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Rhodococcus equi and cytomegalovirus pneumonia in a renal transplant patient: Diagnosis by fine‐needle aspiration biopsy
Author(s) -
Simsir Aylin,
Oldach David,
Forest Graham,
Henry Michael
Publication year - 2001
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/1097-0339(200102)24:2<129::aid-dc1025>3.0.co;2-6
Subject(s) - medicine , rhodococcus equi , cytomegalovirus , pneumonia , renal transplant , aspiration pneumonia , biopsy , fine needle aspiration , renal biopsy , pathology , kidney , virology , viral disease , virus , herpesviridae , chemistry , virulence , gene , biochemistry
Rhodococcus equi is a common cause of pneumonia in animals. Human infection is rare. Increasing number of cases are being reported in immunosuppressed individuals mostly associated with HIV infection, but also in solid organ transplant recipients and leukemia/lymphoma patients. We report on an adult male who developed pneumonia and gastroenteritis 4 mo after receiving a renal transplant. CT scan of the lungs showed a dominant 2.5‐cm upper lobe lung mass and smaller bilateral nodules. He underwent a diagnostic bronchoscopy with fine‐needle aspiration biopsy of the largest lung nodule. Smears showed histiocytic granulomatous inflammation, foamy macrophages, and acute inflammatory exudate. Scattered foamy macrophages displayed intracellular coccobacilli identifiable on Diff‐Quik stain. A few cells with changes suggestive of viral inclusions were identified. Cytomegalovirus (CMV) immunostain was positive in the cell block sections. Lung cultures grew R. equi . To the best of our knowledge, this is the first report of coinfection with R. equi and CMV. Diagn. Cytopathol. 24:129–131, 2001. © 2001 Wiley‐Liss, Inc.