surgery
Lung Diseases - microbiology
Lung Diseases - surgery
Middle Aged
renal transplant
Rhodococcus equi
Rhodococcus equi - isolation & purification
surgical indications
Treatment Failure
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Summary:Rhodococcus equi is an animal pathogen that causes infrequent but challenging infections in immunocompromised individuals, few of which have been described in solid organ transplant recipients. Common clinical presentations include indolent cough, fever, and dyspnea, with necrotizing pneumonia and cavitation. We report a case of a dense right upper lung pneumonia with resultant R. equi bacteremia in a renal transplant recipient. Our patient initially responded to antibiotic treatment with resolution of bacteremia and clinical recovery, followed by interval progression in her right upper lobe consolidation on follow‐up computed tomography scans. She underwent lobectomy for definitive therapy with resolution of symptoms. Lobectomy can be utilized in isolated infection after antibiotic failure with excellent clinical outcomes.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.12314