The first isolation of Nocardia nova from an HIV-1 infected individual in Japan.
Nocardia species are opportunistic pathogens of immunocompromised patients. We report a case of Nocardia nova infection complicating Pneumocystis carinii pneumonia (PCP) in an HIV-1 infected individual. A 27-year-old man with hemophilia A was admitted on October 17, 2000, with fever and dyspnea. CD4 cell counts were 5/microl on admission. Prophylaxis against PCP was administered by inhalation of pentamidine isethionate because he was allergic to sulfamethoxazole-trimethoprim (SMZ-TMP). He was diagnosed with PCP from chest X-ray and bronchoalveolar lavage. The sputum obtained for culture on admission was positive for Gram-positive branching rods; the organism was later identified as Nocardia nova. He died from respiratory failure on November 7, 2000. Although PCP might be a principal factor in respiratory failure, this case shows the need to consider pulmonary nocardiosis as a cause of respiratory illness in patients with advanced HIV-1 infection.
Koibuchi
Tomohiko
T
Department of Infectious Disease and Applied Immunology, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.
Takahashi
Takashi
T
Nakamura
Tetsuya
T
Suzuki
Masato
M
Minamoto
Fujihiko
F
Oyaizu
Naoki
N
Yazawa
Katsukiyo
K
Mikami
Yuzuru
Y
Iwamoto
Aikichi
A
D000163:Acquired Immunodeficiency Syndrome / Q000382:microbiology*; D000328:Adult; D015497:HIV-1; D006801:Humans; D008297:Male; D009615:Nocardia / Q000302:isolation & purification*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D015662:Trimethoprim, Sulfamethoxazole Drug Combination