Cavitary pneumonia secondary to Tsukamurella in an AIDS patient. First case and a review of the literature

Tsukamurella is a Gram-positive, variable rod-shaped, weakly acid-alcohol-fast, non motile, aerobic bacterium that belongs to the genus Rhodococcus. Tsukamurella has been reported as a cause of infections in humans with immunosuppression and indwelling foreign bodies. It has also been isolated in one patient with AIDS (Acquired Immunodeficiency Syndrome) as a saprophytic organism. Optimal management of infections secondary to this micro-organism is still uncertain due to the paucity of cases. The combination of a beta-lactam and an aminoglycoside, along with removal of medical devices, appear to be the treatment of choice. We report the case of an AIDS patient who presented with multiple lung cavitary lesions secondary to Tsukamurella. This is the first case reported of Tsukamurella as a pathogenic agent in an AIDS patient. We also propose a successful oral antibiotic regimen with fluoroquinolone and rifampin to treat infections secondary to this uncommon micro-organism.