Nocardia asteroides pneumonia, subcutaneous abscess and meningitis in a patient with advanced malignant lymphoma: successful treatment based on in vitro antimicrobial susceptibility.
Nocardia asteroides pneumonia, subcutaneous abscess and meningitis without brain abscesses developed in a patient with advanced non-Hodgkin's lymphoma, who had received corticosteroid therapy and cancer chemotherapy for a long time. At the time of nocardial pneumonia, profound lymphocytopenia and hypogammaglobulinemia was seen. The severely immunosuppressed condition most likely accounted for the uncommon infection, nocardiosis. The organism isolated from the sputum, subcutaneous abscess and cerebrospinal fluid was strongly resistant to cotrimoxazole, which is the recommended standard treatment, but it was susceptible to imipenem (IPM) and erythromycin (EM) in an in vitro antimicrobial susceptibility study. The patient's nocardiosis responded well to chemotherapy including IPM and EM.
Sakai
C
C
Division of Hematology and Chemotherapy, Chiba Cancer Center Hospital.
Takagi
T
T
Satoh
Y
Y
D000038:Abscess / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004917:Erythromycin / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D066298:In Vitro Techniques; D016393:Lymphoma, B-Cell / Q000150:complications*; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009617:Nocardia Infections / Q000188:drug therapy*; D009616:Nocardia asteroides; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D013256:Steroids / Q000009:adverse effects
D013256:Steroids; D004917:Erythromycin; D015378:Imipenem