Muñoz P, Burillo A, Palomo J, Rodríguez-Créixems M, Bouza E
Department of Clinical Microbiology-Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Transplantation. 1998 Feb 15;65(3):449-53. doi: 10.1097/00007890-199802150-00031.
Rhodococcus equi is an opportunistic pathogen that usually causes infection in immunocompromised hosts, mainly human immunodeficiency virus-positive patients, yet solid organ transplant recipients may be affected as well. Infections in this group of patients have not been sufficiently analyzed.
We report an R equi pneumonia in a heart transplant recipient and review another 11 cases.
Infection appeared a mean of 49 months (range 1-180) after transplantation. Lung was primarily involved in 10 cases (83.3%). The remaining two cases presented with a paravertebral abscess and a purulent pericarditis. Invasive techniques were necessary to reach the diagnosis in nine cases. One patient healed with surgical resection of the lesion; the remaining 11 received antimicrobial agents. Six of them required additional surgical treatment. Three patients died.
Clinicians should consider R equi when evaluating a solid organ recipient with an asymptomatic lung nodule. Microbiology laboratories should be alerted in these cases because it could be mistaken for a contaminant diphtheroid and will not respond to the standard empirical therapy.
马红球菌是一种机会致病菌，通常在免疫功能低下的宿主中引起感染，主要是人类免疫缺陷病毒阳性患者，但实体器官移植受者也可能受到影响。这组患者的感染情况尚未得到充分分析。
我们报告了1例心脏移植受者发生的马红球菌肺炎，并回顾了另外11例病例。
感染出现在移植后平均49个月（范围1 - 180个月）。10例（83.3%）主要累及肺部。其余2例表现为椎旁脓肿和化脓性心包炎。9例需要采用侵入性技术才能确诊。1例患者通过手术切除病灶治愈；其余11例接受了抗菌药物治疗。其中6例需要额外的手术治疗。3例患者死亡。
临床医生在评估有无症状肺结节的实体器官移植受者时应考虑马红球菌感染。在这些病例中应提醒微生物实验室，因为它可能被误认为污染的类白喉杆菌，且对标准经验性治疗无反应。
