Disseminated Nocardiosis in Idiopathic CD4 Lymphocytopenia: A Rare Case and Literature Review

被引：0

作者：

Seto, Nayuta

Suzuki, Takayuki

Fukuchi, Takahiko

Honjo, Momori

Watanabe, Shinya

Cui, Longzhu

Sugawara, Hitoshi

机构：

[1] Jichi Med Univ, Dept Infect & Immun, Div Infect Dis, Shimotsuke, Japan

[2] Fukaya Red Cross Hosp, Trauma & Emergency Ctr, Fukaya, Japan

[3] Jichi Med Univ, Dept Infect & Immun, Div Bacteriol, Shimotsuke, Japan

来源：

INTERNAL MEDICINE | 2025年

关键词：

Idiopathic CD4 lymphocytopenia; immunologic deficiency syndromes; opportunistic infections; Nocardia; bacteremia; brain abscess; OPPORTUNISTIC INFECTIONS; T-LYMPHOCYTOPENIA; OTITIDISCAVIARUM; PATIENT;

D O I：

10.2169/internalmedicine.4984-24

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Nocardiosis typically affects immunocompromised patients; however, the clinical characteristics of idiopathic CD4 lymphocytopenia (ICL) remain poorly understood. A 64-year-old patient was diagnosed with ICL following disseminated nocardiosis, including bacteremia, pneumonia, knee arthritis, and brain abscess. The patient underwent trimethoprim-sulfamethoxazole therapy with frequent dose adjustments based on the renal function, ranging from 2 to 12 single-strength tablets daily over 5 months of hospitalization. While he had a 1-year uneventful course of lifelong prophylaxis, he experienced prolonged recovery in physical activity. A literature review highlighted the life-threatening nature of nocardiosis in ICL, underscoring the importance of a timely diagnosis and tailored management strategies.

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页数：7

相关论文

共 20 条

[1]

Ahmad Dina S, 2013, Avicenna J Med, V3, P37, DOI 10.4103/2231-0770.114121

[2] Evaluation of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry for Identification of Mycobacterium species, Nocardia species, and Other Aerobic Actinomycetes [J].

Buckwalter, S. P. ;

Olson, S. L. ;

Connelly, B. J. ;

Lucas, B. C. ;

Rodning, A. A. ;

Walchak, R. C. ;

Deml, S. M. ;

Wohlfiel, S. L. ;

Wengenack, N. L. .

JOURNAL OF CLINICAL MICROBIOLOGY, 2016, 54 (02) :376-384

[3]

Centers for Disease Control (CDC), 1992, MMWR Morb Mortal Wkly Rep, V41, P541

[4] Nocardiosis: Risk Factors, Clinical Characteristics and Outcome [J].

Darazam, Ilad Alavi ;

Shamaei, Masoud ;

Mobarhan, Mandana ;

Ghasemi, Shahin ;

Tabarsi, Payam ;

Motavasseli, Masoud ;

Mansouri, Davood .

IRANIAN RED CRESCENT MEDICAL JOURNAL, 2013, 15 (05) :436-439

[5] IDIOPATHIC CD4+ T-LYMPHOCYTOPENIA - 4 PATIENTS WITH OPPORTUNISTIC INFECTIONS AND NO EVIDENCE OF HIV-INFECTION [J].

DUNCAN, RA ;

VONREYN, CF ;

ALLIEGRO, GM ;

TOOSSI, Z ;

SUGAR, AM ;

LEVITZ, SM .

NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (06) :393-398

[6] Idiopathic CD4+ T lymphocytopenia with epidermodysplasia verruciformis-like skin eruption, Nocardia farcinica brain abscesses and pulmonary tuberculosis: A case report with fatal outcome [J].

Goktay, Fatih ;

Mansur, Ayse Tulin ;

Ersahin, Mehmet ;

Adaleti, Riza ;

Gunes, Pembegul .

JOURNAL OF DERMATOLOGY, 2011, 38 (09) :930-933

[7] Pulmonary nocardiosis in a patient with idiopathic CD4 T-lymphocytopenia [J].

Jayaschandran, Vivek ;

Gjorgova-Gjeorgjievski, Sandra ;

Siddique, Haamid .

RESPIROLOGY CASE REPORTS, 2018, 6 (02)

[8] Recurrent pulmonary nocardiosis due to Nocardia Otitidiscaviarum in a patient with isolated CD4 lymphocytopenia: a case report [J].

Kanagiri, Tejasvi ;

Meena, Durga Shankar ;

Kumar, Deepak ;

Midha, Naresh Kumar ;

Kombade, Sarika ;

Yadav, Taruna .

BMC INFECTIOUS DISEASES, 2024, 24 (01)

[9] Nocardiosis Associated with Primary Immunodeficiencies (Nocar-DIP): an International Retrospective Study and Literature Review [J].

Lafont, Emmanuel ;

Marciano, Beatriz E. ;

Mahlaoui, Nizar ;

Neven, Benedicte ;

Bustamante, Jacinta ;

Rodriguez-Nava, Veronica ;

Rawat, Amit ;

Unzaga, Miren Josebe ;

Fischer, Alain ;

Blanche, Stephane ;

Lortholary, Olivier ;

Holland, Steven M. ;

Lebeaux, David .

JOURNAL OF CLINICAL IMMUNOLOGY, 2020, 40 (08) :1144-1155

[10] Reappraisal of Idiopathic CD4 Lymphocytopenia at 30 Years [J].

Lisco, Andrea ;

Ortega-Villa, Ana M. ;

Mystakelis, Harry ;

Anderson, Megan V. ;

Mateja, Allyson ;

Laidlaw, Elizabeth ;

Manion, Maura ;

Roby, Gregg ;

Higgins, Jeanette ;

Kuriakose, Safia ;

Walkiewicz, Magdalena A. ;

Similuk, Morgan ;

Leiding, Jennifer W. ;

Freeman, Alexandra F. ;

Sheikh, Virginia ;

Sereti, Irini .

NEW ENGLAND JOURNAL OF MEDICINE, 2023, 388 (18) :1680-1691