[Pulmonary infection from Rhodococcus equi after renal transplantation. Review of the literature].

This research study discusses a case of a kidney transplant patient who developed a pulmonary infection caused by Rhodococcus equi, a bacterium commonly found in horses. The study further reviews previously documented cases of this infection in organ transplant patients.

Background of Rhodococcus equi

• Rhodococcus Equi is an aerobic Gram-positive bacterium that often infects horses and foals.
• It can also lead to opportunistic infections, particularly in humans with compromised immune systems, such as those with AIDS.

Case Study

• The subject of this study is a 47-year-old man who breeds horses and has undergone a kidney transplant.
• Eight years post-transplant, he exhibited deteriorated health, fever, and signs of pulmonary disease.
• A pulmonary biopsy and microbiology study confirmed an infection caused by Rhodococcus equi.
• The infection was successfully treated with double antibiotherapy, with no recurrence for 27 months post-treatment.

Review of Related Literature

• The researchers identified ten similar cases of Rhodococcus equi infection in organ transplant patients – eight kidney, one heart, and one liver transplant.
• In the majority of these cases, the infection was located in the lungs.
• Interestingly, only 30% of these cases reported direct contact with animals.

Presentation and Treatment of Rhodococcus equi Infection

• The presentation of Rhodococcus equi infection can be likened to pulmonary tuberculosis or nocardiosis, both of which are often seen in individuals with suppressed immune systems.
• Treatment typically requires two bactericidal antibiotics. However, if the infection recurs, a surgical lobectomy may be considered.

Mortality Rate and Conclusion

• The overall mortality rate among those infected with Rhodococcus equi is reported to be 30%.
• The study emphasizes the need to consider Rhodococcus equi infection in the differential diagnosis of pulmonary diseases in immunosuppressed patients, especially those with a history of organ transplantation.