Feng Yin-Hsun, Huang Wen-Tsung, Tsao Chao-Jung
Division of Hemato-oncology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
J Chin Med Assoc. 2004 Aug;67(8):416-8.
Nocardia infection occurs primarily among patients with deficient cell-mediated immunity. The portal of entry in the majority of patients with Nocardia infection is pulmonary origin. Central venous catheter-associated bacteremia caused by Nocardia species is very rare, and the optimal management for these situations was indeterminate. Most patients were cured after discontinuation of central venous catheter and prolonged antibiotics use. Thereafter, we reported an 18-year-old male who received chemotherapy for his nasal rhabdomyosarcoma had central venous catheter-associated N. asteroids bacteremia. The outcome was satisfying after discontinuation of central venous catheter followed by short-term antibiotics. Conclusively, prolonged antibiotics may not be necessary in catheter-associated Nocardia bacteremia without distant metastatic site after removal of catheter.
诺卡菌感染主要发生在细胞介导免疫功能缺陷的患者中。大多数诺卡菌感染患者的感染途径源自肺部。诺卡菌属引起的中心静脉导管相关菌血症非常罕见,对于这些情况的最佳治疗方法尚无定论。大多数患者在拔除中心静脉导管并长期使用抗生素后治愈。此后,我们报告了一名18岁男性,他因鼻横纹肌肉瘤接受化疗,发生了中心静脉导管相关的星形诺卡菌菌血症。拔除中心静脉导管并短期使用抗生素后,结果令人满意。总之,对于拔除导管后无远处转移部位的导管相关诺卡菌菌血症,可能无需长期使用抗生素。