Shahani Lokesh
Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
BMJ Case Rep. 2014 Jun 18;2014:bcr2014204721. doi: 10.1136/bcr-2014-204721.
Rhodococcus equi is an aerobic facultative intracellular organism that is known to infect cells of the macrophage-monocyte lineage. It is a common veterinary pathogen; however, the incidence of this infection in humans has risen and it has been recognised as an emerging opportunistic pathogen among the immunocompromised patients. We present the case of a patient with chronic myeloid leukaemia who had received allogenic stem cell transplant and presented to the hospital with clinical picture of pneumonia. Her condition worsened on initial broad spectrum antimicrobials and 3 weeks into her hospitalisation, R. equi was isolated from her broncheoalveolar lavage and blood cultures. Based on the susceptibility, therapy was changed to four active antimicrobials; however, the patient failed to improve and eventually died. This case highlights the importance of considering the diagnosis of R. equi among immunosuppressed patients early in the right clinical setting due to the high virulence associated with this organism.
马红球菌是一种需氧兼性胞内菌，已知可感染巨噬细胞-单核细胞谱系的细胞。它是一种常见的兽医病原体；然而，这种感染在人类中的发病率有所上升，并且已被确认为免疫功能低下患者中一种新兴的机会性病原体。我们报告了一例慢性髓性白血病患者的病例，该患者接受了异基因干细胞移植，因肺炎临床表现入院。她在最初使用广谱抗菌药物治疗时病情恶化，住院3周后，从她的支气管肺泡灌洗和血培养物中分离出马红球菌。根据药敏结果，治疗改为使用四种有效的抗菌药物；然而，患者病情未见改善，最终死亡。由于该病原体具有高毒力，本病例强调了在正确的临床环境中早期考虑免疫抑制患者马红球菌感染诊断的重要性。
