%0 Case Reports
%T Challenges in treatment of disseminated nocardiosis in an elderly patient with renal failure on corticosteroids: a case report.
%A Nagasaki K
%A Gomi H
%A Ishioka H
%A Taguchi S
%A Takayashiki N
%A Kobayashi H
%J IDCases
%V 20
%N 0
%D 2020
%M 32373466
暂无%R 10.1016/j.idcr.2020.e00755
%X We report the case of a 71-year-old Japanese man with a history of chronic kidney disease and sarcoidosis receiving chronic corticosteroids who presented with disseminated Nocardia brasiliensis infection. He initially showed improvement with empiric antimicrobial therapy including trimethoprim-sulfamethoxazole. However, he deteriorated after modifying the empiric regimen due to complicated hyperkalemia and ultimately died. In general, elderly patients have decreased renal function. Standard therapy for nocardiosis with trimethoprim-sulfamethoxazole may not be used for a prolonged period of time. This case emphasizes the challenges and importance of prudent selection of empiric antimicrobial therapy for disseminated nocardiosis in elderly patients with underlying kidney disease.