Document 0426
 DOCN  M9550426
 TI    Rhodococcus equi infection in HIV-positive patients: report of 5 cases
       and literature overview.
 DT    9505
 AU    Fiaccadori F; Elia GF; Calzetti C; Degli Antoni A; Magnani G; Cattedra
       di Malattie Infettive, Universita di Parma, Italia.
 SO    Monaldi Arch Chest Dis. 1994 Dec;49(5):380-8. Unique Identifier :
       AIDSLINE MED/95144128
 AB    The importance of Rhodococcus equi infection, an uncommon human pathogen
       that almost exclusively affects immunocompromised hosts, has greatly
       increased following the advent of acquired immune deficiency syndrome
       (AIDS) epidemics. Until the present time, 38 cases of R. equi infection
       have been described in human immunodeficiency virus (HIV)-infected
       patients; we now report a further five personal cases. R. equi was
       acquired via respiratory exposure to animals in less than half of the
       patients, and caused invasive pulmonary infection (91%), bacteraemia and
       sometimes bloodstream dissemination. R. equi was easily cultured from
       sputum or blood, but its diagnosis was often difficult due to
       microbiological and clinical similarities with other pathogens. The
       persistence of the micro-organism inside macrophages and its high
       tissular load represent the major limitation to an effective treatment.
       Several antibiotics are active in vitro, but their efficacy in vivo
       depends on macrophage uptake and/or bactericidal activity. Treatment
       should start with at least two intravenous bactericidal antibiotics for
       3-4 weeks, and then continue with oral therapy for a period of up to
       several months with at least two intracellularly active drugs. Surgical
       resection of the lesions may be beneficial in selected cases.
 DE    Actinomycetales Infections/*ETIOLOGY  Adult  *AIDS-Related Opportunistic
       Infections  Case Report  Female  Human  Male  Middle Age  *Rhodococcus
       equi  JOURNAL ARTICLE  REVIEW  REVIEW OF REPORTED CASES

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