Anan Tomoe, Takahashi Yasuyuki, Kimura Yuta, Tabayashi Takayuki, Kubota Yasushi
Department of Hematology, Saitama Medical University, Saitama Medical Center, Kawagoe, JPN.
Cureus. 2024 Apr 17;16(4):e58489. doi: 10.7759/cureus.58489. eCollection 2024 Apr.
infections have been reported to occur in immunocompromised patients. Early diagnosis and therapeutic intervention are especially important for disseminated nocardiosis because of its high mortality rate. A case of disseminated nocardiosis after allogeneic hematopoietic stem cell transplantation, which was promptly treated after identification of the organism by genetic analysis, is presented. A 43-year-old man was diagnosed with T-cell prolymphocytic leukemia and underwent allogeneic hematopoietic stem cell transplantation. Subsequently, during long-term prednisolone administration for chronic graft-versus-host disease, he developed mass lesions throughout his body at 1033 days after transplantation. Pus culture and genetic testing of the parotid mass showed , which improved with treatment with sulfamethoxazole, trimethoprim, and imipenem cilastatin, and there has been no recurrence. When multiple mass lesions occur after hematopoietic stem cell transplantation, and the diagnosis is difficult, disseminated nocardiosis should be included in the differential diagnosis, and appropriate laboratory testing and treatment should be performed.
据报道，免疫功能低下的患者会发生感染。由于播散性诺卡菌病死亡率高，早期诊断和治疗干预尤为重要。本文介绍了1例异基因造血干细胞移植后发生播散性诺卡菌病的病例，该病例在通过基因分析鉴定出病原体后得到了及时治疗。一名43岁男性被诊断为T细胞原淋巴细胞白血病，并接受了异基因造血干细胞移植。随后，在长期使用泼尼松龙治疗慢性移植物抗宿主病期间，他在移植后1033天全身出现肿块病变。腮腺肿块的脓液培养和基因检测显示……，经磺胺甲恶唑、甲氧苄啶和亚胺培南西司他丁治疗后病情好转，且未复发。当造血干细胞移植后出现多个肿块病变且诊断困难时，应将播散性诺卡菌病纳入鉴别诊断，并进行适当的实验室检查和治疗。
