title: Nocardia infection in a renal transplant recipient.
abstract: Opportunistic infection occurs in up to 20% renal transplant patients and is associated with a high mortality. We report a 47-year-old diabetic female with 1-year-old deceased donor renal allograft on triple drug immunosuppression. She developed cytomegalovirus retinitis at ten months post-transplant followed by nocardiasis manifested by hemiparesis with comatose state due to lumbar epidural and multiple brain abscesses, in spite of immediately curtailing immunosuppression. She recovered with linezolid and cotrimoxazole and was discharged two weeks later. She is maintaining stable graft function with serum creatinine 1.4 mg/dL on cyclosporin 2.5 mg/kg/day and prednisone10 mg/day with maintenance therapy for nocardiasis.
authors.affiliation: Department of Nephrology and Transplantation Medicine, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases & Research Centre, Ahmedabad, Gujarat, India.
authors.forename: K K
authors.initials: KK
authors.lastname: Kaswan
authors.forename: A V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: A
authors.initials: A
authors.lastname: Feroz
authors.forename: H V
authors.initials: HV
authors.lastname: Patel
authors.forename: M
authors.initials: M
authors.lastname: Gumber
authors.forename: H L
authors.initials: HL
authors.lastname: Trivedi
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D020802:Epidural Abscess / Q000382:microbiology / Q000601:surgery; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D007796:Laminectomy; D000069349:Linezolid; D008875:Middle Aged; D009617:Nocardia Infections / Q000188:drug therapy / Q000453:epidemiology*; D009894:Opportunistic Infections / Q000453:epidemiology*; D023303:Oxazolidinones / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D000935:Antifungal Agents; D005938:Glucocorticoids; D023303:Oxazolidinones; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D016572:Cyclosporine; D000069349:Linezolid; D011241:Prednisone