Document 0007
 DOCN  M9480007
 TI    Rhodococcus equi pneumonia and pulmonary malakoplakia in acquired
       immunodeficiency syndrome. Pathologic features.
 DT    9410
 AU    Kwon KY; Colby TV; Department of Pathology, Keimyung University School
       of Medicine,; Taegu, Korea.
 SO    Arch Pathol Lab Med. 1994 Jul;118(7):744-8. Unique Identifier : AIDSLINE
       MED/94296228
 AB    Pulmonary infection with Rhodococcus equi is rare, and most cases are
       seen in immunocompromised patients, particularly those with acquired
       immunodeficiency syndrome. We describe the pathologic features in four
       cases of culture-positive R equi pneumonia occurring in patients
       infected with human immunodeficiency virus. All four patients had a
       solitary cavitary pulmonary mass that was resected (n = 3) or had
       undergone biopsy (n = 1). Pathologically, all specimens revealed sheets
       of histiocytes with abundant foamy to eosinophilic cytoplasm with
       numerous phagolysosomes that were positive for periodic acid-Schiff,
       Gomori methenamine silver, and Grocott stains. Occasional histiocytes
       contained Michaelis-Gutmann bodies, diagnostic of malakoplakia. The
       Michaelis-Gutmann bodies yielded positive results with periodic
       acid-Schiff, Gomori methenamine silver, Grocott, Giemsa, and von Kossa
       stains (three of three cases studied) and with alizarin red and Prussian
       blue stains (two of three cases studied). Many gram-positive
       coccobacilli within histiocytes and associated with neutrophils were
       found in one case. Ultrastructural study of one case showed histiocytes
       containing abundant phagolysosomes with degenerated bacterial components
       and Michaelis-Gutmann bodies. The latter had a targetoid appearance with
       variegated phagolysosome cores that were mineralized by deposition of
       electron-dense spicules surrounded by peripheral rings of granular and
       membranous material. Based on our observations and reports in the
       literature, there appears to be a more than coincidental association
       between pulmonary R equi infection, malakoplakia, and human
       immunodeficiency virus infection.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY
       Actinomycetales Infections/*ETIOLOGY/PATHOLOGY  Adult  Case Report
       Human  Lung/MICROBIOLOGY/PATHOLOGY  Lung Diseases/*ETIOLOGY
       Malacoplakia/*ETIOLOGY  Male  Middle Age  Pneumonia/*ETIOLOGY/PATHOLOGY
       Rhodococcus equi/*ISOLATION & PURIF  Stains and Staining  JOURNAL
       ARTICLE

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