Thread by @IUIDfellowship

#idtwitter #idboardreview by our now faculty @mmcclean1 @CIDJournal @SamirGu02674263 doi.org/10.1093/cid/ci… 58 M Indiana farmer using manuer fertilizer x months w/progressive cough, dyspnea, pleuritic chest pain, chills x11mo: CT: pulm nodules. BC: gram+bacilli #meded

#Rhodococcus hoagii (previously R equi) bacteremia with septic pulmonary emboli
-aerobic gram+coccobacillus
-Cells adopt a coccoid morphology when grown on solid media &
-in liquid media bacilli of varying lengths that often appear beaded in gram-stained preparations are formed

#rhodococcus Diagnosis requires a high index of suspicion, thorough history, and accurate laboratory identification methods. Can be mislabeled as corynebacterium on blood culture or kocuria on vitek

#rhodococcus Most isolates are susceptible to clarithromycin, rifampin, imipenem, erythromycin, aminoglycosides, azithromycin, doxycycline, and vancomycin. Combination therapy is required