Unusual mixed infection of thoracic empyema caused by Mycobacteria tuberculosis, nontuberculosis mycobacteria and Nocardia asteroides in a woman with systemic lupus erythematosus

J Infect. 2007 Jan;54(1):e25-8. doi: 10.1016/j.jinf.2006.03.024. Epub 2006 May 18.

Abstract

We report a 45-year-old woman of systemic lupus erythematosus (SLE) with thoracic empyema that was unusually infected by Mycobacterium tuberculosis (MTB), Nontuberculosis mycobacteria (NTM) concomitant with Nocardia asteroides. After a combined treatment of cotrimoxazole, clarithromycin and anti-tuberculosis drugs with a short-term of intravenous immunoglobulin (IVIG), the patient recovered from the critical illness. On the basis of the results in this case, we recommend a thorough survey of the probably concomitant infections of MTB and NTM in an immunocompromised patient with a known N. asteroid infection. In addition, an adjuvant intravenous immunoglobulin therapy may have beneficial effect in the control of infections in an SLE patient.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Clarithromycin / therapeutic use
  • Drug Therapy, Combination
  • Empyema, Pleural / complications
  • Empyema, Pleural / drug therapy
  • Empyema, Pleural / microbiology*
  • Empyema, Tuberculous / complications
  • Empyema, Tuberculous / drug therapy
  • Empyema, Tuberculous / microbiology*
  • Female
  • Humans
  • Immunocompromised Host
  • Immunoglobulins, Intravenous / therapeutic use
  • Lupus Erythematosus, Systemic / complications*
  • Middle Aged
  • Mycobacterium / isolation & purification*
  • Nocardia asteroides / isolation & purification*
  • Taiwan
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Antitubercular Agents
  • Immunoglobulins, Intravenous
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Clarithromycin