Disseminated rhodococcus equi infection in HIV infection despite highly active antiretroviral therapy

Francesca Ferretti, Antonio Boschini, Cristiana Iabichino, Simonetta Gerevini, Paola De Nardi, Monica Guffanti, Giuseppe Balconi, Adriano Lazzarin, Paola Cinque

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Rhodococcus equi (R.equi) is an acid fast, GRAM + coccobacillus, which is widespread in the soil and causes pulmonary and extrapulmonary infections in immunocompromised people. In the context of HIV infection, R.equi infection (rhodococcosis) is regarded as an opportunistic disease, and its outcome is influenced by highly active antiretroviral therapy (HAART).Case presentation: We report two cases of HIV-related rhodococcosis that disseminated despite suppressive HAART and anti-rhodococcal treatment; in both cases there was no immunological recovery, with CD4+ cells count below 200/μL. In the first case, pulmonary rhodococcosis presented 6 months after initiation of HAART, and was followed by an extracerebral intracranial and a cerebral rhodococcal abscess 1 and 8 months, respectively, after onset of pulmonary infection. The second case was characterized by a protracted course with spread of infection to various organs, including subcutaneous tissue, skin, colon and other intra-abdominal tissues, and central nervous system; the spread started 4 years after clinical resolution of a first pulmonary manifestation and progressed over a period of 2 years.Conclusions: Our report highlights the importance of an effective immune recovery, despite fully suppressive HAART, along with anti-rhodococcal therapy, in order to clear rhodococcal infection.

Original languageEnglish
Article number343
JournalBMC Infectious Diseases
Volume11
DOIs
Publication statusPublished - Dec 14 2011

ASJC Scopus subject areas

  • Infectious Diseases

Fingerprint Dive into the research topics of 'Disseminated rhodococcus equi infection in HIV infection despite highly active antiretroviral therapy'. Together they form a unique fingerprint.

Cite this