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Case report of disseminated nocardiosis complicated in an elderly person with pneumoconiosis
Authors:Nakamura Shigeki  Mihara Tomo  Hitotsumatsu Tsutomu  Soejima Yoshifumi  Izumikawa Koichi  Seki Masafumi  Ohno Hideaki  Yanagihara Katsunori  Higashiyama Yasuhito  Miyazaki Yoshitsugu  Hirakata Yoichi  Tashiro Takayoshi  Kohno Shigeru
Affiliation:Department of Respiratory Medicine, National Hospital Organization Ureshino Medical Center.
Abstract:Nocardia is typically regarded as an opportunistic infection, with pulmonary nocardiosis frequently disseminated to organs hematogenous by, and nearly half of these cases resulting in complicated nocardia brain abscess. Disseminated nocardia has a dismal prognosis with high mortality, and should be checked for multiple organs including the brain when nocardiosis is diagnosed. We describe the successful treatment of nocardia brain abscesses in an immunocompetent older people with pneumoconiosis by combining trimethoprim-sulfamethoxazole and ciprofloxacin. Patients had no history of fever, headache, or respiratory symptoms such as cough, or sputum until the acute hemiplegia episode. Nocardia infection is not as rare as generally assumed and should be considered as a possibility in the elderly due to its high mortality.
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