title: Pulmonary nocardiosis developed in a hematopoietic stem cell transplant recipient with bronchiolitis obliterans.
abstract: The chronic graft-versus-host disease often requires unceasing immunosuppressive therapy (IST), which increases a risk of infectious complications in hematopoietic stem cell transplantation (HSCT) recipients. We report an adult T-cell leukemia/lymphoma case who developed pulmonary nocardiosis, a rare pulmonary complication, after allogeneic HSCT despite administration of the prophylactic trimethoprim-sulfamethoxazole (TMP/STX). The inhaled corticosteroid in addition to systemic IST had been started for bronchiolitis obliterance 4 months prior to nocardiosis development. The patient was successfully treated with an increased dose of TMP/STX combined with meropenem. Transplantation physicians should keep this rare pulmonary complication in mind during sustained IST.
authors.affiliation: Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
authors.forename: Ruriko
authors.initials: R
authors.lastname: Nishida
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Mori
authors.forename: Hiromi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Takahito
authors.initials: T
authors.lastname: Tokuyama
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kamezaki
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nagasaki
authors.forename: Hideyo
authors.initials: H
authors.lastname: Oka
authors.forename: Kohta
authors.initials: K
authors.lastname: Miyawaki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Saito
authors.forename: Katsuto
authors.initials: K
authors.lastname: Takenaka
authors.forename: Naoki
authors.initials: N
authors.lastname: Harada
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
authors.forename: Koichi
authors.initials: K
authors.lastname: Akashi
mesh_terms: D001989:Bronchiolitis Obliterans / Q000150:complications / Q000175:diagnosis*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000175:diagnosis* / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000209:etiology