Successful treatment of Nocardia pneumonia with cytomegalovirus retinitis coinfection in a renal transplant recipient.
Nocardiosis is a rare opportunistic infection, especially seen in immunocompromised patients, including renal allograft recipients. Primary pulmonary infection is the most common clinical pattern and can easily result in disseminated Nocardia infection if treatment therapy is not adequate at the beginning. We report a case of pulmonary nocardiosis associated with cytomegalovirus retinitis in a renal transplant recipient, followed by chronic allograft dysfunction. Our patient was a 50-year-old male renal allograft recipient, with diabetes mellitus and hypertension, who was diagnosed with pneumonia and cytomegalovirus retinitis. High-resolution computed tomography scan of the thorax and bronchoscopy revealed nocardial pneumonia. The patient responded well to ceftriaxone and was later switched to oral minocycline. To our knowledge, this is the first report of a successful treatment of co-infection with Nocardia pneumonia and cytomegalovirus retinitis in a renal transplant patient, with early diagnosis and prompt treatment.
Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre [IKDRC], Dr. H. L. Trivedi Institute of Transplantation Sciences [ITS], Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India. drmohan610@yahoo.com
Mohan P
MP
Patel
Vivek B
VB
Kute
Manoj R
MR
Gumber
Pankaj R
PR
Shah
Himanshu V
HV
Patel
K L
KL
Dhananjay
Siddharth H
SH
Jain
Hargovind L
HL
Trivedi
Aruna V
AV
Vanikar
D060085:Coinfection; D017726:Cytomegalovirus Retinitis / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000150:complications* / Q000188:drug therapy*; D018410:Pneumonia, Bacterial / Q000150:complications* / Q000188:drug therapy*; D011183:Postoperative Complications / Q000188:drug therapy*; D012074:Remission Induction