Fatal pneumonia and empyema thoracis caused by imipenem-resistant Nocardia abscessus in a cancer patient

Chih-Cheng Lai; Hsih-Yeh Tsai; Sheng-Yuan Ruan; Chun-Hsing Liao; Po-Ren Hsueh

doi:10.1016/j.jmii.2013.01.005

Fatal pneumonia and empyema thoracis caused by imipenem-resistant Nocardia abscessus in a cancer patient

J Microbiol Immunol Infect. 2015 Dec;48(6):706-8. doi: 10.1016/j.jmii.2013.01.005. Epub 2013 Mar 21.

Authors

Chih-Cheng Lai¹, Hsih-Yeh Tsai², Sheng-Yuan Ruan³, Chun-Hsing Liao⁴, Po-Ren Hsueh⁵

Affiliations

¹ Department of Intensive Care Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
² Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
³ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁵ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.

PMID: 23523047
DOI: 10.1016/j.jmii.2013.01.005

Abstract

We describe a case of pneumonia and empyema thoracis caused by trimethoprim-sulfamethoxazole-susceptible, but imipenem-resistant Nocardia abscessus in a cancer patient. The isolate was confirmed to the species level by 16S rRNA sequencing analysis. The patient did not respond to antibiotic therapy, including ceftriaxone and imipenem, and died of progressing pneumonia and multiple organ failure.

Keywords: 16S rRNA sequencing; Empyema thoracis; Imipenem-resistant; Nocardia abscessus.

Publication types

Case Reports

MeSH terms

Anti-Bacterial Agents / therapeutic use*
Ceftriaxone / therapeutic use
Drug Resistance, Multiple, Bacterial*
Empyema, Pleural / drug therapy*
Empyema, Pleural / microbiology
Empyema, Pleural / mortality
Hemangiosarcoma / drug therapy
Humans
Imipenem / therapeutic use*
Immunocompromised Host
Male
Middle Aged
Multiple Organ Failure / mortality
Nocardia / drug effects*
Nocardia / isolation & purification
Nocardia Infections / drug therapy*
Nocardia Infections / microbiology
Nocardia Infections / mortality
Pneumonia / drug therapy*
Pneumonia / microbiology
Pneumonia / mortality
RNA, Ribosomal, 16S / genetics
Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

Anti-Bacterial Agents
RNA, Ribosomal, 16S
Imipenem
Ceftriaxone
Trimethoprim, Sulfamethoxazole Drug Combination