Cargando…

Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review

The increased use of novel and powerful immunosuppressive drugs in kidney diseases may concomitantly expose the patients to higher risk of opportunistic infections, some of which still remain underdiagnosed thus mishandled. As such, we recently had a less prepared encounter of pulmonary nocardial in...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Tao, Jia, Yun, Chu, Bao, Liu, HongTao, Dong, XiaoLi, Zhang, Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ivyspring International Publisher 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643105/
https://www.ncbi.nlm.nih.gov/pubmed/31337957
http://dx.doi.org/10.7150/ijms.32440
_version_ 1783437072269312000
author Wang, Tao
Jia, Yun
Chu, Bao
Liu, HongTao
Dong, XiaoLi
Zhang, Yan
author_facet Wang, Tao
Jia, Yun
Chu, Bao
Liu, HongTao
Dong, XiaoLi
Zhang, Yan
author_sort Wang, Tao
collection PubMed
description The increased use of novel and powerful immunosuppressive drugs in kidney diseases may concomitantly expose the patients to higher risk of opportunistic infections, some of which still remain underdiagnosed thus mishandled. As such, we recently had a less prepared encounter of pulmonary nocardial infection in an ANCA-associated renal vasculitis patient under steroid therapy. Despite the use of broad-spectrum antimicrobials including micafungin, the infection was still unbridled and eventually culminated in lethal brain abscess. We thus chose to renew the knowledge of the clinical features, imaging manifestations, differential diagnosis, specific laboratory tests and unique treatment about this rare infection in kidney diseases patients under immunosuppressive therapy. In addition, CT images of easily confused pulmonary lesions superimposed on kidney diseases were also retrieved from our depository. Moreover, impaired renal function as a risk factor for infection and pharmacological options for the treatment were also focused. By sharing our hard-learnt experience and reviewing the literatures, our report may contribute to the awareness among the clinicians in general and nephrologists in particular of this rare disease in susceptible patients and facilitate a swift thus life-saving treatment.
format Online
Article
Text
id pubmed-6643105
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Ivyspring International Publisher
record_format MEDLINE/PubMed
spelling pubmed-66431052019-07-23 Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review Wang, Tao Jia, Yun Chu, Bao Liu, HongTao Dong, XiaoLi Zhang, Yan Int J Med Sci Review The increased use of novel and powerful immunosuppressive drugs in kidney diseases may concomitantly expose the patients to higher risk of opportunistic infections, some of which still remain underdiagnosed thus mishandled. As such, we recently had a less prepared encounter of pulmonary nocardial infection in an ANCA-associated renal vasculitis patient under steroid therapy. Despite the use of broad-spectrum antimicrobials including micafungin, the infection was still unbridled and eventually culminated in lethal brain abscess. We thus chose to renew the knowledge of the clinical features, imaging manifestations, differential diagnosis, specific laboratory tests and unique treatment about this rare infection in kidney diseases patients under immunosuppressive therapy. In addition, CT images of easily confused pulmonary lesions superimposed on kidney diseases were also retrieved from our depository. Moreover, impaired renal function as a risk factor for infection and pharmacological options for the treatment were also focused. By sharing our hard-learnt experience and reviewing the literatures, our report may contribute to the awareness among the clinicians in general and nephrologists in particular of this rare disease in susceptible patients and facilitate a swift thus life-saving treatment. Ivyspring International Publisher 2019-06-02 /pmc/articles/PMC6643105/ /pubmed/31337957 http://dx.doi.org/10.7150/ijms.32440 Text en © Ivyspring International Publisher This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
spellingShingle Review
Wang, Tao
Jia, Yun
Chu, Bao
Liu, HongTao
Dong, XiaoLi
Zhang, Yan
Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review
title Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review
title_full Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review
title_fullStr Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review
title_full_unstemmed Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review
title_short Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review
title_sort nocardiosis in kidney disease patients under immunosuppressive therapy: case report and literature review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643105/
https://www.ncbi.nlm.nih.gov/pubmed/31337957
http://dx.doi.org/10.7150/ijms.32440
work_keys_str_mv AT wangtao nocardiosisinkidneydiseasepatientsunderimmunosuppressivetherapycasereportandliteraturereview
AT jiayun nocardiosisinkidneydiseasepatientsunderimmunosuppressivetherapycasereportandliteraturereview
AT chubao nocardiosisinkidneydiseasepatientsunderimmunosuppressivetherapycasereportandliteraturereview
AT liuhongtao nocardiosisinkidneydiseasepatientsunderimmunosuppressivetherapycasereportandliteraturereview
AT dongxiaoli nocardiosisinkidneydiseasepatientsunderimmunosuppressivetherapycasereportandliteraturereview
AT zhangyan nocardiosisinkidneydiseasepatientsunderimmunosuppressivetherapycasereportandliteraturereview