A case of intramedullary nocardiosis in a patient after hematopoietic stem cell transplantation.
- Author:
Yi Rang KIM
1
;
Young Joo JIN
;
Donghoi KIM
;
Sang Su JUNG
;
Yong Giun KIM
;
Kyoungwon JUNG
;
Kyoo Hyung LEE
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. khlee2@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Hematopoietic stem cell transplantation;
Nocardia, Spinal cord
- MeSH:
Abscess;
Acquired Immunodeficiency Syndrome;
Defecation;
Fungi;
Hematopoietic Stem Cell Transplantation;
Hematopoietic Stem Cells;
Humans;
Lung;
Middle Aged;
Nocardia;
Nocardia Infections;
Opportunistic Infections;
Organ Transplantation;
Paraplegia;
Sodium;
Spinal Cord;
Transplants
- From:Korean Journal of Medicine
2009;77(Suppl 1):S197-S202
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Nocardiosis is uncommon in healthy people but occurs as an opportunistic infection in patients after hematopoietic stem cell transplantation, solid organ transplantation, malignancy, or acquired immune deficiency syndrome. Involvement of Nocardia in the spinal cord is rare; to our knowledge, only six cases have been reported. We report here the case of a 54-year-old man with a spinal cord abscess and epidural and paraspinal abscesses in the thoracic and lumbar spinal cord, causing paraplegia, voiding and defecation difficulties, and combined lung involvement, which developed 5 months after allogeneic hematopoietic stem cell transplantation. Nocardia grew in a fungus culture obtained by percutaneous lung biospy and CT-guided aspiration of the spinal abscess. A double combination regimen of antibiotic therapy (imipenem/cilastatin sodium, amikacin) was given. His paraplegia and his voiding and defecation difficulties improved considerably. To our knowledge, this is the first reported case of spinal cord Nocardiosis observed after allogeneic hematopoietic stem cell transplantation.
