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Successful treatment of Nocardia pneumonia with cytomegalovirus retinitis coinfection in a renal transplant recipient
Authors:Mohan P. Patel  Vivek B. Kute  Manoj R. Gumber  Pankaj R. Shah  Himanshu V. Patel  K. L. Dhananjay  Siddharth H. Jain  Hargovind L. Trivedi  Aruna V. Vanikar
Affiliation:1. Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre [IKDRC], Dr. H. L. Trivedi Institute of Transplantation Sciences [ITS], Civil Hospital Campus, Asarwa, Ahmedabad, 380016, Gujarat, India
2. Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, IKDRC-ITS, Ahmedabad, India
Abstract:
Nocardiosis is a rare opportunistic infection, especially seen in immunocompromised patients, including renal allograft recipients. Primary pulmonary infection is the most common clinical pattern and can easily result in disseminated Nocardia infection if treatment therapy is not adequate at the beginning. We report a case of pulmonary nocardiosis associated with cytomegalovirus retinitis in a renal transplant recipient, followed by chronic allograft dysfunction. Our patient was a 50-year-old male renal allograft recipient, with diabetes mellitus and hypertension, who was diagnosed with pneumonia and cytomegalovirus retinitis. High-resolution computed tomography scan of the thorax and bronchoscopy revealed nocardial pneumonia. The patient responded well to ceftriaxone and was later switched to oral minocycline. To our knowledge, this is the first report of a successful treatment of co-infection with Nocardia pneumonia and cytomegalovirus retinitis in a renal transplant patient, with early diagnosis and prompt treatment.
Keywords:
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