Int Conf AIDS. 1994 Aug 7-12;10(2):134 (abstract no. PB0551). Unique
PURPOSE: Description of the clinical and therapeutical characteristics
of two patients native from Argentina with asteroid nocardia infection
and HIV infection. Patient 1: Age: 29. Sex: male. Cause of
hospitalization: febrile syndrome, productive cough, dyspnea and loss of
weight. Formerly adicted to intravenous and breathing in drugs.
Heterosexual. First opportunistic infection suffered by the patient. The
physical examination shows a patient who seems severely ill.
Condensation syndrome in the right lung middle field and left middle and
lower field. Tachypnea. Hepatomegaly. Mucopurulent expectoration, once
hemoptoic. Skin and mucosa jaundice. Splenomegaly. Thorax X-rays with
mixed interstice-alveolar-type infiltrate in the right middle lung field
and left middle and lower fields. CD4 less than 50/mm3. Asteroid
Nocardia sputum examination. Sulfadiazine and imipenem treatment.
Patient 2: Age: 19. Sex: male. Cause of hospitalization: febrile
syndrome, diarrhea and subcutaneous nodules on the left upper limb, head
and left pectoral area. Formerly addicted to intravenous drugs.
Heterosexual. First opportunistic infection. First physical examination
shows a patient who seems severely ill. Nodules on the left upper limb
left parietal area and left pectoral area of about 5 cm to 8 cm in
diameter; painful, soft, seem slightly swelling. Drainage of pectoral
tumor and upper limb with abundant purulent secretion. Thorax X-rays
with extended bilateral micronodulillar infiltrate from vertex to base.
CD4 less than 50/mm3. Patient develops a Lyell syndrome in his
evolution. Asteroid nocardia isolated in the purulent material of the
subcutaneous nodules. Treatment with sulfadizine and amikacine.
CONCLUSIONS: Nocardiosis is not commonly found in HIV patients. It must
be included in the differential diagnostic of HIV patients with fever
mainly showing respiratory, neurologic and cutaneous evidences. It was
present among our patients as the first episode of opportunistic
infection, although these were patients with advanced immunosuppression.
We further evaluated the efficiency of the sulfadiazine association to
imipenem and amikacine.
Adult Amikacin/ADMINISTRATION & DOSAGE Antibiotics,
Combined/ADMINISTRATION & DOSAGE AIDS-Related Opportunistic
Infections/*COMPLICATIONS/DRUG THERAPY Case Report Connective Tissue
Diseases/COMPLICATIONS/DRUG THERAPY Human Imipenem/ADMINISTRATION &
DOSAGE Male *Nocardia asteroides Nocardia
Infections/*COMPLICATIONS/DRUG THERAPY Pneumonia/COMPLICATIONS/DRUG
THERAPY Substance Abuse, Intravenous/COMPLICATIONS
Sulfadiazine/ADMINISTRATION & DOSAGE ABSTRACT