Disseminated nocardiosis in a bone marrow transplant recipient with chronic GVHD.
We describe a case of disseminated nocardiosis in a 53-year-old male allogeneic marrow recipient with chronic GVHD, 15 years post BMT. Six months prior to admission he was treated for recurrent chronic GVHD with corticosteroids with a good response. He deteriorated subsequently while still on steroids requiring admission for fever, anorexia, weight loss, productive cough and progressive dyspnoea. On admission he had multiple nodular lesions on chest roentgenogram and subsequently grew Nocardia farcinica in blood culture. N. farcinica is rare post BMT, has a high mortality, is resistant to various antibiotics and needs prolonged antimicrobial therapy. We report the successful management of our patient with single agent trimethoprim-sulphamethoxazole.
Bhave
A A
AA
Department of Haematology, Westmead Hospital, NSW, Australia.
Thirunavukkarasu
K
K
Gottlieb
D J
DJ
Bradstock
K
K
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D014184:Transplantation, Homologous; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination