Adrenal insufficiency, recurrent bacteremia, and disseminated abscesses caused by Nocardia asteroides in a patient with acquired immunodeficiency syndrome.
Nocardia asteroides is an opportunistic pathogen of increasing incidence in human immunodeficiency virus (HIV)-infected persons. The lungs are the most common site of infection, followed by the brain; involvement of other extrapulmonary sites is less common. We describe a patient with acquired immunodeficiency syndrome who presented with a number of unique manifestations of nocardial infection: the first reported case of bilateral adrenal abscesses with adrenal insufficiency, the first case of a renal abscess due to N. asteroides alone, and the first case of recurrent, symptomatic bacteremia. A review of the literature on nocardial infections in HIV-positive individuals is presented.
Arabi
Y
Y
Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
Fairfax
M R
MR
Szuba
M J
MJ
Crane
L
L
Schuman
P
P
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology*; D000038:Abscess / Q000188:drug therapy / Q000382:microbiology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000309:Adrenal Insufficiency / Q000150:complications* / Q000188:drug therapy; D000328:Adult; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D001431:Bacteriological Techniques; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D009617:Nocardia Infections / Q000150:complications* / Q000188:drug therapy; D009616:Nocardia asteroides / Q000187:drug effects / Q000302:isolation & purification; D012008:Recurrence; D014057:Tomography, X-Ray Computed
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones