Korean J Med.  2009 Aug;77(Suppl 1):S197-S202.

A case of intramedullary nocardiosis in a patient after hematopoietic stem cell transplantation

Affiliations
  • 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. khlee2@amc.seoul.kr

Abstract

Nocardiosis is uncommon in healthy people but occurs as an opportunistic infection in patients after hematopoietic stem cell transplantation, solid organ transplantation, malignancy, or acquired immune deficiency syndrome. Involvement of Nocardia in the spinal cord is rare; to our knowledge, only six cases have been reported. We report here the case of a 54-year-old man with a spinal cord abscess and epidural and paraspinal abscesses in the thoracic and lumbar spinal cord, causing paraplegia, voiding and defecation difficulties, and combined lung involvement, which developed 5 months after allogeneic hematopoietic stem cell transplantation. Nocardia grew in a fungus culture obtained by percutaneous lung biospy and CT-guided aspiration of the spinal abscess. A double combination regimen of antibiotic therapy (imipenem/cilastatin sodium, amikacin) was given. His paraplegia and his voiding and defecation difficulties improved considerably. To our knowledge, this is the first reported case of spinal cord Nocardiosis observed after allogeneic hematopoietic stem cell transplantation.

Keyword

Hematopoietic stem cell transplantation; Nocardia, Spinal cord

MeSH Terms

Abscess
Acquired Immunodeficiency Syndrome
Defecation
Fungi
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Humans
Lung
Middle Aged
Nocardia
Nocardia Infections
Opportunistic Infections
Organ Transplantation
Paraplegia
Sodium
Spinal Cord
Transplants
Nocardia Infections
Sodium
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