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Pulmonary and cutaneous infection caused by Nocardia farcinica in a patient with nephrotic syndrome: A case report.

Abstract Nocardia species is known as conditional pathogenic bacteria. Disseminated infection caused by Nocardia species is rare and occurs primarily in immunosuppressed patients. Signs and symptoms of this infection are frequently nonspecific making early diagnosis and treatment difficult.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28614268
OWN - NLM
STAT- MEDLINE
DA  - 20170614
DCOM- 20170706
LR  - 20170706
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 24
DP  - 2017 Jun
TI  - Pulmonary and cutaneous infection caused by Nocardia farcinica in a patient with 
      nephrotic syndrome: A case report.
PG  - e7211
LID - 10.1097/MD.0000000000007211 [doi]
AB  - RATIONALE: Nocardia species is known as conditional pathogenic bacteria.
      Disseminated infection caused by Nocardia species is rare and occurs primarily in
      immunosuppressed patients. Signs and symptoms of this infection are frequently
      nonspecific making early diagnosis and treatment difficult. PATIENT CONCERNS: We 
      report a case of subcutaneous and pulmonary nocardiosis due to Nocardia farcinica
      (N farcinica) in a patient with nephrotic syndrome who is undergoing long-term
      corticosteroid therapy. In this patient, systemic and pulmonary symptoms (usually
      found in nocaria infection) such as fever, cough, and expectoration were absent. 
      DIAGNOSES: Early diagnosis was made by pus culture from subcutaneous abscesses
      and 16S rRNA gene sequencing, which confirm the diagnosis of N farcinica
      infection. INTERVENTIONS: The patient was treated with combination therapy of
      cefatriaxone and trimethoprim-sulfamethoxazole (TMP-SMX) for 2 weeks, and the
      treatment with TMP-SMX continued to 6 months. OUTCOMES: The abscesses were cured 
      in 4 weeks and a lesion in the upper lobe of left lung resolved in 3 months.
      LESSONS: This case indicates that disseminated infection due to N farcinica could
      occur in patients with nephrotic syndrome, even during the period of maintenance 
      therapy with a low-dose corticosteroid and common signs and symptoms of
      infections could be absent.
FAU - Zhu, Ning
AU  - Zhu N
AD  - aDepartment of Cardiology bDepartment of Nephrology, The Third Clinical College
      of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, Zhejiang
      Province, PR China.
FAU - Zhu, Yuan
AU  - Zhu Y
FAU - Wang, Yi
AU  - Wang Y
FAU - Dong, Shaoshao
AU  - Dong S
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Immunosuppressive Agents)
SB  - AIM
SB  - IM
MH  - Adrenal Cortex Hormones/adverse effects/therapeutic use
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Early Diagnosis
MH  - Humans
MH  - Immunosuppressive Agents/adverse effects/therapeutic use
MH  - Lung Diseases/*complications/diagnosis/drug therapy
MH  - Male
MH  - Middle Aged
MH  - Nephrotic Syndrome/*complications/drug therapy
MH  - Nocardia Infections/*complications/diagnosis/drug therapy
MH  - Skin Diseases, Bacterial/*complications/diagnosis/drug therapy
PMC - PMC5478353
EDAT- 2017/06/15 06:00
MHDA- 2017/07/07 06:00
CRDT- 2017/06/15 06:00
AID - 10.1097/MD.0000000000007211 [doi]
AID - 00005792-201706160-00054 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jun;96(24):e7211. doi: 10.1097/MD.0000000000007211.