Clinical features and successful recovery from disseminated nocardiosis after BMT.
Nocardiosis has rarely been described after BMT. When the doses of immunosuppressive therapy were tapered, a 46-year-old BMT recipient developed chronic graft-versus-host disease (GVHD) and immunosuppresive drugs were increased. Sixteen days later the patient developed nocardiosis diagnosed by lung biopsy. Trimethoprim/sulfamethoxazole (TMP/SMZ) was initiated but the doses were reduced because of rising creatinine levels. Skin and cerebral dissemination of nocardiosis was observed and TMP/SMZ doses were increased. After 4 months, the brain lesion was unaltered despite resolution of pulmonary lesions. Clinical improvement was observed after drainage of the brain abscess.
Machado
C M
CM
BMT Program, Fundação Pró Sangue Hemocentro de São Paulo, Brazil.
Macedo
M C
MC
Castelli
J B
JB
Ostronoff
M
M
Silva
A C
AC
Zambon
E
E
Massumoto
C
C
Chamone
D F
DF
Dulley
F L
FL
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary; D007166:Immunosuppressive Agents; D014295:Trimethoprim; D013420:Sulfamethoxazole