Pulmonary nocardiosis in a patient with CML relapse undergoing imatinib therapy after bone marrow transplantation.
We describe a case of pulmonary nocardiosis in a female patient with graft-versus-host disease (GVHD) underwent therapy with imatinib mesylate for a relapse of chronic myeloid leukemia (CML) after allogeneic bone marrow transplantation (BMT). The patient developed chronic GVHD 8 months after the use of imatinib and was on corticosteroid therapy. Three months after the development of chronic GVHD, she acquired pulmonary nocardiosis and a computed tomography (CT) scan of the chest showed multiple nodular lesions with cavitations over both lungs. She was successfully treated with single-agent trimethoprim-sulfamethoxazole (TMP/SMX) and the infection did not recur. Our case indicated that pulmonary nocardiosis could occur in patients with GVHD undergoing imatinib and corticosteroid therapy and might be treated by single-agent TMP/SMX.
Lin
Jen-Tsun
JT
Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Shi-Pai, Taiwan.
Lee
Ming-Yang
MY
Hsiao
Lian-Tsai
LT
Yang
Mu-Hua
MH
Chao
Ta-Chon
TC
Chen
Po-Min
PM
Chiou
Tzeon-Jye
TJ
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001549:Benzamides; D016026:Bone Marrow Transplantation; D001989:Bronchiolitis Obliterans / Q000209:etiology; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications; D006801:Humans; D000068877:Imatinib Mesylate; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D008168:Lung / Q000000981:diagnostic imaging; D009617:Nocardia Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D009616:Nocardia asteroides / Q000302:isolation & purification*; D010879:Piperazines / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011743:Pyrimidines / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D001549:Benzamides; D007166:Immunosuppressive Agents; D010879:Piperazines; D011743:Pyrimidines; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000068877:Imatinib Mesylate