Nocardiosis in a recently transplanted renal patient.
Opportunistic infections are common after renal transplantation because of the use of immunosuppression. Nocardiosis is a rare but important cause of morbidity and mortality among renal transplant recipients. Depending upon the transplant center, the estimated incidence of nocardiosis among renal transplant recipients varies widely from 0 to 20%. We report the first case of nocardiosis in a recently transplanted renal patient maintained on tacrolimus, prednisone, and mycophenolate mofetil. It is likely that the nocardial infection in our patient was related to the development of her diabetes mellitus, and to her early episode of rejection and treatment which included high-dose steroids, and the addition of mycophenolate mofetil. Our case illustrates the importance of maintaining a heightened awareness so that nocardiosis may be diagnosed early and treated successfully.
Reddy
S S
SS
Nephrology Unit, University of Rochester Medical Center, NY, USA.
Holley
J L
JL
D048909:Diabetes Complications; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007168:IMP Dehydrogenase / Q000037:antagonists & inhibitors; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D016030:Kidney Transplantation; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009617:Nocardia Infections / Q000453:epidemiology / Q000209:etiology*; D009616:Nocardia asteroides; D009894:Opportunistic Infections / Q000453:epidemiology / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D007168:IMP Dehydrogenase; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus