論文 - 詳細
| RRC ID | 56852 |
|---|---|
| 著者 | Yamate R, Matono T, Yaguchi T, Fujii Y, Goto Y, Tobino K, Imura H, Nagano S. |
| タイトル | Disseminated nocardiosis with Nocardia brasiliensis bacteremia in a patient with rheumatoid arthritis using tocilizumab. |
| ジャーナル | J Infect Chemother |
| Abstract |
Here, we present a case of disseminated nocardiosis, involving pneumonia, percutaneous abscess, and bacteremia, in a 67-year-old Japanese woman. She had also been treated for rheumatoid arthritis with prednisolone, methotrexate, and tocilizumab (interleukin-6 receptor inhibitor). Based on the 16S rRNA sequence analysis and a blast search, we identified the isolate as Nocardia brasiliensis. We discontinued methotrexate and tocilizumab on admission, and administered intravenous antimicrobial combination therapy for 6 weeks, followed by oral trimethoprim-sulfamethoxazole for 12 months, in total. Nocardia bacteremia is rare, often difficult to diagnose, and substantially fatal. However, due to our prompt diagnosis within one day of the onset of symptoms, and administration of appropriate treatment based on antimicrobial susceptibilities, this patient succeeded in surviving the infection. Not only microbiologists but also clinicians should be aware of the characteristic bacterial form of Gram/Kinyoun staining for early recognition of nocardiosis. |
| 巻・号 | 25(7) |
| ページ | 552-555 |
| 公開日 | 2019-7-1 |
| DOI | 10.1016/j.jiac.2019.02.005 |
| PII | S1341-321X(18)30324-6 |
| PMID | 30852105 |
| MeSH | Aged Anti-Bacterial Agents / therapeutic use* Antibodies, Monoclonal, Humanized / adverse effects* Arthritis, Rheumatoid / drug therapy Arthritis, Rheumatoid / immunology Bacteremia / diagnosis* Bacteremia / drug therapy Bacteremia / microbiology DNA, Bacterial / isolation & purification Drug Therapy, Combination / methods Female Gentian Violet Humans Nocardia / genetics Nocardia / isolation & purification* Nocardia Infections / diagnosis* Nocardia Infections / drug therapy Nocardia Infections / microbiology Phenazines RNA, Ribosomal, 16S / genetics Treatment Outcome |
| IF | 1.539 |
| 引用数 | 1 |
| オルトメトリクス指標 |
オルトメトリクス指標項目
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| 各媒体での言及数の合計 | 0 |
| リソース情報 | |
| 病原真核微生物 | 病原放線菌：IFM 11970 |