trimethoprim--sulfamethoxazole-drug-combination and Liver-Cirrhosis--Alcoholic

Nocardiosis is usually a disseminated disease seen in immunocompromised individuals. We herein present a rare case of isolated Nocardia liver abscess post liver transplantation. The patient responded well to treatment and is on long-term antibiotics for Nocardia infection.

Topics: Anti-Bacterial Agents; End Stage Liver Disease; Glucocorticoids; Humans; Immunocompromised Host; Immunosuppression Therapy; Immunosuppressive Agents; Liver Abscess; Liver Cirrhosis, Alcoholic; Liver Transplantation; Male; Middle Aged; Mycophenolic Acid; Nocardia; Nocardia Infections; Paracentesis; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Tacrolimus; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography, Doppler; Ultrasonography, Interventional

Topics: Aged; Anti-Bacterial Agents; Anti-Infective Agents; Ascites; Humans; Liver Cirrhosis, Alcoholic; Male; Norfloxacin; Peritonitis; Staphylococcaceae; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Sirolimus is a powerful immunosuppressive drug initially used in kidney transplant patients but now increasingly employed in recipients of other types of solid organ transplants, such as liver, heart, lung, or pancreas. Sirolimus is indicated for rescue therapy and to reduce the toxic side effects of calcineurin inhibitors. However, its use has been associated with an uncommon but important pulmonary toxicity. Reports have described interstitial pneumonitis, bronchiolitis obliterans, organizing pneumonia, and alveolar proteinosis. We present the case of a liver transplant patient with interstitial pneumonitis associated with sirolimus.

Topics: Humans; Immunosuppressive Agents; Liver Cirrhosis, Alcoholic; Liver Transplantation; Lung Diseases, Interstitial; Male; Middle Aged; Sirolimus; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination