Pulmonary infection by Rhodococcus equi is characterized by indolent infection in an immunocompromised host with a propensity to form cavitary lesions.
Recurrence is common.
This case illustrates that the spectrum of disease caused by R equi is not fully appreciated and that significant pitfalls complicate the diagnosis and management of infection by this unusual and probably underrecognized pathogen. Golub et al1 described the first case of human infection in 1967. Clinical infection is often difficult to eradicate and treatment typically consists of an extended course of multiple antibiotics. Occasionally, surgical resection of the involved tissue is required.10-12 Experience with clinical infection due to R equi, however, remains limited, and its identification is subject to many pitfalls. For this reason, the spectrum of clinical disease caused by R equi probably is underestimated.