Case Report: Primary Pulmonary Nocardiosis and Candidosis with Cutaneous Involvement in Nephrotic Syndrome Patient under Steroid Therapy  

Priyatam Khadka , Shyam Kumar Mishra , Dibya Sing Shah , Basistha Parsad Rijal
Medical Laboratory Technician, Tribhuvan University Teaching Hospital, MSc Medical Microbiology, TU, Nepal
Author    Correspondence author
International Journal of Clinical Case Reports, 2016, Vol. 6, No. 11   doi: 10.5376/ijccr.2016.06.0011
Received: 02 Feb., 2016    Accepted: 28 Mar., 2016    Published: 05 May, 2016
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Preferred citation for this article:

Priyatam Khadka, Shyam Kumar Mishra, Dibya Sing Shah, and Basistha Parsad Rijal, 2016, Case Report: Primary Pulmonary Nocardiosis and Candidosis with Cutaneous Involvement in Nephrotic Syndrome Patient under Steroid Therapy, International Journal of Clinical Case Report, 6(11): 1-7 (doi: 10.5376/ijccr.2016.06.0011)

Abstract

Background: Nocardiosis along with Candiodiosis are an opportunistic infection which predominantly affects an immunocompromised and debilitated patient. The Host immune systems, medication with an Immunosuppressive drug and other predisposing factors have an important role in systemic dissemination of infection.

Case summary: A case of 62 year old man with a history of hypertension and steroid treated nephrotic syndrome, a chief complain of shortening of breathe, restlessness, lethargy was admitted to intensive care unit. Radiological findings shows bilateral pneumonia with parapneumonic effusion and right thigh abscesses.

Method: AFB staining, Gram staining, Fluorescence staining, Culture techniques, phenotypic characteristics, biochemical interpretation and antibiotic susceptibility pattern suggests and confirm the aetiological agent conferring infection. Eventually, a medication with sulfamethoxazole and cefexime results the progressive changes in patient and hence was discharged.

Conclusion: The clinical symptoms and radiological findings are nonspecific and hence microbiological investigations enlighten the aetiological agent, its characteristics features and susceptibility patterns to antibiotics for diagnostic/prognostic approach.

Keywords
Case report; Nephrotic syndrome; Steroid; Nocardia asteroids; Co-infection; Candida albicans
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