Successful rescue of disseminated Nocardia infection with multiple abscesses in a patient with membranous nephropathy after cardiopulmonary resuscitation:A three-year follow-up
Yili Xu1
Hanyang Qian2
Wen Qian3
Li Dong4
Weiying Liu5
Yan Zhu5
Yaning Mei6
Yi Xu3
Ling Wang1
Yi Xia7
Xu Qi7
Huanping Mei8
Xueqiang Xu1
Huijuan Mao1
Changying Xing1
Ningning Wang1
1.Department of Nephrology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China2.Department of Nephrology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China;Department of Nephrology,Nanjing Tongren Hospital,Nanjing,Jiangsu 211102,China3.Department of Image,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China4.Department of Infectious Disease,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China5.Department of Nephrology,the Second Hospital of Nanjing,Nanjing,Jiangsu 210029,China6.Department of Microorganism,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China7.Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China8.Department of Rheumatology and Immunology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China
摘要：Nocardiosis manifests as an opportunistic infection,primarily affecting individuals who are immunocompromised and susceptible to the infection.We present a case study of one patient with nephrotic syndrome and membranous nephropathy,who underwent treatment with prednisone and cyclosporine in 2016.In early 2017,the patient was diagnosed with a"fungal infection"and discontinued the use of cyclosporine.After one month of anti-infection therapy,a cranial magnetic resonance imaging scan showed multiple abscesses in the right temporal region.The diagnosis of nocardiosis was confirmed based on the presence of metastatic abscess masses,multiple lung and brain lesions,and a positive culture of Nocardia in the drainage.We changed the anti-infection therapy to a combination of trimethoprim-sulfamethoxazole(TMP-SMX),minocycline,and voriconazole.However,the patient experienced a sudden cardiac arrest and subsequently recovered after cardiopulmonary resuscitation.During the five-month follow-up period following the discharge,the patient displayed an enhanced nutritional status and stable renal function.The focal infection ultimately resolved during the subsequent three years.Neuro-infection caused by Nocardia should be considered in immunocompromised patients,and TMP-SMX is the preferred initial therapy;however,because of the high mortality rate,a long-term combination therapy with imipenem,cefotaxime,amikacin,and TMP-SMX is suggested.
机标关键词：nocardiapatientafterwithabscessescardiopulmonarydisseminatedfollow-up
分类号：R692(泌尿科学（泌尿生殖系疾病）)
论文发表日期：2024-03-30
在线出版日期：2026-03-31（本平台首次上网日期，不代表文献的发表时间）
页数：7( 中插6,189-194 )
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