title: Primary Cutaneous Nocardiosis in a Patient With Nephrotic Syndrome: A Case Report and Review of the Literature.
abstract: Nocardia infection is not common in clinical practice and most cases occur as an opportunistic infection in immunocompromised patients.We report a case of primary cutaneous nocardiosis characterized by multiple subcutaneous abscesses due to Nocardia brasiliensis in a patient with nephrotic syndrome undergoing long-term corticosteroid therapy. The patient was diagnosed with nephrotic syndrome 9 months ago, and mesangial proliferative glomerulonephritis was confirmed by renal biopsy. Subsequently, his renal disease was stable under low-dose methylprednisolone (8 mg/d). All of the pus cultures, which were aspirated from 5 different complete abscesses, presented Nocardia. Gene sequencing confirmed that they were all N. brasiliensis. The patient was cured by surgical drainage and a combination of linezolid and Trimethoprim-Sulfamethoxazole.The case highlights that even during the period of maintenance therapy with low-dose corticosteroid agents, an opportunistic infection still could occur in patients with nephrotic syndrome.
authors.affiliation: From the Department of Nephrology and Rheumatology (BC, ZL, NW, XG, FW); Department of Clinical Laboratory, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China (JT).
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
authors.forename: Jin
authors.initials: J
authors.lastname: Tang
authors.forename: Zeyuan
authors.initials: Z
authors.lastname: Lu
authors.forename: Niansong
authors.initials: N
authors.lastname: Wang
authors.forename: Xuping
authors.initials: X
authors.lastname: Gao
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy; D009615:Nocardia; D009617:Nocardia Infections / Q000175:diagnosis / Q000209:etiology*
chemical_list: D000305:Adrenal Cortex Hormones
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