Disseminated nocardia in a 12-year-old girl with immune complex mesangiocapillary glomerulonephritis: A case report
DOI:
https://doi.org/10.61529/idjp.v35i1.459Abstract
Nocardia is an uncommon opportunistic organism that mainly infects immunocompromised patients. These Gram-positive, aerobic, branching filamentous actinomycetes may cause nocardiosis, a potentially lethal infection with the ability to spread to multiple organs, including the lungs, brain, spinal cord, and skin. We report a case of a 12-year-old girl with mesangiocapillary glomerulonephritis on immunosuppressive treatment who presented with fever and respiratory distress requiring mechanical ventilation, followed by seizures. High-resolution CT chest showed consolidation of the left lung with internal necrosis, while MRI brain revealed many irregular ring-enhancing lesions. Microbiological culture of the brain biopsy and brain pus samples grew Nocardia species. The child showed quick neurological improvement after start of trimethoprim-sulfamethoxazole and obtained complete resolution within 12 months. This case underscores the clinical significance of considering nocardiosis in children on immunosuppressive treatment and highlights the value of early imaging, microbiological, and pathological assessment for early diagnosis and optimal management of disseminated disease.
Keywords: Actinomycetes, Brain abscess, Immunocompromised, Nocardiosis
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