Journal of Postgraduate Medicine, Education and Research

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VOLUME 56 , ISSUE 3 ( July-September, 2022 ) > List of Articles

CASE REPORT

Disseminated Nocardiosis in a Patient with Steroid-dependent Nephrotic Syndrome

Jasmine Sethi, Tom Kakkanattu, Harbir Singh Kohli

Keywords : Brain abscess, Nephrotic syndrome, Nocardiosis

Citation Information : Sethi J, Kakkanattu T, Kohli HS. Disseminated Nocardiosis in a Patient with Steroid-dependent Nephrotic Syndrome. J Postgrad Med Edu Res 2022; 56 (3):129-130.

DOI: 10.5005/jp-journals-10028-1576

License: CC BY-NC 4.0

Published Online: 01-10-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: We aim to describe an unusual case of disseminated nocardiosis in a patient with steroid-dependent nephrotic syndrome and its successful management with medical therapy alone. Background: Nocardia infection is uncommon in clinical practice, with most cases occurring as the result of opportunistic infection in immunocompromised patients. Here, we report a case of disseminated nocardiosis with brain abscesses in a patient with nephrotic syndrome. Case description: We report a middle-aged female with steroid-dependent nephrotic syndrome with disseminated nocardiosis. The patient was managed with imipenem/cilastatin, oral trimethoprim/sulfamethoxazole (TMP/SMX), and amikacin for 4 weeks followed by dual therapy with co-amoxiclav and TMP/SMX for 6 months. The patient had both clinical and radiological recovery. Clinical significance: The present case indicates the risk of life-threatening infection in patients receiving steroids and the need for prophylactic therapy to prevent serious infections during the course of steroid therapy.


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  1. Ambrosioni J, Lew D, Garbino J. Nocardiosis: updated clinical review and experience at a tertiary center. Infection 2010;38(2):89–97. DOI: 10.1007/s15010-009-9193-9
  2. Lerner PI. Nocardiosis. Clin Infect Dis 1996;22(6):891–895. DOI: 10.1093/clinids/22.6.891
  3. Rudramurthy SM, Honnavar P, Kaur H, et al. Molecular identification of clinical Nocardia isolates from India. J Med Microbiol 2015;64(10): 1216–1225. DOI: 10.1099/jmm.0.000143
  4. Lederman ER, Crum NF. A case series and focused review of nocardiosis: clinical and microbiologic aspects. Medicine (Baltimore) 2004;83(5):300–313. DOI: 10.1097/01.md.0000141100.30871.39
  5. Hardak E, Yigla M, Berger G, et al. Clinical spectrum and outcome of Nocardia infection: experience of 15-year period from a single tertiary medical center. Am J Med Sci 2012;343(4):286–290. DOI: 10.1097/MAJ.0b013e31822cb5dc
  6. Clark NM, Reid GE, AST Infectious Diseases Community of Practice. Nocardia infections in solid organ transplantation. Am J Transplant 2013;13(Suppl 4):83–92. DOI: 10.1111/ajt.12102
  7. Budzik JM, Hosseini M, Mackinnon AC Jr, et al. Disseminated Nocardia farcinica: literature review and fatal outcome in an immunocompetent patient. Surg Infect (Larchmt) 2012;13(3):163–170. DOI: 10.1089/sur.2011.012
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