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Nocardia osteomyelitis in a pachymeningitis patient: an example of a difficult case to treat with antimicrobial agents

Authors
 Kyoo-Ho Shin  ;  Woo-Suk Lee  ;  Young-Ki Son  ;  Kyungwon Lee  ;  Yunsop Chong 
Citation
 YONSEI MEDICAL JOURNAL, Vol.39(6) : 604-610, 1998 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
1998
MeSH
Aged ; Drug Resistance, Microbial/physiology ; Dura Mater/microbiology* ; Fatal Outcome ; Femur/diagnostic imaging ; Humans ; Male ; Meningitis/microbiology* ; Nocardia Infections/drug therapy* ; Nocardia Infections/physiopathology ; Osteomyelitis/diagnostic imaging ; Osteomyelitis/microbiology* ; Radiography ; Radionuclide Imaging
Abstract
Antimicrobial agents played a miraculous role in the treatment of bacterial infections until resistant bacteria became widespread. Besides antimicrobial-resistant bacteria, many factors can influence the cure of infection. Nocardia infection may be a good example which is difficult to cure with antimicrobial agents alone. A 66-year-old man developed soft tissue infection of the right buttock and thigh. He was given prednisolone and azathioprine for pachymeningitis 3 months prior to admission. Despite surgical and antimicrobial treatment (sulfamethoxazole-trimethoprim), the infection spread to the femur and osteomyelitis developed. The case showed that treatment of bacterial infection is not always as successful as was once thought because recent isolates of bacteria are more often resistant to various antimicrobial agents, intracellular parasites are difficult to eliminate even with the active drug in vitro, and infections in some sites such as bone are refractory to treatment especially when the patient is in a compromised state. In conclusion, for the treatment of infections, clinicians need to rely on laboratory tests more than before and have to consider the influence of various host factors.
Files in This Item:
T199802368.pdf Download
DOI
10.3349/ymj.1998.39.6.604
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176809
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