Tuberc Respir Dis > Volume 69(6); 2010 > Article
Tuberculosis and Respiratory Diseases 2010;69(6):469-473.
DOI:    Published online December 1, 2010.
A Case of Pneumonia with Septic Shock Due to Nocardia farcinia in Liver Transplant Patient.
Su Hwan Lee, Byung Hoon Park, Ji Young Son, Ji Ye Jung, Eun Young Kim, Ju Eun Lim, Ji Hoon Lee, Shin Young Hyun, Sang Hoon Lee, Sang Kook Lee, Song Yee Kim, Kyung Jong Lee, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, You Kyung Seo, Kyoung Won Lee, Moo Suk Park
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
3Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
Nocardia farcinia, an aerobic, gram-positive bacilli actinomycetes of the genus Nocardia, is an uncommon pathogen found in humans. The most common Nocardia infection sites are the lung, central nervous system, and skin. Even though hematogenous dissemination can occur, isolation of the organism from blood cultures is very rare. We report a case of Nocardia infection that was isolated on blood cultures. A 59-year-old male with a medical history that includes a liver transplantation 6-years prior due to hepatocellular carcinoma secondary to chronic hepatitis B, developed pneumonia and was transferred to Severance Hospital. At the time of admission, the patient's initial exam showed hypothermia, tachypnea, and hypotension. His chest radiograph showed severe pneumonia and a large abscess on left upper lobe. Under the presumptive diagnosis of bacterial pneumonia or other opportunistic infection, we started broad spectrum antibiotics. However, he developed Nocardia sepsis, rapidly deteriorated, and subsequently died.
Key Words: Nocardia, Pneumonia, Shock, Sepsis, Liver Transplantation

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