King C T, Chapman S W, Butkus D E
Department of Medicine, University of Mississippi Medical Center, Jackson 39208.
South Med J. 1993 Feb;86(2):225-8. doi: 10.1097/00007611-199302000-00018.
As the case presented here illustrates, nocardiosis, like other infections in which cell-mediated immunity plays a large defensive role, can relapse after apparent cure and occasionally at times remote from the original infection. Although relapse in patients with transplants has been cited as a reason for continued prophylaxis, only a few of these cases are adequately documented. This case supports the advice of those authors who give suppressive antibiotic therapy for the duration of immunosuppression in transplant recipients recovering from infections due to Nocardia sp. Alternatively, many transplant centers are routinely using TMP/SMX chemoprophylaxis in all solid organ transplantations to prevent opportunistic infections with Pneumocystis and Listeria sp. Primary prophylaxis has also been associated with a decreased incidence of nocardial infections.
正如这里所呈现的病例所示，诺卡菌病与其他细胞介导免疫起主要防御作用的感染一样，在看似治愈后可能会复发，偶尔在远离原发感染的时间也会复发。虽然移植患者的复发被引述为持续预防的一个原因，但这些病例中只有少数有充分的记录。本病例支持了一些作者的建议，即在因诺卡氏菌属感染而康复的移植受者免疫抑制期间给予抑制性抗生素治疗。另外，许多移植中心在所有实体器官移植中常规使用复方新诺明进行化学预防，以预防卡氏肺孢子虫和李斯特菌属的机会性感染。一级预防也与诺卡菌感染发病率的降低有关。
