minocycline and Nephrotic-Syndrome

We present a case of Rhodococcus equi primary retroperitoneal abscesses without pulmonary involvement in an immunocompromised patient with severe nephrotic syndrome. No risk factors for exposure to R. equi were present. The infection was successfully treated with long-term combination antibiotic treatment including linezolid and tigecycline.

Topics: Abdominal Abscess; Acetamides; Actinomycetales Infections; Adult; Anti-Bacterial Agents; Drug Therapy, Combination; Humans; Immunocompromised Host; Injections, Intravenous; Linezolid; Male; Microbial Sensitivity Tests; Minocycline; Nephrotic Syndrome; Oxazolidinones; Retroperitoneal Space; Rhodococcus equi; Tigecycline; Treatment Outcome

We describe an unusual case of disseminated subcutaneous abscesses caused by Nocardia farcinica in a 49-year-old man with nephrotic syndrome. He had received systemic corticosteroid therapy for 5 months. He developed a submandibular abscess associated with sialoadenitis on the right submaxillary gland. Magnetic resonance imaging revealed connection between the submandibular abscess and the right submaxillary gland. The subcutaneous abscess spread from the submandibular triangle to the left axillary region, the left upper arm, the left hypochondriac region, the left scapular region, the right epigastric region, and the bilateral legs. A chest radiograph and computed tomograms of the chest and the brain did not reveal any pathologic changes. The patient was successfully treated by surgical drainage of the abscesses and by oral administration of minocycline.

Topics: Abdomen; Abscess; Anti-Bacterial Agents; Arm; Axilla; Drainage; Focal Infection; Humans; Leg; Magnetic Resonance Imaging; Male; Middle Aged; Minocycline; Nephrotic Syndrome; Nocardia; Nocardia Infections; Scapula; Shoulder; Skin Diseases, Bacterial; Submandibular Gland Diseases