title: Successful treatment of serial opportunistic infections including disseminated nocardiosis and cryptococcal meningitis in a patient with ANCA-associated vasculitis.
abstract: We herein present a case of serial opportunistic infections that included disseminated nocardiosis and cryptococcal meningitis in a 67-year-old man who was diagnosed with ANCA-associated vasculitis and treated with corticosteroids. Upon admission, the initial manifestations of the disease included subcutaneous tumors and multiple lesions in the brain and lungs. Nocardia farcinica was identified in a culture of the aspirated pus. The patient was successfully treated for disseminated nocardiosis with antibiotics. However, three months after discharge, he was hospitalized with complaints of nuchal pain. Cryptococcus neoformans was identified on a culture of the cerebrospinal fluid. Anti-fungal treatment resulted in the remission of cryptococcal meningitis.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Iwazu
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Iwazu
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Takeda
authors.forename: Tetsu
authors.initials: T
authors.lastname: Akimoto
authors.forename: Wako
authors.initials: W
authors.lastname: Yumura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Chiharu
authors.initials: C
authors.lastname: Ito
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Kanai
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Taniguchi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hirai
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusano
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D009617:Nocardia Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D007166:Immunosuppressive Agents