A Rare Case of Co-Infection with Nocardia farcinica, Pneumocystis jirovecii, and Aspergillus fumigatus Due to Tooth Extraction in a Mildly Immunosuppressed Patient

Guo Jinlin; Song Shaohui; Zhang Wenjun; Cai Xinfeng

doi:10.2147/IDR.S379005

A Rare Case of Co-Infection with Nocardia farcinica, Pneumocystis jirovecii, and Aspergillus fumigatus Due to Tooth Extraction in a Mildly Immunosuppressed Patient

Infect Drug Resist. 2022 Aug 25:15:4853-4857. doi: 10.2147/IDR.S379005. eCollection 2022.

Authors

Guo Jinlin^#¹, Song Shaohui^#², Zhang Wenjun³, Cai Xinfeng⁴

Affiliations

¹ Department of Pharmacy, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China.
² Department of Pharmacy, The Maternal and Child Health Hospital of Dadukou District of Chongqing City, Chongqing, People's Republic of China.
³ Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
⁴ Department of Pharmacy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China.

^# Contributed equally.

Abstract

We report a case of co-infection with Nocardia farcinica, Pneumocystis jirovecii, and Aspergillus fumigatus due to tooth extraction in a mildly immunosuppressed patient. This patient did not respond well to a meropenem-based regimen, and the number of lesions was significantly reduced after switching to imipenem. The patient's trough concentration was insufficient when using conventional doses of voriconazole for the treatment of pulmonary aspergillosis. After adding omeprazole, the concentration reached standard levels and symptoms improved. The patient eventually made a full recovery.

Keywords: Aspergillus fumigatus; Nocardia farcinica; Pneumocystis jirovecii; interaction; intracranial infection; voriconazole.

Publication types

Case Reports

Grants and funding

There is no funding to report.