Nocardiosis in immunosuppressed patients
Ausina, V.; Matas, L.; Coll, P.; Sambeat, M.A.; Verger, G.; Prats, G.
Medicina Clinica 84(3): 90-95
1985
ISSN/ISBN: 0025-7753 PMID: 3883070 Document Number: 251531
Five cases of opportunistic infection by Narcardia asteroides are presented. All patients were receiving steroids, 4 patients had underlying systemic disease (pemphigus vulgaris, dermatomyositis, lupus erythematosus and rheumatoid arthritis) and 1 patient had severe bronchial asthma. The disease had a pulmonary origin in all cases. N. asteroides was isolated from the sputum in 4 patients and from the selective bronchial aspirate in the 5th patient. One of the patients had an empyema and N. asteroides was also isolated from the pus which was obtained by thoracocentesis. All patients had fever and non-specific pulmonary symptoms which presented in a acute or subacute form. Two patients had disseminated nocardiosis. One of them died 72 h after having initiated treatment with co-trimoxazole; N. asteroides was isolated at autopsy from both lungs and from the pus of a cortical abscess in the right kidney. The other patient had multiple s.c. abscesses and the same microorganism was isolated from the pus of the abscesses and from 2 blood cultures. Four patients survived and all received treatment with sulfonamides (sulfadiazine or co-trimoxazole) for 3-6 mo. No relapses were detected after treatment during different follow up periods.