20 April 2004
Lesion resolving, patient worsening! A case of disseminated nocardiosis
Mohammad I Khan, Medhat Osman, Octavian Popescu, Thomas ThompsonCase Rep Clin Pract Rev 2004; 5(null):411-414 :: ID: 12339
Abstract
Background: At times the radiological resolution of a lesion may not be accompanied by clinical improvement,causing a diagnostic dilemma for the treating physician. We report one such case.Case Report: A 59 year old male presented with six weeks history of cough and haemoptysis. Initially the chest X-ray and CT were consistent with bronchogenic carcinoma however bronchoscopy did not show an endobronchial lesion. After a course of antibiotic, a follow up CT showed marked resolution of the lesion suggesting a resolving pneumonic infection however the patient continued to deteriorate and later presented with worsening mental function and back pain. CT brain showed multiple ring enhancing lesions requiring craniotomy and drainage. CT abdomen showed a psoas abscess which was drained. Microbiology was consistent withNocardial infection. He responded to long term Cotrimoxazole and Ceftrioxone.Conclusions: When radiological and clinical impressions don’t match along the follow up of a patient, the clinical impression is generally more accurate.
Keywords: Nocardia, cerebral abscesses, immunocompromised infections
15
In Press
12 Feb 2024 : Case report
Erdheim-Chester Disease Occult on Radiographs and CT but Visible on MRI and PETAm J Case Rep In Press; DOI: 10.12659/AJCR.941169
12 Feb 2024 : Case report
Surgical Treatment of Spontaneous Superficial Temporal Artery Arteriovenous Malformation: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942839
13 Feb 2024 : Case report
Warfarin Woes: A Rare Case of Hemoperitoneum with Intramural Small Bowel HematomaAm J Case Rep In Press; DOI: 10.12659/AJCR.943519
13 Feb 2024 : Case report
Hemorrhagic Presentation in Primary Central Nervous System Lymphoma: A Case StudyAm J Case Rep In Press; DOI: 10.12659/AJCR.942951
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250