trimethoprim--sulfamethoxazole-drug-combination and Bronchiectasis

Topics: Aged; Anti-Infective Agents; Bronchiectasis; Bronchiolitis; Female; Humans; Lung Diseases, Interstitial; Male; Pseudomonas aeruginosa; Pseudomonas Infections; Recurrence; Sjogren's Syndrome; Tracheitis; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Mycobacterium simiae is a slow-growing mycobacteria that in rare cases can cause chronic pulmonary infection. We report the first case of lung transplantation in a patient with active M simiae infection at the time of transplantation. A 56-year-old immunocompetent nonsmoking woman underwent bilateral lung transplantation for end-stage idiopathic bronchiectasis and chronic M simiae infection. The disease proved manageable on a regimen of clarithromycin, moxifloxacin, and cotrimoxazole with a successful outcome 1-year posttransplantation. There is increasing evidence that nontuberculous mycobacterium infection should no longer be an absolute contraindication for lung transplantation.

Topics: Anti-Bacterial Agents; Aza Compounds; Bronchiectasis; Chronic Disease; Clarithromycin; Drug Therapy, Combination; Female; Fluoroquinolones; Humans; Lung Transplantation; Middle Aged; Moxifloxacin; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Quinolines; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

A rare case of pulmonary nocardiosis was presented in a nonimmunocompromised patient who had chronic airway obstruction and bronchiectasis without corticoid treatment. The microbial diagnosis was established after isolating Nocardia in bronchial aspirate and sputum samples. An in vitro study showed sensitivity only to imipenem, netilmicine, amikacin and ofloxacin. The evolution was chronic, with multiple clinical recurrences in spite of prolonged antibiotic treatment. Finally, the eradication of Nocardia was achieved with the combination of imipenem and amikacin.

Topics: Amikacin; Anti-Bacterial Agents; Bronchiectasis; Chronic Disease; Drug Therapy, Combination; Humans; Imipenem; Male; Microbial Sensitivity Tests; Middle Aged; Nocardia asteroides; Nocardia Infections; Recurrence; Respiratory Tract Infections; Thienamycins; Trimethoprim, Sulfamethoxazole Drug Combination

Two patients with severe bronchiectasis, one patient without other disease and the other with hyper IgE syndrome, were successfully treated with long-term therapy with low doses of trimethoprim and sulfamethoxazole (TMP-SMZ). Recurrent respiratory infections with productive cough and high fever were resistant to various antibiotics and often disturbed the patients' activities in daily life. However, they showed marked improvement following TMP-SMZ therapy, which was started for methicillin-resistant Staphylococcus aureus (MRSA) infection. MRSA disappeared some months later, but Pseudomonas aeruginosa appeared again in the sputum. Both patients, however, have remained free from symptoms for over one year.

Topics: Adult; Anti-Bacterial Agents; Bronchiectasis; Female; Humans; Male; Methicillin Resistance; Middle Aged; Pseudomonas Infections; Staphylococcal Infections; Staphylococcus aureus; Trimethoprim, Sulfamethoxazole Drug Combination