Rhodococcus hoagii bloodstream infection in an allogeneic hematopoietic stem cell transplantation patient: Case report and review of literature
Pedro da Silva Campana,
Lorena Zaine Matos Martinho,
Marjorie Vieira Batista,
Hermes Higashino,
Camila Rizek,
Flavia Rossi,
Fernando Nivaldo Oliveira,
Vanderson Rocha,
Silvia Figueiredo Costa
Affiliations
Pedro da Silva Campana
Instituto de Infectologia Emilio Ribas, São Paulo, Brazil
Lorena Zaine Matos Martinho
Infectious Diseases Division of Hospital das Clinicas of University of São Paulo, São Paulo, Brazil
Marjorie Vieira Batista
Infectious Diseases Division of Hospital das Clinicas of University of São Paulo, São Paulo, Brazil
Hermes Higashino
Infectious Diseases Division of Hospital das Clinicas of University of São Paulo, São Paulo, Brazil
Camila Rizek
LIM49-Instituto de Medicina Tropical of University of São Paulo, São Paulo, Brazil
Flavia Rossi
Laboratory of Microbiology of Hospital das Clínicas of University of São Paulo, São Paulo, Brazil
Fernando Nivaldo Oliveira
Infectious Diseases Department of Hospital das Clinicas of University of São Paulo, São Paulo, Brazil
Vanderson Rocha
Bone Marrow Transplantation Unit of Hospital das Clínicas of University of São Paulo, São Paulo, Brazil
Silvia Figueiredo Costa
Department of Infectious Diseases of Faculdade de Medicina of University of São Paulo, São Paulo, Brazil; Corresponding author at: Departament of Infectious Diseases of Faculdade de Medicina of University of São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 - Jardim America, São Paulo, SP, 05403-000, Brazil.
We report a case of bloodstream infection caused by R. hoagii in a woman with acute myeloid leukemia, 37-years-old, who received an allogeneic hematopoietic stem cell transplant. She developed cutaneous and gastrointestinal tract graft versus host disease, respectively on day 29 and day 69. On day 157 she developed to acute severe respiratory failure. Rhodococcus sp was identified by MALDI-TOF and 16S rRNA sequencing from blood culture as Rhodococcus hoagii. The patient was a nurse that lived in urban areas, and stated no recent trips to countryside areas neither contacted with animals. Despite of the treatment with antibiotics with action against R. hoagii such as linezolid and meropenem the patient evolved to multiorgan dysfunction and death. Our case-report emphasizes the importance of early diagnosis and the use of 16S rRNA sequencing to confirmed the identification of species of Rhodococcus infection.
