Successful maintenance therapy with moxifloxacin for disseminated nocardiosis caused by Nocardia farcinica in a patient with Cushing's syndrome

de Escalante Yangüela, Begoña ; Ligero López, Jorge (Universidad de Zaragoza) ; Venegas Robles, Alejandro ; Urdaniz Borque, Rosana ; Vallejo Grijalba, Juan ; Bandrés Nivela, Orosia ; Juan Bañón, José Luis ; Beltrán Rosel, Antonio (Universidad de Zaragoza)

Resumen: Nocardia species are aerobic, Gram-positive actinomycetes often causing opportunistic infections, particularly in immunocompromised hosts. Nocardia farcinica is notable for disseminated nocardiosis (DN), frequently involving the lungs and central nervous system (CNS). Cushing's syndrome (CS), characterized by hypercortisolemia, further predisposes patients to severe infections.
We report a 73-year-old woman with ACTH-dependent CS due to a pituitary adenoma who developed DN with pleuropulmonary, CNS, and gluteal abscesses. Diagnosis was confirmed through cultures and MALDI-TOF MS, identifying N. farcinica. Resistance to standard antibiotics required a tailored regimen, including imipenem, amikacin, and moxifloxacin, alongside surgical management of abscesses and the adenoma.
This case emphasizes the importance of rapid diagnostic methods and individualized therapies in managing DN with CS, a rare but severe combination. It highlights the need for vigilance in high-risk patients and contributes valuable insights for optimizing outcomes in such complex cases.

Idioma: Inglés

DOI: 10.1016/j.diagmicrobio.2025.116718

Año: 2025

Publicado en: Diagnostic Microbiology and Infectious Disease 111, 3 (2025), 116718 [6 pp.]
ISSN: 0732-8893

Tipo y forma: Article (Published version)

Área (Departamento): Área Parasitología (Dpto. Microb.Ped.Radio.Sal.Pú.)
Área (Departamento): Área Microbiología (Dpto. Microb.Ped.Radio.Sal.Pú.)