A case of nocardiasis complicated with meningitis in a patient with immune thrombocytopenic purpura.
Nocardia infection is a well recognized complication of the immunocompromised hosts. It is mostly a primary pulmonary infection, which may disseminate to other organs. The central nervous system (CNS) involvement of nocardiosis is usually manifested as brain abscesses. We report a 25-year-old male patient who presented with nocardial pneumonia and meningitis without brain abscess. He was diagnosed as immune thrombocytopenic purpura and methyl prednisolone was started 5 weeks previously. Nocardia spp. was obtained from his cerebrospinal fluid culture, but he died at the 7th day of intensive care. Nocardia meningitis is a rare manifestation of systemic disease. Nocardia meningitis should be considered in the differential diagnosis of meningitis with the coexisting nodular pulmonary lesions in the immunocompromised patient and medications other than co-trimoxazole may be required.
Mete
Bilgül
B
Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
Yemisen
Mücahit
M
Demirel
Aslihan Ertaban
AE
Ozaras
Resat
R
Mert
Ali
A
Ozturk
Recep
R
Tabak
Fehmi
F
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003643:Death; D006801:Humans; D008297:Male; D008581:Meningitis / Q000150:complications* / Q000188:drug therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D009615:Nocardia / Q000302:isolation & purification; D009617:Nocardia Infections / Q000150:complications* / Q000188:drug therapy; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy; D011696:Purpura, Thrombocytopenic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone