Nocardiosis presenting as a lung mass in a kidney transplant recipient

Nephrology (Carlton). 2015 Mar:20 Suppl 1:6-9. doi: 10.1111/nep.12420.

Abstract

Nocardiosis is a potentially life-threatening disease in renal transplant recipients. It is an uncommon infection with high lethality if left untreated. We report a case of a 67 year-old kidney transplant recipient who developed pulmonary nocardiosis and presented with pleural effusion along with an underlying lung mass, which was successfully treated with trimethoprim-sulphamethoxazole in conjunction with a reduction in immunosuppressive therapy. Five months later, graft function remains stable with complete regression of radiological abnormalities and absence of symptoms. Nocardiosis should be suspected in the presence of pulmonary symptoms in a transplant patient with unusual radiological presentation.

Keywords: nocardia; renal; transplant.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation / adverse effects*
  • Male
  • Nocardia Infections / diagnostic imaging
  • Nocardia Infections / drug therapy
  • Nocardia Infections / microbiology*
  • Opportunistic Infections / diagnostic imaging
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology*
  • Pleural Effusion / microbiology
  • Respiratory Tract Infections / diagnostic imaging
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology*
  • Solitary Pulmonary Nodule / diagnostic imaging
  • Solitary Pulmonary Nodule / drug therapy
  • Solitary Pulmonary Nodule / microbiology*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Immunosuppressive Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination