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Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 22 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Clinical features

● Zoonotic infection originally identified in lungs of foals; also cattle, swine, sheep, deer, goats, dogs, cats, other species
● Worldwide distribution in water and soil, especially near feces of herbivores
● Infection by inhalation or ingestion
● Resides primarily within lung macrophages of infected patients, also some alveolar cells (Microbes Infect 2011;13:438)
R. equi is most common human pathogen of the Rhodococci
● Generally occurs in AIDS patients (may cause malakoplakia, Clin Infect Dis 1999;28:1334); also other immunodeficient patients; very rarely in immunocompetent
● Incidence decreasing, likely due to HAART therapy and azithromycin prophylaxis
● "Rhodo" since salmon-pink pigment in culture
● Treated with antibiotics, but mortality is 50% in AIDS patients, 20% in other immunocompromised and 10% in immunocompetent

Case reports

● 15 year old girl with congenital AIDS and cavitary lesion (Arch Pathol Lab Med 2003;127:e315)
● 68 year old man with fatal lung infection post-chemotherapy for T-PLL (Emerg Infect Dis 2007;13:1942)
● 68 year old man with pneumonia post-heart transplant (University of Pittsburgh)

Gross images

Pulmonary mass in post-renal transplant patient

Micro description

● Epithelioid macrophages containing gram positive, partially acid fast coccobacilli that resemble mycobacteria
● May produce malakoplakia

Micro images

Various images

Figures 2/3: gram stain, 4:autopsy

End of Lung-nontumor > Infections > Rhodococcus

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