Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Med Mycol. 2011 Aug;49(6):662-6. doi: 10.3109/13693786.2011.555849. Epub 2011 Feb 2.
A 42-year-old man with polychondritis and a 2-year history of using low-dose prednisone and other immunosuppressive drugs was admitted to our hospital due to persistent high fever of 10 days duration. A strain of Nocardia was twice isolated from his blood and subsequently identified to be N. concava. The patient was initially treated with sulphadiazine sodium, vancomycin and imipenema for 7 days but the symptoms persisted. Consequently, the regimen was changed to sulphadiazine sodium, ciprofloxacin and amikacin sulfate based on the antibiotic susceptibility tests of the Nocardia isolate. The fever disappeared and the patient's condition improved after 10 days of this treatment to the extent that he was discharged. However, 7 days later, the patient's condition deteriorated and he died due to multiple organ failure. This is the first report of N. concava causing systemic nocardiosis in China.
一位 42 岁的男性，患有多软骨炎，病史 2 年，一直使用小剂量泼尼松和其他免疫抑制剂。因持续高热 10 天，他被收入我院。该患者血液中两次分离出一株奴卡菌，随后鉴定为凹形诺卡菌。患者最初接受磺胺嘧啶钠、万古霉素和亚胺培南治疗 7 天，但症状持续存在。因此，根据奴卡菌分离株的药敏试验，将方案改为磺胺嘧啶钠、环丙沙星和硫酸阿米卡星。经过 10 天的治疗，患者体温下降，病情改善，出院。然而，7 天后，患者病情恶化，因多器官功能衰竭而死亡。这是中国首例凹形诺卡菌引起的全身奴卡菌病的报告。
