Tuberculosis-like pneumonias by the aerobic actinomycetes Rhodococcus, Tsukamurella and Gordonia

The order Actinomycetales includes phylogenetically diverse but morphologically similar aerobic and anaerobic organisms, exhibiting filamentous branching structures which fragment into rods or coccoid forms. Lung pathogens of the order comprise Mycobacterium, Nocardia, Corynebacterium, Actinomyces, Kytococcus, Rothia, Williamsia, as well as Gordonia, Tsukamurella and Rhodococcus.Particularly, members of the last three genera are uncommon aerobic agents of lung cavitations and tuberculosis(TB)-like syndromes, that should be carefully considered in the aetiology of parenchymal lesions. Correct identification of such organisms is hard to obtain, but is crucial to provide patients with adequate diagnose and treatment. Then, this review aims to unearth their airway tropism, as well as their clinical impact as agents of lung disease.