Disseminated infection due to Nocardia transvalensis coincident with Cryptococcus neoformans variety gattii meningitis.
A case of meningitis due to Cryptococcus neoformans var. gattii coincident with disseminated Nocardia transvalensis infection is reported. Nocardia infection initially progressed despite high-dose antimicrobial therapy. Although a specific immunologic defect could not be defined, in vitro lymphocyte proliferation in response to stimulation with the Nocardia isolate was reduced. It is proposed that coinfection with Cryptococcus neoformans may have contributed to the observed impairment of lymphocyte function, leading to disseminated Nocardia disease and a suboptimal treatment response.
Dyer
J R
JR
Infectious Diseases Unit, St. Andrew's Hospital, Ipswich, Queensland, Australia. jdyer@medeserv.com.au
Ketheesan
N
N
Norton
R E
RE
Ashhurst-Smith
C I
CI
Keary
P
P
La Brooy
J T
JT
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003453:Cryptococcosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D016920:Meningitis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009617:Nocardia Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents