Mitwalli Hussam, Alekrish Yazeed, Nafisah Faris, Alkhamshi Abdullah
Division of Rheumatology, Department of Medicine, College of Medicine, King Saud University, Riyadh, SAU.
Department of Medicine, College of Medicine, King Saud University, Riyadh, SAU.
Cureus. 2024 Jun 14;16(6):e62396. doi: 10.7759/cureus.62396. eCollection 2024 Jun.
Deficiency in interleukin-12 (IL-12) can result in susceptibility to opportunistic infection, with IL-12 deficiency being a rare genetic cause. is a gram-positive aerobic actinomycete that can cause disseminated and potentially lethal nocardiosis in immunocompromised patients. This report describes a 16-year-old male adolescent with IL-12 deficiency presenting with generalized lymphadenopathy due to disseminated The subject of our study is a male adolescent who exhibited clinical manifestations consistent with cholestasis. He underwent extensive workup for malignancy, suspecting cholangiocarcinoma initially. The workup turned out unremarkable, and later during his hospital stay, he deteriorated and required intensive care unit (ICU) admission, as he developed superior vena cava (SVC) syndrome from massive enlargement of mediastinal and cervical lymph nodes. During the patient's admission, it was found that he had a deficiency of interleukin-12 (IL-12). Later on, a blood culture revealed the presence of species. Subsequently, the patient was initiated and improved drastically on an empirical antibiotic regimen consisting of amikacin, co-trimoxazole, meropenem, and moxifloxacin. Following that, the susceptibility results came out, and he was switched to oral co-trimoxazole and oral moxifloxacin as he no longer required inpatient care. This report highlights the importance of accurate diagnosis of causes of immunosuppression and early investigation, diagnosis, and management of potentially fatal opportunistic infections such as disseminated
白细胞介素-12（IL-12）缺乏可导致易患机会性感染，IL-12缺乏是一种罕见的遗传病因。诺卡菌是一种革兰氏阳性需氧放线菌，可在免疫功能低下的患者中引起播散性且可能致命的诺卡菌病。本报告描述了一名16岁的男性青少年，因IL-12缺乏而出现播散性诺卡菌病导致全身淋巴结肿大。我们研究的对象是一名男性青少年，他表现出与胆汁淤积相符的临床表现。他接受了针对恶性肿瘤的广泛检查，最初怀疑是胆管癌。检查结果无异常，后来在他住院期间，他病情恶化，因纵隔和颈部淋巴结大量肿大导致上腔静脉（SVC）综合征而需要入住重症监护病房（ICU）。在患者住院期间，发现他缺乏白细胞介素-12（IL-12）。后来，血培养显示存在诺卡菌属菌种。随后，患者开始接受由阿米卡星、复方新诺明、美罗培南和莫西沙星组成的经验性抗生素治疗方案，并大幅好转。之后，药敏结果出来了，由于他不再需要住院治疗，改为口服复方新诺明和口服莫西沙星。本报告强调了准确诊断免疫抑制原因以及对潜在致命的机会性感染（如播散性诺卡菌病）进行早期调查、诊断和管理的重要性。
