1/2. rhodococcus equi and cytomegalovirus pneumonia in a renal transplant patient: diagnosis by fine-needle aspiration biopsy.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.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
2/2. pneumonia involving legionella pneumophila and listeria monocytogenes in an immunocompromised patient: an unusual coinfection.Recently, empirical therapy has been recommended for severe community-acquired pneumonia. We report the case of a 68-year-old prednisone-treated man with multiple myeloma who developed a fatal pneumonia due to legionella pneumophila and listeria monocytogenes confirmed by immunohistochemistry on postmortem lung sampling. Involvement of the latter bacteria and association of two different pathogens are both highly uncommon features in pneumonia. The route of infection with L. monocytogenes is discussed and the literature on respiratory infections with L. monocytogenes is briefly reviewed. This case highlights the need to consider unusual pathogens when facing pneumonia in immunocompromised patients, and to perform extensive microbiological investigations even if broadspectrum antibiotic therapy is the treatment of choice.- - - - - - - - - - ranking = 4keywords = coinfection (Clic here for more details about this article) |