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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. 2017
- 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.
- Subjects :
- 0301 basic medicine
Male
Pathology
medicine.medical_specialty
medicine.medical_treatment
030106 microbiology
Brain Abscess
Nocardia Infections
Lymphoma, Mantle-Cell
Opportunistic Infections
Malignancy
Multimodal Imaging
Trimethoprim
Article
Diagnosis, Differential
03 medical and health sciences
Immunocompromised Host
Fatal Outcome
Anti-Infective Agents
Sulfadoxine
Medicine
Endocarditis
Humans
Brain abscess
Aged
Chemotherapy
biology
medicine.diagnostic_test
business.industry
Brain biopsy
Mitral Valve Insufficiency
Nocardia
General Medicine
Endocarditis, Bacterial
medicine.disease
biology.organism_classification
Magnetic Resonance Imaging
Drug Combinations
Echocardiography
Mantle cell lymphoma
business
Tomography, X-Ray Computed
Rare disease
Subjects
Details
- ISSN :
- 1757790X
- Volume :
- 2017
- Database :
- OpenAIRE
- Journal :
- BMJ case reports
- Accession number :
- edsair.doi.dedup.....242b031575f92edf085cf802e5d2b446