Pulmonary nocardiosis in patients with connective tissue disease: A report of two cases

Shinya Hagiwara; Hiroto Tsuboi; Chihiro Hagiya; Masahiro Yokosawa; Tomoya Hirota; Hiroshi Ebe; Hiroyuki Takahashi; Hiroshi Ogishima; Hiromitsu Asashima; Yuya Kondo; Naoto Umeda; Takeshi Suzuki; Shigemi Hitomi; Isao Matsumoto; Takayuki Sumida

doi:10.5582/irdr.3.25

Case Reports

Pulmonary nocardiosis in patients with connective tissue disease: A report of two cases

Shinya Hagiwara, Hiroto Tsuboi, Chihiro Hagiya, Masahiro Yokosawa, Tomoya Hirota, Hiroshi Ebe, Hiroyuki Takahashi, Hiroshi Ogishima, Hiromitsu Asashima, Yuya Kondo, Naoto Umeda, Takeshi Suzuki, Shigemi Hitomi, Isao Matsumoto, Takayuki Sumida

Author information

Shinya Hagiwara
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Hiroto Tsuboi
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Chihiro Hagiya
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Masahiro Yokosawa
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Tomoya Hirota
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Hiroshi Ebe
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Hiroyuki Takahashi
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Hiroshi Ogishima
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Hiromitsu Asashima
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Yuya Kondo
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Naoto Umeda
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Takeshi Suzuki
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Shigemi Hitomi
Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba
Isao Matsumoto
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba
Takayuki Sumida
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba

Keywords: Connective tissue disease, immunosuppressive therapy, nocardia, pulmonary nocardiosis

JOURNAL FREE ACCESS

2014 Volume 3 Issue 1 Pages 25-28

DOI https://doi.org/10.5582/irdr.3.25

Details

Abstract

Reported here are 2 patients with connective tissue disease who developed pulmonary nocardiosis. Case 1 involved a 73-year-old man with malignant rheumatoid arthritis treated with prednisolone 25 mg/day. Chest X-rays revealed a pulmonary cavity and bronchoscopy detected Nocardia species. The patient was successfully treated with trimethoprim/sulfamethoxazole. Case 2 involved a 41-year-old woman with systemic lupus erythematosus. The patient received remission induction therapy with 50 mg/day of prednisolone and tacrolimus. Six weeks later, a chest CT scan revealed a pulmonary cavity; bronchoscopy resulted in a diagnosis of pulmonary nocardiosis. The patient had difficulty tolerating trimethoprim/sulfamethoxazole, so she was switched to and successfully treated with imipenem/cilastatin and amikacin.

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