| Successful therapy combined with surgery for severe post-transplant nocardiosis. | |
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MedLine Citation:
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PMID: 11506255 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report a case of a 35-year-old man with nocardiosis infection involving soft tissue and the central nervous system who had received a cadaveric donor kidney. The patient was admitted with fever, malaise and right shoulder pain. Soft tissue abscess was seen on ultrasound examination. It was presumed due to gram (+) microorganisms, so 4 g day (IV) ampicillin/sulbactam was started empirically once the abscess was drained. Nocardia asteroides was found in the pus specimen. On the second day in hospital, severe headache, ataxia and signs of meningeal irritation appeared. The cranial CT showed two intracranial abscesses in the frontal lobe and cerebellum. We assumed Nocardia asteroides was the infective agent for the cerebral abscesses, so antibiotic therapy was switched to trimethoprim-sulphamethox-asole (3x160/800 mg/d). Nausea and vomiting occurred on the fifth day of therapy, improving after drainage from the frontal abscess. However, these complaints recurred five days later. CT showed cerebellar abscess had become bigger. The patient's complaints improved after the second surgical drainage. N. asteroides was again grown in the aspiration fluids of both cerebral abscesses. Complete regression of the abscesses was seen in the CT after two months. Co-trimoxazole was continued for six months then withdrawn. Graft dysfunction was not observed. Early medical and surgical interventions may be life-saving in this potentially lethal disease. |
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Authors:
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S M Kayacan; A Türkmen; H Aliş; M Imer; O Barlas; S T Ecder; A Yildiz; A E Aydin; U Eldegez; M S Sever |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of nephrology Volume: 14 ISSN: 1121-8428 ISO Abbreviation: J. Nephrol. Publication Date: 2001 Jul-Aug |
Date Detail:
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Created Date: 2001-08-16 Completed Date: 2002-08-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9012268 Medline TA: J Nephrol Country: Italy |
Other Details:
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Languages: eng Pagination: 304-6 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Istanbul School of Medicine, Turkey. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Brain Abscess / therapy* Cerebellar Diseases / therapy* Combined Modality Therapy Frontal Lobe* Humans Kidney Transplantation / adverse effects* Male Nocardia Infections / therapy* Remission Induction Severity of Illness Index Soft Tissue Infections / therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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