Successful maintenance therapy with moxifloxacin for disseminated nocardiosis caused by Nocardia farcinica in a patient with Cushing's syndrome

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease Pub Date : 2025-01-30 DOI:10.1016/j.diagmicrobio.2025.116718

Begoña de Escalante Yangüela , Jorge Ligero López , Alejandro Venegas Robles , Rosana Urdaniz Borque , Juan Vallejo Grijalba , Orosia Bandrés Nivela , José Luis Juan Bañón , Antonio Beltrán Rosel

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引用次数: 0

Abstract

Nocardia species are aerobic, Gram-positive actinomycetes often causing opportunistic infections, particularly in immunocompromised hosts. Nocardia farcinica is notable for disseminated nocardiosis (DN), frequently involving the lungs and central nervous system (CNS). Cushing's syndrome (CS), characterized by hypercortisolemia, further predisposes patients to severe infections.

We report a 73-year-old woman with ACTH-dependent CS due to a pituitary adenoma who developed DN with pleuropulmonary, CNS, and gluteal abscesses. Diagnosis was confirmed through cultures and MALDI-TOF MS, identifying N. farcinica. Resistance to standard antibiotics required a tailored regimen, including imipenem, amikacin, and moxifloxacin, alongside surgical management of abscesses and the adenoma.

This case emphasizes the importance of rapid diagnostic methods and individualized therapies in managing DN with CS, a rare but severe combination. It highlights the need for vigilance in high-risk patients and contributes valuable insights for optimizing outcomes in such complex cases.

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来源期刊

Diagnostic microbiology and infectious disease 医学-传染病学

CiteScore

5.30

自引率

3.40%

发文量

149

审稿时长

56 days

期刊介绍： Diagnostic Microbiology and Infectious Disease keeps you informed of the latest developments in clinical microbiology and the diagnosis and treatment of infectious diseases. Packed with rigorously peer-reviewed articles and studies in bacteriology, immunology, immunoserology, infectious diseases, mycology, parasitology, and virology, the journal examines new procedures, unusual cases, controversial issues, and important new literature. Diagnostic Microbiology and Infectious Disease distinguished independent editorial board, consisting of experts from many medical specialties, ensures you extensive and authoritative coverage.