Nocardia asteroides pneumonia, subcutaneous abscess and meningitis in a patient with advanced malignant lymphoma: Successful treatment based on in vitro antimicrobial susceptibility

Nocardia asteroides pneumonia,subcutaneous abscess and meningitis without b rain abscesses developed in a patient with advanced non-Hodgkin's lymphoma, who had received corticosteroid therapy and cancer chemotherapy for a long time, At the time of nocardial pneumonia, profound lymphocytopenia and hyp ogammaglobulinemia was seen. The severely immunosuppressed condition most l ikely accounted for the uncommon infection, nocardiosis. The organism isola ted from the sputum, subcutaneous abscess and cerebrospinal fluid was stron gly resistant to cotrimoxazole, which is the recommended standard treatment , but it was susceptible to imipenem (IPM) and erythromycin (EM) in an in v itro antimicrobial susceptibility study, The patient's nocardiosis responde d well to chemotherapy including IPM and EM.