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