Pulmonary infiltrate and painful nodular leg lesions in a patient with membranous glomerulonephritis

BMJ Case Rep. 2015 Jul 28:2015:bcr2015210032. doi: 10.1136/bcr-2015-210032.

Abstract

Nocardia otitidis-cavarium is rarely isolated as an infectious pathogen in the western world. We report on a 71-year-old Caucasian man with membranous glomerulonephritis who presented with several seemingly unrelated clinical symptoms that, after laborious diagnostics, turned out to be caused by disseminated infection with N. otitidis-cavarium. This case highlights the variable clinical presentations that can occur in nocardial infections and underscores the need to search for rare pathogens in patients taking immunosuppressive medication.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Glomerulonephritis, Membranous / complications*
  • Glomerulonephritis, Membranous / drug therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Leg Dermatoses / microbiology*
  • Lung Abscess / diagnostic imaging
  • Lung Abscess / microbiology*
  • Male
  • Mycetoma / complications*
  • Mycetoma / diagnosis*
  • Mycetoma / drug therapy
  • Nocardia*
  • Pneumonia / diagnostic imaging
  • Pneumonia / microbiology*
  • Radiography

Substances

  • Antifungal Agents
  • Immunosuppressive Agents