Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 20-year-old woman receiving corticosteroid treatment for systemic lupus erythematosus developed pulmonary nocardiosis with hydrophneumothorax. The organism identified as Nocardia asteroides resisted to sulfonamide and cotrimoxazole but sensitive to chloramphenicaol and streptomycin in vitro. She seemed to respond to chloramphenicol but subsequently had peritonitis and succumbed later.
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PMID:Pulmonary nocardiosis in a patient receiving immunosuppressive agent. 60 22

A 24-year-old Thai woman receiving corticosteroid treatment for systemic lupus erythematosus, developed pulmonary nocardiosis after pulmonary collapse. The correct diagnosis was reached when dissemination had occurred which was characterized by two subcutaneous abscesses and acute uveitis of the right eye. Gram stain of sputum and pus revealed delicate, branching, Gram-positive filamentous mycelia which were identified as Nocardia asteroides on culture. Subcutaneous abscesses and exophthalmos disappeared after one week of therapy and she made an uneventful recovery.
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PMID:Disseminated nocardiosis after pulmonary collapse: a case report. 61 17

From 1982 to 1988, 20 patients with pulmonary nocardiosis were diagnosed at the Department of Medicine, Chulalongkorn Hospital University. The infection was found to be common in immuno-compromised hosts particularly in patients who were suffering from lymphoreticular malignancy, systemic lupus erythematosus, nephrotic syndrome, pulmonary alveolar proteinosis and in patients who were receiving corticosteroids. The clinical manifestations were usually nonspecific. Diagnosis of pulmonary nocardiosis in cases who presented with a short duration of fever and productive cough was often delayed because they were considered to have acute bacterial pneumonia. The findings on chest roentgenogram were nonspecific as nonhomogeneous airspace infiltrates, cavitary lesions, nodule, or miliary infiltrates. The complete blood count frequently showed leukocytosis and neutrophilia. The diagnosis of nocardiosis was suspected if the staining of specimens obtained from the lesions showed typically weakly gram-positive and modified acid-fast branching filament organism and the diagnosis was confirmed by culture. The skin and the central nervous system were the most common hematogenous disseminations. Sulfamethoxazole and trimethoprim in combination were the drugs of choice. The treatment for a minimum of 6 months was appropriate in order to prevent relapse. Poor prognostic factors in nocardiosis were acute infection, Cushing's disease; and disseminated infection involving the central nervous system.
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PMID:Pulmonary nocardiosis in Chulalongkorn Hospital. 178 75

Two cases of nocardiosis with underlying SLE are presented. Both were female patients aged 19 and 34 years and had been treated with steroid and endoxan for some time. Death from lesions in the respiratory tract and right kidney with growth of Nocardia asteroides at autopsy was noted in the first case. The second patient exhibited fever with dyspnea and subsequent peripheral neuromuscular dysfunction. Disseminated nocardial abscesses in multiple organs including lungs, liver, spleen, lymph nodes and subcutaneous tissue were disclosed postmortem. Moreover, intravascular dissemination of the organisms had resulted in thrombosis of several blood vessels supplying the spinal cord resulting in widespread myelomalacia. Recent infarction of a few spinal nerve roots was also observed.
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PMID:Nocardiosis: report of 2 cases with review of literature in Thailand. 202 81

Nocardiosis is an increasingly recognised opportunistic infection in immunologically incompetent hosts but diagnosis is often delayed. Between December 1975 to October 1988, our two Nephrology Units have encountered five cases of nocardiosis occurring in two post-renal transplant patients, two patients with systemic lupus erythematous (SLE) and one patient with mesangiocapillary glomerulo--nephritis. All were on immunosuppressants at the time. The first three patients presented with predominant pulmonary disease and were cured by combined trimethoprim-sulphamethoxazole (cotrimoxazole) and doxycycline therapy. The patient with limited skin involvement responded to cotrimoxazole alone. However, the last patient with lymphocutaneous disease initially responded to cotrimoxazole (+ chloramphenicol) but developed acute-on-chronic renal failure and relapsed with dose reduction of cotrimoxazole. Alternative treatment with amikacin and doxycycline was instituted with good response. We shall review potential clues that may suggest the diagnosis of nocardiosis and discuss other effective antimicrobial agents.
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PMID:Spectrum of nocardiosis in renal patients. 239 40

The second reported case of laryngeal nocardiosis in a patient with lupus is described. The manifestations of laryngeal lupus and clinical features that may help to differentiate laryngeal lupus from infection are discussed.
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PMID:Laryngeal infection in lupus: report of nocardiosis and review of laryngeal involvement in lupus. 304 81

Pulmonary nocardiosis developed in three male patients with systemic lupus erythematosus (SLE), all of whom had been or were being treated with steroids and cytotoxic agents. These three cases comprise virtually the entire experience of our medical center with this infectious agent since 1971, and no cases of nocardiosis have been seen in a large group of treated and untreated female SLE patients. Unlike nine of ten previously reported cases, our patients each survived the infection with appropriate therapy, and subsequently either did well or died of other disease complications. The predisposition of nocardial infection for immunologically suppressed male subjects appears to hold true in SLE in spite of the strong predilection of this disease for women.
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PMID:Pulmonary nocardiosis. Occurrence in men with systemic lupus erythematosus. 736 55

Nocardiosis is an uncommon complication in children with systemic lupus erythematosus (SLE). This is a case report of pulmonary nocardiosis in a 13 year-old girl with SLE, who presented with fever, chest pain and tachypnea. She had been treated with steroids and cytotoxic agents for five months. Nocardia asteroides was isolated from a surgical specimen culture. The pulmonary nocardiosis was treated by surgical excision in combination with trimethoprim-sulfamethoxazole. Nocardia sp should be considered as a possible agent of infection in immunocompromised patients, especially those treated with corticosteroids at the time of infection.
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PMID:Pulmonary nocardiosis in a child with systemic lupus erythematosus: report of a case. 754 82

We report a case of lymphocutaneous nocardiosis due to Nocardia brasiliensis, marked by multiple subcutaneous nodules and abscesses on the extensor aspect of the left forearm in a 53-year-old woman with systemic lupus erythematosus. Nine months before she was first examined, she had fallen on a concrete surface. A nodule had appeared 2 months later at the same site and had expanded and been followed by others, which finally covered most of the extensor aspect of the forearm. We speculated that the bacteria may have been conveyed retrogradely via the lymph vessels in a distal direction, perhaps as a result of the trauma and the subsequent development of an intradermal lesion.
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PMID:Lymphocutaneous nocardiosis with multiple subcutaneous nodules distributed over the extensor aspect of the forearm. Report of a case. 770 76

Nocardia is an important but often overlooked opportunistic infection agent in immunocompromised hosts. Nocardiosis is primarily pulmonary; central nervous system involvement, usually in the form of brain abscess, is less common. Primary nocardial meningitis without associated brain abscess and pulmonary lesion is extremely rare and poses a formidable diagnostic challenge. We report on a patient with systemic lupus erythematosus who presented with a clinical picture of chronic meningitis which failed to respond to empirical antibiotic treatment. She deteriorated and succumbed. Post-mortem examination showed nocardial meningitis without associated brain abscesses. Nocardial meningitis should be considered a differential diagnosis of subacute meningitis in immunocompromised hosts.
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PMID:Primary nocardial meningitis in systemic lupus erythematosus. 770 68


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