Malacoplaquia pulmonar y abdominal en un paciente VIH positivo. Reporte preliminar

Pulmonary malakoplakia associated with Rhodococcus equi is unusual. Herein we describe a 19-year-old man infected with the human immunodeficiency virus complaining of fever and cough. The computerized tomography scan revealed a mediastinal and right pulmonary tumor mass with multiples abdominal lymph nodes enlargements. Histologic examination of a bronchial biopsy specimen revealed sheets of histiocytic cells that contained coccobacillary organisms and «target-like» cytoplasmic inclusions corresponding with Michaelis-Gutmann bodies. Cultures of the lung tissue yielded growth of gram-positive coccobacilli subsequently identified as Rhodococcus equi. The intraabdominal biopsy reveals areas with similar histopathology of lung lesion. In immunocompromised patients, the possibility of malakoplakia should be considered in the differential diagnosis of pulmonary and/or systemic lesions composed of histiocytic cells.