RESUMO
Systemic infections with Nocardia species continue to be a serious threat to immunosuppressed hosts. Diagnosis of these infections can be difficult despite their known tendency for cerebral and subcutaneous involvement. We describe a patient who presented with nonspecific constitutional symptoms and was found to have subcutaneous and cerebral abscesses due to Nocardia farcinica. In addition, a blood culture yielded the organism. The patient responded remarkably to oral therapy; resolution of the cerebral disease was observed on serial magnetic resonance images. We discuss the important clinical features on N. farcinica infection, the rarity of positive blood cultures, and the importance of susceptibility testing of Nocardia species in selecting drug therapy.
Assuntos
Antibacterianos/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Nocardiose/tratamento farmacológico , Nocardia/isolamento & purificação , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/microbiologia , Abscesso Encefálico/fisiopatologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Nocardia/efeitos dos fármacos , Nocardia/crescimento & desenvolvimento , Nocardiose/diagnóstico , Nocardiose/microbiologia , Nocardiose/fisiopatologiaRESUMO
We describe a case of renal-cell carcinoma insulated and entrapped in the renal capsule by a calcified and ossified rim. To our knowledge, this is the first time a renal-cell carcinoma of the renal capsule is reported. The fact that the tumor cells originated from the distal/medullary tubules was supported by immunohistochemical studies. The pertinent literature is reviewed.