Disseminated nocardiosis due to Nocardia farcinica: diagnosis by thyroid abscess culture.
A previously healthy 75-year-old white male dentist presented with a 6-month history of low-back pain treated with chronic steroid therapy had a Nocardia farcinica infection diagnosed by aspirate of thyroid abscess and six blood cultures. Despite the treatment with parenteral combination of trimethoprim/sulfamethoxazole, the patient failed to respond and died after two days of therapy. Autopsy revealed disseminated nocardiosis, involving lungs with pleural purulent exudate in both sides, heart, thyroid, kidneys, brain, bones, and lumbosacral soft tissue with destruction of L2-L4.
Laboratório de Micologia, Hospital Santa Rita, Santa Casa Complexo-Hospitalar, Porto Alegre, RS, Brasil. severo@santacasa.tche.br
Cecília Bittencourt
CB
Severo
Flávio de Mattos
Fde M
Oliveira
Lenine
L
Cunha
Vlademir
V
Cantarelli
Luiz Carlos
LC
Severo
D000038:Abscess / Q000382:microbiology*; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009615:Nocardia / Q000235:genetics / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013961:Thyroid Gland / Q000382:microbiology*; D014057:Tomography, X-Ray Computed; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination