Korean J Med.
2009 Jul;77(1):128-132.
Streptococcus salivarius pneumonia with pulmonary nocardiosis in a rheumatoid arthritis patient treated with immunosuppressants
- Affiliations
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- 1Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea. scyang@snu.ac.kr
Abstract
- Streptococcus salivarius is a Gram-positive organism that belongs to the viridians group of streptococci. It is a relatively non-virulent bacterium that is part of the normal flora. It is rarely isolated from blood and is usually considered a contaminant. Nevertheless, S. salivarius may cause life-threatening infections, especially in immunocompromised hosts. There have been relatively few reports of S. salivarius pneumonia. Nocardiosis is also a rare opportunistic infection. Pulmonary nocardiosis is difficult to diagnose and, consequently, the diagnosis is often delayed. We report an unusual presentation with multiple pulmonary mass-like consolidations caused by a mixed infection of S. salivarius and Nocardia sp. in a 58-year-old man with rheumatoid arthritis who was taking oral corticosteroid, methotrexate, and leflunomide. The patient's symptoms and radiographic findings improved after six weeks of antibiotic therapy
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