Disseminated Nocardia farcinica infection in a uraemia patient with idiopathic thrombocytopenia purpura receiving steroid therapy.
Nocardia farcinica has been reported as an increasingly frequent cause of localized and disseminated infections in immunocompromised patients in recent years, but N. farcinica bacteraemia remains a rare finding. Here, the case is described of a 68-year-old man with end-stage renal disease and idiopathic thrombocytopenia purpura treated with steroid therapy who developed disseminated infection (bacteraemia, multilobar pneumonia and brain abscesses) due to N. farcinica. The isolate was confirmed by partial sequencing analysis of the 16S rRNA gene. The patient recovered after prolonged trimethoprim-sulfamethoxazole therapy with no recurrence in over 1 year.
Lai
Chih-Cheng
CC
Department of Internal Medicine1 and Department of Laboratory Medicine2, National University Hospital, Taipei, Taiwan 3,4School of Medical Technology3 and Center for Optoelectronic Biomedicine4, National Taiwan University College of Medicine, Taipei, Taiwan.
Lee
Li-Na
LN
Department of Internal Medicine1 and Department of Laboratory Medicine2, National University Hospital, Taipei, Taiwan 3,4School of Medical Technology3 and Center for Optoelectronic Biomedicine4, National Taiwan University College of Medicine, Taipei, Taiwan.
Teng
Lee-Jene
LJ
Department of Internal Medicine1 and Department of Laboratory Medicine2, National University Hospital, Taipei, Taiwan 3,4School of Medical Technology3 and Center for Optoelectronic Biomedicine4, National Taiwan University College of Medicine, Taipei, Taiwan.
Wu
Ming Shiou
MS
Department of Internal Medicine1 and Department of Laboratory Medicine2, National University Hospital, Taipei, Taiwan 3,4School of Medical Technology3 and Center for Optoelectronic Biomedicine4, National Taiwan University College of Medicine, Taipei, Taiwan.
Tsai
Jui-Chang
JC
Department of Internal Medicine1 and Department of Laboratory Medicine2, National University Hospital, Taipei, Taiwan 3,4School of Medical Technology3 and Center for Optoelectronic Biomedicine4, National Taiwan University College of Medicine, Taipei, Taiwan.
Hsueh
Po-Ren
PR
Department of Internal Medicine1 and Department of Laboratory Medicine2, National University Hospital, Taipei, Taiwan 3,4School of Medical Technology3 and Center for Optoelectronic Biomedicine4, National Taiwan University College of Medicine, Taipei, Taiwan.
D000368:Aged; D016470:Bacteremia / Q000382:microbiology; D001922:Brain Abscess / Q000382:microbiology / Q000473:pathology; D004269:DNA, Bacterial / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D006801:Humans; D008297:Male; D009615:Nocardia / Q000145:classification / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D011014:Pneumonia / Q000382:microbiology / Q000473:pathology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D013256:Steroids / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage; D014511:Uremia / Q000150:complications*
D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S; D013256:Steroids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination