Rhodococcus equi an unusual pathogen in pleural effusion in a patient with primitive neuroectodermal tumor (pnet): a case report

Rhodococcus equi is anonsporing, nonmotile, aerobic Gram positive bacillus previously called as Corynebacterium equi is one of the important cause of zoonosis. The organism has ability to survive inside the macrophages. This property is considered important for its pathogenesis. Human infection with R. equi is a rare occurrence. Immunocompromised patients with HIV infection with CD4+ Helper T cell count <100 cells/mm3 are predisposed. Cancer patients and patients undergoing organ transplantation receiving aggressive chemotherapeutic protocols are more susceptible. The degree and duration of neutropenia is an independent risk factor for these patients. R equi has a diverse clinical manifestations. Almost 80% patients have pulmonary system involvement with pleuritis, pleural effusion and cavitatorylung lesions. There is increased incidence of R. equi infections in humans reportedin recent times, may be due to the rising number of immunosuppressed patients as a result of increasing numbers of organ transplantations and use of immunosuppressive agents and aggressive antitumor chemotherapy.Here we describe an unusual case of Rhodococcusequi from pleural effusion in a patient with Primitive neuro-ectodermal tumor (PNET) of chest wallwith febrile neutropenia disease with unilateral lung opacities.