Successful rescue of disseminated Nocardia infection with multiple abscesses in a patient with membranous nephropathy after cardiopulmonary resuscitation: A three-year follow-up
机构:[1]Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.江苏省人民医院[2]Department of Nephrology, Nanjing Tongren Hospital, Nanjing, Jiangsu 211102, China.[3]Department of Image, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.江苏省人民医院[4]Department of Infectious Disease, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.江苏省人民医院[5]Department of Nephrology, the Second Hospital of Nanjing, Nanjing, Jiangsu 210029, China.[6]Department of Microorganism, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.江苏省人民医院[7]Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.江苏省人民医院[8]Department of Rheumatology and Immunology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.江苏省人民医院
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.
基金:
The research was funded by grants from the
National Natural Science Foundation of China (Grant No. 81570666), International Society of Nephrology
Clinical Research Program (Grant No. 18-01-0247),
Program of Jiangsu Clinical Research Center (Grant
No. BL2014084), Jiangsu Province Key Medical
Personnel Project (Grant No. ZDRCA2016002), CKD
Anemia Research Foundation from China
International Medical Foundation (Grant No. Z-2017-
24-2037), and Outstanding Young and Middle-aged
Talents Support Program of the First Affiliated
Hospital of Nanjing Medical University (Jiangsu
Province Hospital).
第一作者机构:[1]Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.
共同第一作者:
通讯作者:
通讯机构:[1]Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.[*1]Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China.
推荐引用方式(GB/T 7714):
Xu Yili,Qian Hanyang,Qian Wen,et al.Successful rescue of disseminated Nocardia infection with multiple abscesses in a patient with membranous nephropathy after cardiopulmonary resuscitation: A three-year follow-up[J].JOURNAL OF BIOMEDICAL RESEARCH.2024,38(2):1-6.doi:10.7555/JBR.37.20230107.
APA:
Xu Yili,Qian Hanyang,Qian Wen,Dong Li,Liu Weiying...&Wang Ningning.(2024).Successful rescue of disseminated Nocardia infection with multiple abscesses in a patient with membranous nephropathy after cardiopulmonary resuscitation: A three-year follow-up.JOURNAL OF BIOMEDICAL RESEARCH,38,(2)
MLA:
Xu Yili,et al."Successful rescue of disseminated Nocardia infection with multiple abscesses in a patient with membranous nephropathy after cardiopulmonary resuscitation: A three-year follow-up".JOURNAL OF BIOMEDICAL RESEARCH 38..2(2024):1-6