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Chest, Vol 90, 912-914, Copyright © 1986 by American College of Chest Physicians

ARTICLES

Pulmonary nocardiosis in the acquired immunodeficiency syndrome. Diagnosis with bronchoalveolar lavage and treatment with non-sulphur containing drugs

JL Rodriguez, JL Barrio and AE Pitchenik

A patient with the acquired immunodeficiency syndrome (AIDS) presented with Pneumocystis carinii pneumonia and pulmonary nocardiosis. The nocardial lesions appeared small and localized on chest radiograph. On two separate occasions, nocardial organisms were absent in transbronchial lung biopsy specimens, but were identified in bronchoalveolar lavage fluid probably because the latter specimen sampled a larger area of lung. The patient was initially treated with trimethoprim-sulfamethoxazole (TMP/SMX) for both infections. When TMP/SMX was discontinued because of an adverse reaction, the nocardiosis promptly exacerbated but was then easily controlled with minocycline and amikacin followed by minocycline and cycloserine. Among patients with AIDS who have sulfamethoxazole hypersensitivity during treatment for nocardiosis, alternative drugs may be efficacious and may be particularly important in this setting because they have a lower incidence of toxicity.


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C. Mayaud, A. Parrot, and J. Cadranel
Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients
Eur. Respir. J., July 1, 2002; 20(36_suppl): 28S - 39s.
[Abstract] [Full Text] [PDF]


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