Open AccessMembranous Nephropathy Complicated with Disseminated Nocardia farcinica Infection: A Case Report and Literature Review
Author(s) -
Lei Pan,
Xu-Hao Wang,
Fanqi Meng,
Xinming Su,
Yue Li,
Ming Xu,
Feng-Yuan Su,
Delei Kong,
Wei Wang
Publication year - 2021
Publication title -
infection and drug resistance
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.033
H-Index - 39
ISSN - 1178-6973
DOI - 10.2147/idr.s331737
Subject(s) - nocardia , medicine , membranous nephropathy , prednisone , nocardia infections , pathology , trimethoprim , meropenem , dermatology , nocardiosis , kidney , proteinuria , biology , microbiology and biotechnology , genetics , antibiotic resistance , bacteria , antibiotics
Disseminated infection caused by Nocardia farcinica with primary nephrotic syndrome is exceedingly rare. A 66-year-old female visited the outpatient department due to fever and fatigue who had been diagnosed as membranous nephropathy and with a long-term prednisone and immunosuppressive therapy. After lung biopsy for many times, culture from space-occupying lesion of the right lung and species identification by mass spectrometry-based methods (MALDI-TOF) revealed Nocardia farcinica . By imaging examination, space-occupying lesions from the lungs, brain, abdominal cavity and kidney were found. After 2 weeks of meropenem intravenous and up to 6 months of trimethoprim-sulfamethoxazole (TMP-SMX) therapy, our patient has remained relapse-free at that time of writing. Disseminated infection caused by Nocardia farcinica is usually subacute with complex clinical manifestations. In addition, it can be easily confused with diseases such as tumor and mycobacterial infection, and lead to fatal consequences. Therefore, we hope that we can remind clinicians considering by discussing common features of disseminated Nocardia farcinica infection.