Back to Search
Start Over
[Nocardia farcinica: life-threatening chorioiditis under systemic immunosuppression].
- Source :
-
Klinische Monatsblatter fur Augenheilkunde [Klin Monbl Augenheilkd] 2002 Mar; Vol. 219 (3), pp. 164-7. - Publication Year :
- 2002
-
Abstract
- Background: Immunosuppressed patients occasionally suffer from a multifocal infection with Nocardia. It is important to distinguish Nocardia farcinica from Nocardia asteroides, because of different sensitivity against antibiotics.<br />Patient and Methods: A 40-year-old patient with polycystic renal disease successfully underwent a kidney transplantation without complications. Immunosuppression consisted of: corticosteroids, azathioprin and ciclosporin A. Ten weeks later he developed acute choroiditis with consecutive retinal detachment and neovascular glaucoma in one eye. In addition, 14 weeks after transplantation CT scans revealed multiple cerebral abscesses.<br />Results: In the course of the disease Nocardia farcinica (N. f.) was identified by cerebral stereotactic biopsy of a cerebral lesion, histological examination of the enucleated globe and sputum culture. Histologically filamentous, eosinophilic organisms were found. Microbiology identified aerobic actinomycetes in cultures and Nocardia farcinica by PCR. Therapeutically the combination of vancomycin, ampicillin, and sulbactam was successful.<br />Conclusion: In immunosuppressed patients Nocardia farcinica can become life-threatening. One of the first manifestations may be a choroiditis. Infection of the respiratory tract followed by hematogenous spread is the common way of systemic nocardiosis. Biopsy followed by identification of species by PCR is recommended because of the specific therapeutic strategies associated with each species.
- Subjects :
- Adult
Biopsy
Brain Abscess diagnosis
Brain Abscess pathology
Cerebral Cortex pathology
Choroiditis surgery
Diagnosis, Differential
Eye Enucleation
Fluorescein Angiography
Glaucoma, Neovascular diagnosis
Glaucoma, Neovascular surgery
Humans
Immunosuppressive Agents therapeutic use
Male
Nocardia Infections surgery
Opportunistic Infections surgery
Postoperative Complications surgery
Reoperation
Retinal Hemorrhage diagnosis
Retinal Hemorrhage surgery
Choroiditis diagnosis
Graft Rejection prevention & control
Immunosuppressive Agents adverse effects
Kidney Transplantation
Nocardia Infections diagnosis
Opportunistic Infections diagnosis
Postoperative Complications diagnosis
Subjects
Details
- Language :
- German
- ISSN :
- 0023-2165
- Volume :
- 219
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Klinische Monatsblatter fur Augenheilkunde
- Publication Type :
- Academic Journal
- Accession number :
- 11987046
- Full Text :
- https://doi.org/10.1055/s-2002-26724