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Nocardia Pneumonia with Empyema Thoracis in a Healthy Neonate: A Case Report†


Taweewong Tantracheewathorn MD*,
Somsak Lolekha MD, PhD**, Supapan Tantracheewathorn MD*

† Presented at the 1st Asian Congress of Pediatric Infectious Diseases,
Pattaya, Thailand, November 10-13, 2002
* Department of Pediatrics, Bangkok Metropolitan Administration Medical College and Vajira Hospital
** Department of Pediatrics, Faculty of Medicine ,Ramathibodi Hospital,Mahidol University


A 40-day-old male infant presented with fever and non-productive cough for 3 weeks, tachypnea and dyspnea 5 days before admission. The chest radiograph and computed tomographic (CT) scan revealed right lung consolidation with pleural effusion. Pleural tapping showed frank pus that grew Nocardia asteroides. The CT scan of the brain and abdomen were normal. The patient was treated with 15 mg/kg/day of trimethoprim and 75 mg/kg/day of sulfamethoxazole intravenously for 3 weeks and then orally for 6 months with complete recovery. T cell quantitative studies were normal and anti-HIV was non-reactive. A flow cytometric assay with Staphylococcal aureus and phorbol myristate acetate (PMA) as the stimulants showed normal oxidative burst which represented normal intracellular killing. One year after completion of treatment , he was healthy and the chest radiograph was normal.

Keyword : Nocardia, Nocardiosis, Pneumonia, Empyema Thoracis

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