ADRENAL INSUFFICIENCY, RECURRENT BACTEREMIA, AND DISSEMINATED ABSCESSES CAUSED BY NOCARDIA-ASTEROIDES IN A PATIENT WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME

Nocardia asteroides is an opportunistic pathogen of increasing inciden ce in human immunodeficiency virus (HIV)-infected persons. The lungs a re the most common site of infection, followed by the brain; involveme nt of other extrapulmonary sites is less common. We describe a patient with acquired immunodeficiency syndrome who presented with a number o f unique manifestations of nocardial infection: the first reported cas e of bilateral adrenal abscesses with adrenal insufficiency, the fist case of a renal abscess due to N. asteroides alone, and the first case of recurrent, symptomatic bacteremia. A review of the literature on n ocardial infections in HIV-positive individuals is presented.