Pulmonary nocardiosis due to nocardia farcinica in a renal transplant recipient.
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Date
2009-10
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Abstract
Nocardia farcinica is an infrequent cause of nocardiosis among the renal transplant recipients and it has not been reported so far from India. We report a case of pulmonary nocardiosis due to N. farcinica in a 32-year-old woman with hypothyroidism and post-renal transplant status, currently on immunosuppressive therapy (prednisolone, azathioprine and tacrolimus). The N. farcinica isolate was susceptible to trimethoprim-sulfamethoxazole (TMP-SMZ), linezolid, imipenem, gentamicin but
resistant to ceftriaxone, ciprofloxacin, tobramycin, erythromycin, amoxycillin-clavulanic acid and tetracycline. Treatment
with TMP-SMZ and linezolid resulted in marked clinico-radiological improvement but after two weeks both of the drugs had to be stopped due to severe pancytopenia as adverse effect of their use. Currently, the patient is on imipenem and remains stable after four weeks of treatment. In N. farcinica infections, multi antibiotic resistance and toxicity of some specific
drugs enhances the risk of therapeutic failure in renal transplant recipients.
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Keywords
Nocardiosis, Nocardia farcinica, Renal transplantation, Chemotherapy, Trimethoprim-Sulfamethoxazole, Linezolid
Citation
Gowrinath K, Baig Waqas Wahid, Prabhu Attur Ravindra, Chawla Kiran, Bairy Indira. Pulmonary nocardiosis due to nocardia farcinica in a renal transplant recipient. The Indian Journal of Chest Diseases and Allied Sciences, 2009 Oct; 51(4): 237-239.