Nocardia asteroides Pneumonia, Subcutaneous Abscess and Meningitis in a Patient with Advanced Malignant Lymphoma. Successful Treatment Based on In Vitro Antimicrobial Susceptbility.

Abstract

Nocardia asteroides pneumonia,subcutaneousabscess and meningitis without brain abscesses developed in a patient with advanced non-Hodgkin's lymphoma, who had received corticosteroid therapy and cancer chemotherapy for a long time. At the time of nocardial pneumonia, profound lymphocytopenia and hypogammaglobulinemiawas seen. The severely immunosuppressed condition most likely accounted for the uncommoninfection, nocardiosis. The organism isolated from the sputum, subcutaneous abscess and cerebrospinal fluid was strongly resistant to cotrimoxazole, which is the recommended standard treatment, but it was susceptible to imipenem (IPM) and erythromycin (EM) in an in vitro antimicrobial susceptibility study. The patient's nocardiosis responded well to chemotherapy including IPM and EM. (Internal Medicine 38: 683-686, 1999)

A case of nocardiasis complicated with meningitis in a patient with immune thrombocytopenic purpura

“…Formerly, Ando et al and Cokkinos et al [5,6] have reported pure pulmonary nocardiosis in ITP patients. However, this is the first report about nocardial meningitis in an ITP patient and in the English language literature, there are only a few reported non-ITP cases about isolated nocardial meningitis [7][8][9][10][11][12].…”

Pulmonary Nocardiosis in a Non-Hodgkin's Lymphoma Patient

“…Nocardia species cause invasive infections, especially in patients with immunodeficiency such as patients with lymphoreticular malignancies and those receiving corticosteroids or antineoplastic chemotherapy [1,3,5]. Suppression of cellular immunity appears to play a key role in the establishment of nocardial infection.…”

“…Pulmonary nocardiosis is a severe infection especially in immunocompromised patients. Few cases have been reported in lymphoma patients so far [1][2][3]. Although trimethoprim-sulfamethoxazole (TMP/SMZ) is regarded as the drug of choice, failure has been reported and the duration of therapy required is not well defined [4].…”