Dual disseminated infection with Nocardia farcinica and Mucor in a patient with systemic lupus erythematosus: a case report

Journal of Medical Case Reports

Johan Decruyenaere¹  Piet Cools²  Geert Claeys²  Arnika Hugel³  Patrick Druwé¹  Dominque Benoit¹  Pieter Depuydt¹  Florence Van Ryckeghem⁴  Frederik de Clerck⁵ 

[1] Department of Intensive Care, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium;Department of Microbiology, Immunology and Clinical Chemistry, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium;Department of Pathology, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium;Department of Medical Oncology, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium;Department of Gastroenterology and Hepatology, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium

关键词: Systemic lupus erythematosus;    Nocardia;    Mucormycosis;    Mucor;    Infection;   

Others  :  1180977
DOI  :  10.1186/1752-1947-8-376

 received in 2014-04-08, accepted in 2014-09-23,  发布年份 2014

【 摘 要 】

Introduction

Infections remain a major cause of morbidity and mortality in immunocompromised patients and require early diagnosis and treatment. However, correct diagnosis and treatment are often delayed by a multitude of factors. We report what we believe to be the first case of a combined disseminated infection with Nocardia and Mucor in a patient with systemic lupus erythematosus.

Case presentation

A 74-year-old Caucasian woman with systemic lupus erythematosus presented with recurrent pneumonia. Despite empirical treatment with antibiotics, her condition gradually deteriorated. Microbiological sampling by thoracoscopy revealed the presence of Nocardia. Despite the institution of therapy for disseminated nocardiosis, she died of multi-organ failure. A post-mortem investigation confirmed nocardiosis, but showed concomitant disseminated mucormycosis infection as well.

Conclusion

Members of the bacterial genus Nocardia and the fungal genus Mucor are ubiquitous in the environment, have the ability to spread to virtually any organ, and are remarkably resistant to appropriate therapy. Both pathogens can mimic other pathologies both on clinical and radiological investigations. Invasive sampling procedures are often needed to prove their presence. Establishing a timely, correct diagnosis and a specific treatment is essential for patient survival.

【 授权许可】

   
2014 de Clerck et al.; licensee BioMed Central Ltd.

【 图 表 】

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