Empyema due to Rhodococcus hoagii, an unusual presentation

Abstract

Rhodococcus hoagii is an unusual infectious agent in humans. It typically presents as an opportunistic
infection in immunosuppressed patients, although it has also been reported as an occupational disease following exposure to farm animals (such as horses, goats, sheep and cattle). The most common clinical presentation is slowly resolving cavitary pneumonia, so it should be included in the differential diagnosis of tuberculosis. Less common manifestations include pleural effusion, empyema, and lung abscess. We report the case of a 57-year-old man, HIV-positive, who was employed as a racetrack stable worker, diagnosed with empyema caused by Rhodococcus hoagii (presently R. equi).