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A case report of disseminated nocardiosis with ocular involvement in a myasthenia gravis patient and literature review

Authors
  • Wang, Shuhui1
  • Jiang, Bin1
  • Li, Yao1
  • Shang, Yanchang2
  • Liu, Zhengshan3
  • Zhang, Yongbo1
  • 1 Capital Medical University, Department of Neurology, Beijing Friendship Hospital, Beijing, 100050, China , Beijing (China)
  • 2 National Clinical Research Center for Geriatric Diseases, Department of Geriatric Neurology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, China , Beijing (China)
  • 3 University of Rochester Medical Center, Department of Neurology and Center for Translational Neuromedicine, New York, NY, USA , New York (United States)
Type
Published Article
Journal
BMC Neurology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Oct 21, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12883-019-1482-4
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundNocardiosis is a rare and life-threatening opportunistic infection in immunocompromised patients. Myasthenia gravis (MG) patients are potentially at risk of nocardia infection because of the use of immunosuppressive agents. To date, only 7 patients with MG have been reported to have nocardiosis. Disseminated nocardiosis with ocular involvement has not been reported in MG patients.Case presentationA 66-year-old man with MG who was receiving treatment with methylprednisolone and azathioprine was found to have a respiratory infection. He also had heterogeneous symptoms with skin, brain and ocular manifestations. Nocardia bacteria verified by the culture of puncture fluid, and a diagnosis of disseminated nocardiosis was made. Except for left eye blindness, the patient completely recovered from the disease with combination antibiotic therapy. To further understand nocardiosis in patients with MG, we reviewed the previous relevant literature. According to the literature, this is the first report of disseminated nocardiosis with ocular involvement in an MG patient.ConclusionsMG patients with immunosuppressant treatments are potentially at risk of a rare nocardia infection, and a favourable prognosis can be achieved through early diagnosis and appropriate antibiotic therapy.

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