Toukap A N, Hainaut P, Moreau M, Pieters T, Noirhomme P, Gigi J
Service de Médecine Interne Générale, Cliniques-Universitaires St Luc, Bruxelles, Belgium.
Acta Clin Belg. 1996;51(3):161-5. doi: 10.1080/17843286.1996.11718505.
We report a case of acute pleuropulmonary nocardial infection in a 24-year-old woman suffering from systemic lupus erythematosus. In most instances, No-cardia asteroides is an opportunistic pathogen. In our patient, the infection was facilitated by systemic lupus erythematosus and chronic use of corticosteroids and immunosuppressive drugs. N. asteroides was cultured from both pleural effusion and blood. No extrathoracic location was found and the patient improved upon intravenous antibiotics and pleural drainage. Owing to the poor tolerance of trimethoprim/sulfamethoxazole, the patient was treated successfully with imipenem. The predisposing factors, the clues to the diagnosis and the therapy of nocardiosis are briefly reviewed.
我们报告一例24岁患有系统性红斑狼疮的女性急性胸膜肺诺卡菌感染病例。在大多数情况下，星形诺卡菌是一种机会致病菌。在我们的患者中，系统性红斑狼疮以及长期使用皮质类固醇和免疫抑制药物促使了感染的发生。从胸腔积液和血液中均培养出星形诺卡菌。未发现胸外感染部位，患者经静脉使用抗生素及胸腔引流后病情好转。由于患者对甲氧苄啶/磺胺甲恶唑耐受性差，故成功使用亚胺培南进行治疗。本文简要回顾了诺卡菌病的易感因素、诊断线索及治疗方法。
