1. Clinical features and successful recovery from disseminated nocardiosis after BMT
- Author
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M. C. A. Macedo, A C M Silva, C M Massumoto, Jussara Bianchi Castelli, Frederico Luiz Dulley, M. Ostronoff, Dalton de Alencar Fischer Chamone, E Zambon, and Clarisse Martins Machado
- Subjects
Male ,medicine.medical_specialty ,Sulfamethoxazole ,medicine.medical_treatment ,Anti-Infective Agents, Urinary ,Graft vs Host Disease ,Nocardia Infections ,Lung biopsy ,Nocardia ,Trimethoprim ,medicine ,Humans ,Brain abscess ,Bone Marrow Transplantation ,Transplantation ,Chemotherapy ,business.industry ,Nocardiosis ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Anti-Bacterial Agents ,surgical procedures, operative ,Actinomycosis ,Complication ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
Nocardiosis has rarely been described after BMT. When the doses of immunosuppressive therapy were tapered, a 46-year-old BMT recipient developed chronic graft-versus-host disease (GVHD) and immunosuppressive drugs were increased. Sixteen days later the patient developed nocardiosis diagnosed by lung biopsy. Trimethoprim/sulfamethoxazole (TMP/SMZ) was initiated but the doses were reduced because of rising creatinine levels. Skin and cerebral dissemination of nocardiosis was observed and TMP/SMZ doses were increased. After 4 months, the brain lesion was unaltered despite resolution of pulmonary lesions. Clinical improvement was observed after drainage of the brain abscess.
- Published
- 1997