Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Pneumonia with Septic Shock Due to Nocardia farcinia in Liver Transplant Patient

간이식 환자에서 발생한 Nocardia farcinia 폐렴 및 패혈성 쇼크 1예

  • Lee, Su-Hwan (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Byung-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Son, Ji-Young (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Jung, Ji-Ye (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Eun-Young (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lim, Ju-Eun (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Ji-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Hyun, Shin-Young (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Sang-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Sang-Kook (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Song-Yee (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Kyung-Jong (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kang, Young-Ae (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young-Sam (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Se-Kyu (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Seo, You-Kyung (Department of Laboratory Medicine, Yonsei University College of Medicine) ;
  • Lee, Kyoung-Won (Department of Laboratory Medicine, Yonsei University College of Medicine) ;
  • Park, Moo-Suk (Department of Internal Medicine, Yonsei University College of Medicine)
  • 이수환 (연세대학교 의과대학 내과학교실) ;
  • 박병훈 (연세대학교 의과대학 내과학교실) ;
  • 손지영 (연세대학교 의과대학 내과학교실) ;
  • 정지예 (연세대학교 의과대학 내과학교실) ;
  • 김은영 (연세대학교 의과대학 내과학교실) ;
  • 임주은 (연세대학교 의과대학 내과학교실) ;
  • 이지훈 (연세대학교 의과대학 내과학교실) ;
  • 현신영 (연세대학교 의과대학 내과학교실) ;
  • 이상훈 (연세대학교 의과대학 내과학교실) ;
  • 이상국 (연세대학교 의과대학 내과학교실) ;
  • 김송이 (연세대학교 의과대학 내과학교실) ;
  • 이경종 (연세대학교 의과대학 내과학교실) ;
  • 강영애 (연세대학교 의과대학 내과학교실) ;
  • 김영삼 (연세대학교 의과대학 내과학교실) ;
  • 김세규 (연세대학교 의과대학 내과학교실) ;
  • 장준 (연세대학교 의과대학 내과학교실) ;
  • 서유경 (연세대학교 의과대학 진단검사의학교실) ;
  • 이경원 (연세대학교 의과대학 진단검사의학교실) ;
  • 박무석 (연세대학교 의과대학 내과학교실)
  • Received : 2010.07.02
  • Accepted : 2010.10.06
  • Published : 2010.12.30
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Abstract

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.

Keywords

References

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