Nocardia farcinica lung abscess presenting in the context of advanced HIV infection: Spontaneous resolution in response to highly active antiretroviral therapy alone.

A 43-year-old man, known to be HIV-positive, presented with a six-week history of symptoms including cough, hemoptysis, anterior chest pain, fever and wasting. His CD4 cell count was 46 cells/muL, and his chest x-ray showed a cavitating lesion in the left upper lobe. Sputum culture was positive for Nocardia farcinica. His infection resolved following initiation of antiretroviral therapy. Nocardia is an uncommon opportunistic pathogen in patients with HIV infection and is usually associated with advanced CD4 depletion, cavitary pneumonia, metastatic infection and high mortality. The impact of antiretroviral therapy on Nocardia infection in the setting of HIV has not been clearly elucidated. The current report is the first to present a case in which a complete clinical cure of Nocardia pneumonia has been documented, primarily in response to highly active antiretroviral therapy alone.

Sterically hindered and robust pnictogen ligands derived from carboranes: synthesis and X-ray structure determination of tris(1'-methyl(1,2-dicarba-closo-dodecaboran-1-yl))phosphine, tris(1'-methyl(1,2-dicarba-closo-dodecaboran-1-yl))arsine and chloro(tris(1'-methyl(1,2-dicarba-closo-dodecaboran-1-yl))phosphine)gold(I).

Sterically hindered phosphine and arsine ligands derived from ortho-carborane were synthesized and characterized by X-ray crystallography. Tris(1'-methyl(1,2-dicarba-closo-dodecaboran-1-yl))phosphine, 2 (crystal data, hexagonal, space group P6(3), a = b = 12.251(3) A, c = 11.514(4) A, alpha = beta = 90 degrees, gamma = 120 degrees, V = 1496.6(7) A(3), Z = 2, R(1) = 0.0568) and tris(1'-methyl(1,2-dicarba-closo-dodecaboran-1-yl))arsine, 3 (crystal data, hexagonal, space group P6(3), a = b = 12.330(3) A, c = 11.474(4) A, alpha = beta = 90 degrees, gamma = 120 degrees, V = 1510.7(7) A(3), Z = 2, R(1) = 0.0930) were prepared in 82% and 68% yield, respectively. The phosphine ligand is resistant to air-oxidation but was converted to corresponding oxide when heated with hydrogen peroxide. The tertiary carboranyl phosphine reacted with (Tht)AuCl to yield chloro(tris(1'-methyl(1,2-dicarba-closo-dodecaboran-1-yl))phosphine)gold(I), 4 (crystal data, monoclinic, space group P2(1)/c, a = 19.101(4) A, b = 12.167(2) A, c = 13.846(3) A, alpha = gamma = 90 degrees, beta = 91.13(3) degrees, V = 3217.2(11) A(3), Z = 4, R(1) = 0.0396) in 82% yield. From the X-ray structure of the gold complex, the cone angle of the phosphine was determined to be 213(2) degrees, which is among the largest values reported to date.