[Pulmonary Nocardia otitidis-caviarum infection in a patient with Cushing's disease].
While Nocardial infections are being diagnosed with increasing frequency, infection with Nocardia otitidiscaviarum remains relatively uncommon. We report a case of pulmonary Nocardia otitidis-caviarum infection in a 35-year-old man with Cushing's disease. This work describes the first case of nocardiosis in Japan caused by Nocardia otitidis-caviarum in Cushing's disease. The patient was admitted to our department because of edema. A diagnosis of Cushing's disease was made on the basis of elevated serum levels of cortisol and adrenocorticotropic hormone (ACTH) and pituitary adenoma was found in a cranial CT scan. One month after admission, chest radiographs showed a large bilateral mass on the lung fields. Nocardia otitidis-caviarum was isolated from the sputum. The patient responded poorly to intravenous PAPM/BP, but later improved after treatment with trimethoprim-sulfamethoxazole, but he died of heart failure and respiratory failure after the initiation of this therapy. This case demonstrated that nocardiosis must be considered in differential diagnosis as an opportunistic infection.
Sudou
A
A
Fifth Department of Internal Medicine, Tokyo Medical University.
Hashimoto
T
T
Nakamura
H
H
Yagyuu
H
H
Sarashina
G
G
Hatao
E
E
Tuchida
F
F
Adachi
H
H
Kishi
K
K
Matuoka
T
T
D000328:Adult; D003480:Cushing Syndrome / Q000150:complications*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009617:Nocardia Infections / Q000175:diagnosis / Q000209:etiology*; D009894:Opportunistic Infections / Q000175:diagnosis; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000209:etiology*