Case of muscle abscess due to disseminated nocardiosis in a patient with autoimmune hemolytic anemia, and review of the published work.
Although disseminated nocardiosis has been increasing with the expansion of immunosuppressive therapy and improvement in diagnostic methods, muscle abscess is a rare complication. There have been only nine case reports of muscle abscess due to Nocardia infection in the English-language published work. We present a case of muscle abscess with disseminated nocardiosis, and review the published work. The patient had been taking prednisolone at 20 mg a day for autoimmune hemolytic anemia for 14 years. She presented with erythema on her thigh resembling cellulitis. Computed tomography showed muscle abscess. The isolated organism was identified as Nocardia farcinica employing polymerase chain reaction and antibiotic sensitivity testing. The diagnosis of muscle abscess due to nocardiosis can be easily missed because there are no characteristic symptoms.
Department of Dermatology, Shiga University of Medical Science, Shiga, Japan. yoshiko8@belle.shiga-med.ac.jp
Yoshiko
Y
Ukai
Noriki
N
Fujimoto
Norikazu
N
Fujii
Masae
M
Shirai
Makiko
M
Wakabayashi
Toshiaki
T
Uenishi
Yusuke
Y
Koizumi
Keiko
K
Hodohara
Kaoru
K
Shimizu
Toshihiro
T
Tanaka
D000038:Abscess / Q000188:drug therapy / Q000209:etiology*; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000188:drug therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008875:Middle Aged; D009135:Muscular Diseases / Q000188:drug therapy / Q000209:etiology*; D009615:Nocardia / Q000302:isolation & purification; D009617:Nocardia Infections / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D011239:Prednisolone / Q000009:adverse effects; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011239:Prednisolone