Abstract
Rhodococcus equi is a rare opportunistic Gram-positive bacterium that primarily affects immunocompromised individuals, particularly those with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The infection often presents as a multisystem, disseminated disease with rapid progression and high mortality if not promptly diagnosed and treated. We report the case of a 34-year-old male AIDS patient who developed pulmonary infection due to Rhodococcus equi. Cultures from bronchoalveolar lavage fluid, metagenomic next-generation sequencing (mNGS), and bronchoscopic brushing all indicated infection with Rhodococcus equi. Following combined anti-infective treatment, the pulmonary infection was controlled, and his condition improved. Clinicians should be alert to the possibility of Rhodococcus equi infection in AIDS patients, emphasizing early diagnosis and targeted therapy to improve patient outcomes.