Iwazu Kana, Iwazu Yoshitaka, Takeda Shin-ichi, Akimoto Tetsu, Yumura Wako, Takahashi Hideaki, Ito Chiharu, Kanai Kuniyuki, Taniguchi Nobuyuki, Hirai Yoshikazu, Kusano Eiji
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
Intern Med. 2012;51(21):3051-6. doi: 10.2169/internalmedicine.51.7886. Epub 2012 Nov 1.
We herein present a case of serial opportunistic infections that included disseminated nocardiosis and cryptococcal meningitis in a 67-year-old man who was diagnosed with ANCA-associated vasculitis and treated with corticosteroids. Upon admission, the initial manifestations of the disease included subcutaneous tumors and multiple lesions in the brain and lungs. Nocardia farcinica was identified in a culture of the aspirated pus. The patient was successfully treated for disseminated nocardiosis with antibiotics. However, three months after discharge, he was hospitalized with complaints of nuchal pain. Cryptococcus neoformans was identified on a culture of the cerebrospinal fluid. Anti-fungal treatment resulted in the remission of cryptococcal meningitis.
我们在此报告一例67岁男性患者，其患有与抗中性粒细胞胞浆抗体（ANCA）相关的血管炎并接受了皮质类固醇治疗，出现了一系列机会性感染，包括播散性诺卡菌病和隐球菌性脑膜炎。入院时，该疾病的初始表现包括皮下肿瘤以及脑和肺部的多处病变。在吸出的脓液培养物中鉴定出了鼻疽诺卡菌。患者通过抗生素成功治疗了播散性诺卡菌病。然而，出院三个月后，他因颈部疼痛住院。在脑脊液培养物中鉴定出新型隐球菌。抗真菌治疗使隐球菌性脑膜炎得到缓解。
