Pulmonary nocardiosis with brain abscess in a sensitized kidney transplant recipient with a history of repeated graft loss and HLA-antibody depletion treatment--a case report

Ups J Med Sci. 2008;113(1):111-6. doi: 10.3109/2000-1967-212.

Abstract

Nocardiosis is an opportunistic infection with unfavourable prognosis and is predominantly seen in immunocompromised patients. We here present a kidney transplant recipient with a history of two early graft losses who subsequently developed Human Leukocyte Antigen (HLA)-antibodies and underwent a desensitization treatment with plasmapheresis and monoclonal anti-CD20 antibody application. However, 3 months after a third HLA-identical kidney transplantation he developed Nocardiosis with pulmonary and asymptomatic brain manifestation. The present case report exemplifies this opportunistic infection and gives an overview of the literature.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies / immunology
  • Autoantibodies / isolation & purification*
  • Brain Abscess / complications
  • Brain Abscess / therapy*
  • Cyclophosphamide / administration & dosage
  • Cyclosporine / administration & dosage
  • Graft Rejection*
  • HLA Antigens / immunology*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Kidney Transplantation*
  • Lung Diseases / complications
  • Lung Diseases / therapy*
  • Male
  • Middle Aged
  • Nocardia Infections / complications
  • Nocardia Infections / therapy*
  • Treatment Outcome

Substances

  • Autoantibodies
  • HLA Antigens
  • Immunosuppressive Agents
  • Cyclosporine
  • Cyclophosphamide