Benetucci J, Cecchini D, Ambrosioni J, Gomez A, Castellaro P, Chidid C, Biscione F, Orduna T, Yampolsky C, Negroni R; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. MoPeB3197.
Hospital F.J.Muniz, Buenos Aires, Argentina
Background: To describe systemic nocardiosis affecting the CNS in a patients with HIV infection. Method: A 33-year-old man with supurative lesion in left gluteus and two-month history of asthenia, anorexia and malaise. Results: A lesion sample revealed acid fast filamentous branching rods on Kinyoun stain, sugestive of Nocardia spp. He also had finding of Nocardia spp. in broncho-alveolar lavage. HIV serology positive and CD4+ T cell 11cells/ul. Brain MRI revealed multiple supratentorial abscesses with significant perilesional edema. The patient was put on cotrimoxazole+ciprofloxacine for nocardiosis and on prymethamine+clindamicine empirically for toxoplasmosis. Evolution of skin lesions, favorable. C. neoformans was isolated in blood cultures, starting treatment with amphotericin-B. One-month-control MRI, minimal reduction in lesions size. The treatment was changed to cotrimoxazole+ceftriaxone. A brain stereotactic biopsy was performed, and removal of the largest abscess was done. Sample positive for Nocardia spp on culture. Two-month-control MRI, marked reduction and almost disappearance of lesions. Typing: Nocardia abscessus. Conclusions: Need of CNS image in HIV-infected patients with isolated lung or disseminated compromise due to Nocardia spp. Lack of agreement regarding the most appropriate treatment for CNS involvement and response criteria. Need to obtain a tissue sample by stereotactic brain biopsy to confirm diagnosis. As far as we know, this is the first literature report of N. abscessus in a HIV-infected host.
Publication Types:
Keywords:
- AIDS Vaccines
- Abscess
- Acquired Immunodeficiency Syndrome
- Antigens, CD4
- Brain Abscess
- HIV Seropositivity
- Humans
- Male
- Nocardia
- Nocardia Infections
- Toxoplasmosis
- Trimethoprim-Sulfamethoxazole Combination
- immunology
- therapy
Other ID:
UI: 102279501
From Meeting Abstracts