pISSN 2093-2340   eISSN 2092-6448
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    Infect Chemother. 2011 Aug;43(4):367-371. Korean.
    Published online Aug 31, 2011.
    https://doi.org/10.3947/ic.2011.43.4.367
    Copyright © 2011 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy
    Case Report

    A Case of Disseminated Nocardiosis by Nocardia brasiliensis after Steroid Injection

    Na Ra Yun,1 Hee Jeong Lee,1 Su Jin Hong,1 Jun Lee,1 Dong-Min Kim,1 Sook Jin Jang,2 and Ran Hong3
      • 1Department of Internal Medicine, Chosun University, School of Medicine, Gwangju, Korea.
      • 2Department of Laboratory Medicine, Chosun University, School of Medicine, Gwangju, Korea.
      • 3Department of Pathology, Chosun University, School of Medicine, Gwangju, Korea.
    • Correspondence to Dong-Min Kim, M.D. Department of Internal Medicine, Chosun University, School of Medicine, 588, Seosuk-dong, Dong-gu, Gwangju 501-717, Korea. Tel: +82-62-220-3093, Fax: +82-62-234-9653, Email: drongkim@chosun.ac.kr
    Received March 28, 2011; Revised May 04, 2011; Accepted May 20, 2011.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Nocardiosis in the immunocompromised host is a rare but life-threatening infection. Nocardia farcinica and N. asteroides have been reported as the most common causative pathogens of disseminated nocardiosis. It is well known that infection of N. brasiliensis can cause cutaneous nocardiosis mainly, but is rarely known to cause disseminated nocardiosis. We report a case of disseminated nocardiosis by N. brasiliensis. A 68-year-old male subject with no underlying disease developed painful swelling on both lower legs, as well as dyspnea. He was diagnosed with intramuscular abscess, pneumonia and brain abscess by N. brasiliensis. He underwent incision and drainage for intramuscular abscess, as well as antibiotic therapy, and was successfully treated.

    Keywords
    Nocardiosis; Disseminated; Steroid injection; N. brasiliensis

    Figures

    Figure 1
    Chest CT scan shows (A) Focal consolidation in the left upper lobe (1st day of admission). (B) Nearly resoluted lesions (21 days of treatment).

    Figure 2
    Tibia MRI shows wall enhanced fluid collections at medial heads of both gastrocnemius muscles.

    Figure 3
    (A) Lung biopsy shows accumulation of amorphous periodic acid-Schiff (+) eosinophilic material in the alveolar lumina (PAS, ×100), (B) Skin biopsy shows exuberant abscess with long, slender, and filametous rods (Grocott's methenamine silver (GMS), ×400).

    Figure 4
    Brain MRI shows. (A) Ill-defined mass lesion with multiple rim enhancements in the right cerebellar hemisphere and both parietal lobes, (B) Lesion improved on the 90 days after start of treatment.

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    MeSH Terms
    Abscess
    Aged
    Brain Abscess
    Drainage
    Dyspnea
    Humans
    Immunocompromised Host
    Leg
    Male
    Nocardia
    Nocardia Infections
    Pneumonia
    Metrics
    Share
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