title: Nocardia beijingensis pulmonary infection successfully treated with intravenous beta-lactam antibiotics and oral minocycline.
abstract: We report a case of pulmonary infection caused by a rare Nocardia species, Nocardia beijingensis, in a 48-year-old man who received multiple immunosuppressive therapy after renal transplantation. This pathogen was isolated from a bronchoscopic protected specimen brush and was identified as N. beijingensis by 16S rRNA gene sequence analysis. The patient was initially treated with imipenem/cilastatin followed by ceftriaxone and oral minocycline. Traditionally, trimethoprim-sulfamethoxazole (SXT) has been one of the first-line antibiotics chosen as an initial therapy for pulmonary nocardiosis, but this case was successfully treated without SXT. Considering recent reports about failures of both prophylaxis and treatment for nocardial infections with SXT and its various side effects, treatment with beta-lactam antibiotics and minocycline for pulmonary nocardiosis can be chosen in mild to moderate cases with confirmed susceptibility to these antibiotics in vitro.
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Ogawa
authors.forename: Kei
authors.initials: K
authors.lastname: Kasahara
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Yonekawa
authors.forename: Chiyo
authors.initials: C
authors.lastname: Nakagawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Maeda
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Konishi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Mikasa
authors.forename: Ken
authors.initials: K
authors.lastname: Kikuchi
mesh_terms: D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents; D007275:Injections, Intravenous; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use*; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D002443:Ceftriaxone; D008911:Minocycline