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First reported case of disseminated Nocardia kroppenstedtii sp nov. infection presenting with brain abscess and endocarditis in an immunocompromised patient with mantle cell lymphoma: challenges in diagnosis and treatment.
- Source :
-
BMJ case reports [BMJ Case Rep] 2017 Jan 06; Vol. 2017. Date of Electronic Publication: 2017 Jan 06. - Publication Year :
- 2017
-
Abstract
- A 72-year-old man with a history of blastoid variant stage IV relapsed refractory mantle cell lymphoma presented with new central nervous system (CNS) symptoms. Brain imaging was positive for rim-enhancing lesions along with a mitral valve mass on the echocardiogram. It was a challenge to establish the exact aetiology of these lesions in this patient. He was empirically treated with chemotherapy on the presumption that the brain lesions were secondary to progressive malignancy. However, brain biopsy was negative for malignancy and blood cultures were found positive for Nocardia kroppenstedtii sp nov. He subsequently improved with antibiotic therapy. Disseminated Nocardia can present with multiorgan involvement. Clinical and microbiological diagnosis can be challenging. Antimicrobial treatment-related side effects require close monitoring, and dosage changes or therapy adjustments may be necessary.<br />Competing Interests: Conflicts of Interest: None declared.<br /> (2017 BMJ Publishing Group Ltd.)
- Subjects :
- Aged
Anti-Infective Agents therapeutic use
Brain Abscess complications
Brain Abscess drug therapy
Diagnosis, Differential
Drug Combinations
Echocardiography
Endocarditis, Bacterial drug therapy
Endocarditis, Bacterial microbiology
Fatal Outcome
Humans
Immunocompromised Host
Magnetic Resonance Imaging
Male
Mitral Valve Insufficiency diagnosis
Mitral Valve Insufficiency drug therapy
Mitral Valve Insufficiency microbiology
Multimodal Imaging
Nocardia Infections complications
Nocardia Infections drug therapy
Opportunistic Infections complications
Opportunistic Infections drug therapy
Sulfadoxine therapeutic use
Tomography, X-Ray Computed
Trimethoprim therapeutic use
Brain Abscess diagnosis
Endocarditis, Bacterial diagnosis
Lymphoma, Mantle-Cell complications
Nocardia Infections diagnosis
Opportunistic Infections diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1757-790X
- Volume :
- 2017
- Database :
- MEDLINE
- Journal :
- BMJ case reports
- Publication Type :
- Academic Journal
- Accession number :
- 28062425
- Full Text :
- https://doi.org/10.1136/bcr-2016-217337