Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation · 2009
Epididymo-orchitis and central nervous system nocardiosis in a bone marrow transplant recipient for acute lymphoblastic leukemia.
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Dehghani Mehdi, Davarpanah Mohammad-Ali
Аннотация
OBJECTIVES: We report a case of epididymo-orchitis and central nervous system nocardiosis in a 22-year-old man with T-cell acute lymphoblastic leukemia; he was an allogeneic marrow recipient with acute and chronic graft-versus-host disease.
MATERIALS AND METHODS: He had microscopic hematuria and cytomegalovirus antigenemia. He deteriorated subsequently while on cyclosporine and steroids, requiring hospital admission owing to fever and swelling of the left testis and generalized tonic-clonic convulsions.
RESULTS: Brain magnetic resonance imaging showed abnormal signal area in right parietal and left parieto-occipital lobes. The lesions had mass effect, edema, and ring enhancement. Findings were indicative of a brain abscess. A testicular biopsy from the lower pole of the left testis was done. A white-to-yellowish discharge was seen and subsequently, Nocardia grew in culture.
CONCLUSIONS: Trimethoprim-sulfamethoxazole was prescribed, and significant improvement was seen after 2 weeks. The patient was discharged. He was subsequently referred after 3 weeks due to graft-versus-host disease and died of pancytopenia.
MATERIALS AND METHODS: He had microscopic hematuria and cytomegalovirus antigenemia. He deteriorated subsequently while on cyclosporine and steroids, requiring hospital admission owing to fever and swelling of the left testis and generalized tonic-clonic convulsions.
RESULTS: Brain magnetic resonance imaging showed abnormal signal area in right parietal and left parieto-occipital lobes. The lesions had mass effect, edema, and ring enhancement. Findings were indicative of a brain abscess. A testicular biopsy from the lower pole of the left testis was done. A white-to-yellowish discharge was seen and subsequently, Nocardia grew in culture.
CONCLUSIONS: Trimethoprim-sulfamethoxazole was prescribed, and significant improvement was seen after 2 weeks. The patient was discharged. He was subsequently referred after 3 weeks due to graft-versus-host disease and died of pancytopenia.
Предметные рубрики MeSH
Acute DiseaseAnti-Infective AgentsBone Marrow TransplantationBrain AbscessChronic DiseaseEpididymitisEpilepsy, Tonic-ClonicFatal OutcomeGraft vs Host DiseaseHumansImmunosuppressive AgentsMagnetic Resonance ImagingMaleNocardia InfectionsOrchitisPancytopeniaPrecursor Cell Lymphoblastic Leukemia-LymphomaTrimethoprim, Sulfamethoxazole Drug CombinationYoung Adult