title: Fatal pneumonia and empyema thoracis caused by imipenem-resistant Nocardia abscessus in a cancer patient.
abstract: We describe a case of pneumonia and empyema thoracis caused by trimethoprim-sulfamethoxazole-susceptible, but imipenem-resistant Nocardia abscessus in a cancer patient. The isolate was confirmed to the species level by 16S rRNA sequencing analysis. The patient did not respond to antibiotic therapy, including ceftriaxone and imipenem, and died of progressing pneumonia and multiple organ failure.
authors.affiliation: Department of Intensive Care Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Lai
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Hsih-Yeh
authors.initials: HY
authors.lastname: Tsai
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Ruan
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Chun-Hsing
authors.initials: CH
authors.lastname: Liao
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D016724:Empyema, Pleural / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D006394:Hemangiosarcoma / Q000188:drug therapy; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality; D009615:Nocardia / Q000187:drug effects* / Q000302:isolation & purification; D009617:Nocardia Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S; D015378:Imipenem; D002443:Ceftriaxone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: 16S rRNA sequencing; Empyema thoracis; Imipenem-resistant; Nocardia abscessus