Pulmonary Malakoplakia by Rhodococcus equi in an HIV-Infected Patient in Mexico: A Case Report

Table 1

Rhodococcus equi-associated pulmonary malakoplakia in HIV-infected patients.

Age/sex	Immune status	Location	Endobronchial appearance	Lung findings	Culture results	Histologic features	Outcome	Reference
15F	HIV/AIDS	Left main stem bronchus, near carina	Occlusive masses	Cavitary lesion, necrotizing pneumonia	R. equi (PBL)	Sheets of PAS-positive foamy macrophages filled with Gram-positive coccobacilli	Death	Fidvi [10]
32M	HIV/AIDS	RML bronchus	Occlusive mass	RML consolidation	R. equi (PBL, BAL, pseudotumor)	Histiocytes with associated lymphocytes, plasma cells, and neutrophils; malakoplakia-like features	RML lobectomy	Canfrere [11]
30F	HIV/AIDS	LUL bronchus, LUL	Partially occlusive endobronchial mass, lung mass	LUL mass lesion	R. equi (bronchial aspirate, BAL, tissue)	Sheets of histiocytes with eosinophilic, faintly granular cytoplasm	LUL lobectomy, resolution	Bishopric [12]
25M	HIV/AIDS	Left main stem bronchus	Partially occlusive mass	Cavitary left lower lobe lesion	R. equi (bronchial aspirate)	Sheets of epithelioid histiocytes	Resolution	Shapiro [13]
47M	HIV/AIDS	Trachea	Occlusive mass with erosion to esophagus	Cavitary RUL lesion	R. equi (laryngeal pseudotumor)	Sheets of histiocytes with eosinophilic, coarsely granular cytoplasm	Persistence requiring tracheostom	Akilesh [14]
30M	HIV/AIDS	RML bronchus	Occlusive mass	RUL nodular lesion, right hilar lymphadenopathy	R. equi (BAL, blood)	Bland cells with abundant cytoplasm (CD68+), histiocytes with intracellular Gram-positive coccobacilli	Loss of follow-up	Krieg [15]
35M	HIV/AIDS	RLL bronchus	Bronchial tumor	RLL abscessed tumor with central necrosis	R. equi (sputum, BAL, lung biopsy)	Histiocytic infiltrate with intracellular inclusions (Michaelis–Gutmann bodies)	Resolution	Romero [16]
36F	HIV/AIDS	Multiple billateral lesions		Cavitary lesions	R. equi (fine needle aspirate culture)	Clusters of granular histiocytes with numerous intracytoplasmic and extracytoplasmic M-G bodies	Resolution	Sughayer [17]

RUL: right upper lobe, RML right middle lobe, RLL: right lower lobe, LUL: left upper lobe, PBL: peripheral blood, BAL: bronchioloalveolar lavage, MAI: Mycobacterium avium intracellulare complex, and ND: not done.