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Abstract：
A nocardial abscess is a relatively rare opportunistic infection that typically occurs after immunosuppressive treatment and is a clinical challenge. In the present study, the case of a 69-year-old patient with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and lung and kidney involvement, was reported. The patient received systemic glucocorticoid and cyclophosphamide treatment for 6 months, after which a large encapsulated abscess appeared on magnetic resonance imaging and CT in the subcutaneous tissue of the left hip and lung, respectively, and the pus culture showed Nocardia. Orthopedic abscess incision and ultrasound-guided thoracic puncture drainage were performed, and the lesion was completely absorbed after 1 month of treatment with linezolid and compound sulfamethoxazole. Tests for ANCA were negative, and renal function and urine tests were completely normal after 1 year of follow-up. Furthermore, a literature review performed for the present study retrieved a few reports of successful treatment of multiple nocardial abscesses secondary to ANCA-associated vasculitis in elderly patients in a short period of time. Therefore, the present case report and literature review have been reported to improve awareness of this rare disease, so as to facilitate its early diagnosis and treatment.
摘要：
心脓肿是一种相对罕见的机会性感染，通常在免疫抑制治疗后发生，是一种临床挑战。在本研究中,一例69岁的抗中性粒细胞胞浆抗体（ANCA）相关性血管炎患者，肺和肾脏受累，已报告。患者接受全身糖皮质激素和环磷酰胺治疗6个月，此后，在磁共振成像和CT上，左髋和肺的皮下组织中出现了一个大的包裹性脓肿，分别,脓液培养显示诺卡氏菌.行骨科脓肿切开及超声引导下胸腔穿刺引流术,利奈唑胺和复方磺胺甲恶唑治疗1个月后病灶完全吸收。ANCA检测结果呈阴性,随访1年后，肾功能和尿液检查完全正常。此外，本研究进行的文献综述检索了一些在短时间内成功治疗老年患者ANCA相关性血管炎继发的多个腔内脓肿的报告.因此,目前的病例报告和文献综述已经报道，以提高对这种罕见疾病的认识，以利于其早期诊断和治疗。
