Prednisolone
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Disseminated nocardiosis caused by Nocardia farcinica infection: case report A 52-year-old man developed a Nocardia farcinica infection causing disseminated nocardiosis during treatment with prednisolone for systemic lupus erythematosus. The man had received prednisolone 40 mg/day for 1 month and then tapered to 20 mg/day over 6 months [route not stated]. He developed a subcutaneous nodule on his left flank [time to reaction onset not stated]. Further subcutaneous nodules appeared on his trunk and left leg within 2 months; he also had muscle pain in his left lower thigh area. Examination revealed a tender erythematous mass in the left femoral area with CT scan showing a hypodense, spherical muscle lesion in the left rectus femoris muscle. A brain MRI scan showed brain abscesses. His muscular and subcutaneous abscesses were drained yielding a thick, yellow pus. Gram-staining revealed filamentous Gram-positive rod-shaped bacteria, confirmed as N. farcinica. A disseminated nocardiosis caused by N. farcinica was diagnosed. The man received cotrimoxazole [trimethoprim/ sulfamethoxazole] and imipenem and responded well. Imipenem was continued for 4 weeks and after discharge, he was treated with cotrimoxazole for 10 more months. His brain lesions had healed at 2.5 months. Hara H, et al. Disseminated nocardia farcinica infection in a patient with systemic lupus erythematosus. Journal of Medical Microbiology 60: 847-850, No. 6, Jun 2011. Available from: URL: http://dx.doi.org/10.1099/jmm.0.025577-0 803057064 Japan
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Reactions 16 Jul 2011 No. 1360
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