Nocardiosis-an uncommon infection in patients with myasthenia gravis: report of three cases and review of literature.


Journal

BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291

Informations de publication

Date de publication:
31 Dec 2020
Historique:
entrez: 1 1 2021
pubmed: 2 1 2021
medline: 20 2 2021
Statut: epublish

Résumé

Nocardiosis is a rare infection in patients with myasthenia gravis (MG). We identified three cases of MG admitted with nocardiosis in our unit. We performed systematic literature search of previous publications and identified 18 patients. This paper presents three patients and reviews the clinical characteristics of 21 patients. The first case was a 69-year-old woman with thymomatous MG who presented with pustules and left lower limb pain. Evaluation showed osteomyelitis of the pubic ramus and ileopsoas abscess. The second case was a 54-year-old man who presented in myasthenic crisis due to pulmonary nocardiosis. The third case was a 48-year-old man with thymomatous MG who presented with lung abscess. All of them recovered completely after treatment with co-trimoxazole. Analysis of the 21 patients identified four risk factors for nocardiosis in MG: elderly men; thymoma; immunosuppressant medication, mainly steroid therapy; and pre-existing lung disease. Lungs was the most common site of infection. Suppurative disease was common manifestation regardless of organ involved. Clinical course is not unfavourable.

Identifiants

pubmed: 33384345
pii: 13/12/e237208
doi: 10.1136/bcr-2020-237208
pmc: PMC7780555
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0
Trimethoprim, Sulfamethoxazole Drug Combination 8064-90-2

Types de publication

Case Reports Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Y Muralidhar Reddy (Y)

Neurology, CARE Hospitals - Banjara Hills, Hyderabad, Telangana, India muralidharnims@gmail.com.

Subhendu Parida (S)

Neuroradiology, CARE Hospitals - Banjara Hills, Hyderabad, Telangana, India.

Shyam K Jaiswal (SK)

Neurology, CARE Hospitals - Banjara Hills, Hyderabad, Telangana, India.

Jagarlapudi Mk Murthy (JM)

Neurology, CARE Hospitals - Banjara Hills, Hyderabad, Telangana, India.

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Classifications MeSH