Successful rescue of disseminated Nocardia infection with multiple abscesses in a patient with membranous nephropathy after cardiopulmonary resuscitation:A three-year follow-up  

作　　者：Yili Xu Hanyang Qian Wen Qian Li Dong Weiying Liu Yan Zhu Yaning Mei Yi Xu Ling Wang Yi Xia Xu Qi Huanping Mei Xueqiang Xu Huijuan Mao Changying Xing Ningning Wang 

机构地区：[1]Department of Nephrology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China [2]Department of Nephrology,Nanjing Tongren Hospital,Nanjing,Jiangsu 211102,China [3]Department of Image,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China [4]Department of Infectious Disease,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China [5]Department of Nephrology,the Second Hospital of Nanjing,Nanjing,Jiangsu 210029,China [6]Department of Microorganism,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China [7]Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China [8]Department of Rheumatology and Immunology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China

出　　处：《Journal of Biomedical Research》2024年第2期189-194,I0019,I0020,共8页生物医学研究杂志（英文版）

基　　金：funded by grants from the National Natural Science Foundation of China(Grant No.81570666);International Society of Nephrology Clinical Research Program(Grant No.18-01-0247);Program of Jiangsu Clinical Research Center(Grant No.BL2014084);Jiangsu Province Key Medical Personnel Project(Grant No.ZDRCA2016002);CKD Anemia Research Foundation from China International Medical Foundation(Grant No.Z-2017-24-2037);Outstanding Young and Middle-aged Talents Support Program of the First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital).

摘　　要：Nocardiosis manifests as an opportunistic infection,primarily affecting individuals who are immunocompromised and susceptible to the infection.We present a case study of one patient with nephrotic syndrome and membranous nephropathy,who underwent treatment with prednisone and cyclosporine in 2016.In early 2017,the patient was diagnosed with a"fungal infection"and discontinued the use of cyclosporine.After one month of anti-infection therapy,a cranial magnetic resonance imaging scan showed multiple abscesses in the right temporal region.The diagnosis of nocardiosis was confirmed based on the presence of metastatic abscess masses,multiple lung and brain lesions,and a positive culture of Nocardia in the drainage.We changed the anti-infection therapy to a combination of trimethoprim-sulfamethoxazole(TMP-SMX),minocycline,and voriconazole.However,the patient experienced a sudden cardiac arrest and subsequently recovered after cardiopulmonary resuscitation.During the five-month follow-up period following the discharge,the patient displayed an enhanced nutritional status and stable renal function.The focal infection ultimately resolved during the subsequent three years.Neuro-infection caused by Nocardia should be considered in immunocompromised patients,and TMP-SMX is the preferred initial therapy;however,because of the high mortality rate,a long-term combination therapy with imipenem,cefotaxime,amikacin,and TMP-SMX is suggested.

关 键 词：Nocardia infection GLOMERULONEPHRITIS membranous nephrology cardiopulmonary resuscitation 

分 类 号：R692[医药卫生—泌尿科学]