A pulmonary mass caused by rhodococcus equi infection in a renal transplant recipient

A pulmonary mass caused by rhodococcus equi infection in a renal transplant recipient

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ABSTRACT BACKGROUND A 62-year-old male kidney transplant recipient was admitted to hospital with a 14-day history of fever, hemoptysis and left-sided pleuritic chest pain. He had suffered


malaise, weight loss, night sweats and exertional dyspnea over the previous 3 months. Imaging studies of the patient's chest revealed a noncavitated mass measuring 5 × 8 cm in the


anterior segment of the left upper lobe of the lung and a left-sided pleural effusion with septa, and bacterial cultures revealed the presence of _Rhodococcus equi_. INVESTIGATIONS Physical


examination, laboratory tests, chest X-ray, CT scan of the chest, bronchoscopy, and bacterial culture of blood, sputum, bronchoalveolar lavage fluid and pleural fluid. DIAGNOSIS _R. equi_


infection with bacteremic pleuropneumonia and pseudotumor. A secondary myopathy occurred 6 months after diagnosis of the infection as a result of a drug interaction between clarithromycin


and simvastatin. MANAGEMENT Long-term combination antibiotic therapy (ciprofloxacin plus vancomycin or clarithromycin), resection of the inflammatory pseudotumor, and reduction of


immunosuppressive therapy. Following the diagnosis of myopathy, simvastatin was discontinued. Access through your institution Buy or subscribe This is a preview of subscription content,


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OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Meyer DK and Reboli AC (2005) _Rhodococcus equi_. In _Principles and


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Pharmacol_ 50: 285–295 Article  CAS  Google Scholar  Download references ACKNOWLEDGEMENTS The authors would like to thank C Öhlschlegel, K Boggian, W Nagel and W Riesen, all at Cantonal


Hospital St Gallen, for their helpful input into this Case Study. Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the


learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * D


Speck is a Fellow in Internal Medicine in the Department of Medicine, I Koneth is a Chief Resident in the Division of Nephrology, M Diethelm is Chief Physician of Internal Medicine in the


Department of Medicine and I Binet is Head of the Division of Nephrology, all at Cantonal Hospital St Gallen, St Gallen, Switzerland., Dorothee Speck, Irene Koneth, Markus Diethelm & 


Isabelle Binet Authors * Dorothee Speck View author publications You can also search for this author inPubMed Google Scholar * Irene Koneth View author publications You can also search for


this author inPubMed Google Scholar * Markus Diethelm View author publications You can also search for this author inPubMed Google Scholar * Isabelle Binet View author publications You can


also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Irene Koneth. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing financial


interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Speck, D., Koneth, I., Diethelm, M. _et al._ A pulmonary mass caused by _Rhodococcus equi_


infection in a renal transplant recipient. _Nat Rev Nephrol_ 4, 398–403 (2008). https://doi.org/10.1038/ncpneph0833 Download citation * Received: 14 January 2008 * Accepted: 04 April 2008 *


Published: 27 May 2008 * Issue Date: July 2008 * DOI: https://doi.org/10.1038/ncpneph0833 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get


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