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Disseminated Nocardia pseudobrasiliensis in a Renal Transplant Recipient

Benwill, Jeana L. MD*; Schnadig, Vicki J. MD; Blanton, Lucas S. MD*

Infectious Diseases in Clinical Practice: July 2013 - Volume 21 - Issue 4 - p 272–274
doi: 10.1097/IPC.0b013e31827695cc
Case Reports

Abstract: Nocardia are aerobic actinomycetes that cause localized and disseminated disease in both immunocompetent and immunosuppressed individuals. Nocardia pseudobrasiliensis is a recently recognized nocardial species associated with invasive manifestations of disease. We herein describe a case of disseminated N pseudobrasiliensis involving the central nervous system, lungs, thyroid, skin, and soft tissue of a renal transplant recipient. Diagnosis proved challenging owing to inconsistent staining of the cell wall with routine stains and poor growth in culture media. The patient improved with appropriate antibiotic therapy, but she was left with paraplegia. Recognition of N pseudobrasiliensis as an emerging opportunistic pathogen is imperative in the care of at risk transplant recipients.

From the *Division of Infectious Diseases, Department of Internal Medicine and †Department of Pathology, The University of Texas Medical Branch, Galveston, TX.

Correspondence to: Lucas S. Blanton, MD, 301 University Blvd, Galveston, TX. E-mail: lsblanto@utmb.edu.

The authors have no funding or conflicts of interest to disclose.

© 2013 by Lippincott Williams & Wilkins.