title: Clinical features and successful recovery from disseminated nocardiosis after BMT.
abstract: 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.
authors.affiliation: BMT Program, Fundação Pró Sangue Hemocentro de São Paulo, Brazil.
authors.forename: C M
authors.initials: CM
authors.lastname: Machado
authors.forename: M C
authors.initials: MC
authors.lastname: Macedo
authors.forename: J B
authors.initials: JB
authors.lastname: Castelli
authors.forename: M
authors.initials: M
authors.lastname: Ostronoff
authors.forename: A C
authors.initials: AC
authors.lastname: Silva
authors.forename: E
authors.initials: E
authors.lastname: Zambon
authors.forename: C
authors.initials: C
authors.lastname: Massumoto
authors.forename: D F
authors.initials: DF
authors.lastname: Chamone
authors.forename: F L
authors.initials: FL
authors.lastname: Dulley
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary; D007166:Immunosuppressive Agents; D014295:Trimethoprim; D013420:Sulfamethoxazole