Pulmonary nocardiosis developed in a hematopoietic stem cell transplant recipient with bronchiolitis obliterans.
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.
Nishida
Ruriko
R
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Mori
Yasuo
Y
Iwasaki
Hiromi
H
Tokuyama
Takahito
T
Kamezaki
Kenjiro
K
Nagasaki
Yoji
Y
Oka
Hideyo
H
Miyawaki
Kohta
K
Saito
Noriyuki
N
Takenaka
Katsuto
K
Harada
Naoki
N
Miyamoto
Toshihiro
T
Teshima
Takanori
T
Akashi
Koichi
K
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