Nocardia asteroides peritoneal dialysis-related peritonitis: First case in pediatrics, treated with protracted linezolid

• Published in: Journal of infection and public health 2016-03, Vol.9 (2), p.192-197
• Main Authors: El-Naggari, Mohamed, El Nour, Ibtisam, Al-Nabhani, Dana, Al Muharrmi, Zakaria, Gaafar, Heba, Al Wogoud Abdelmogheth, Anas
• Format: Article
• Language: English
• Subjects: Abscess - diagnosis; Abscess - drug therapy; Abscess - microbiology; Abscess - pathology; Administration, Intravenous; Administration, Oral; Adolescent; Anti-Bacterial Agents - therapeutic use; Continuous ambulatory peritoneal dialysis; Female; Humans; Infectious Disease; Internal Medicine; Intra-abdominal abscess; Linezolid - therapeutic use; Nocardia asteroides; Nocardia asteroides - isolation & purification; Nocardia Infections - diagnosis; Nocardia Infections - drug therapy; Nocardia Infections - microbiology; Nocardia Infections - pathology; Oman; Peritoneal dialysis; Peritoneal Dialysis - adverse effects; Peritonitis; Peritonitis - diagnosis; Peritonitis - drug therapy; Peritonitis - microbiology; Peritonitis - pathology; Treatment Outcome
• ISSN: 1876-0341; 1876-035X
• DOI: 10.1016/j.jiph.2015.11.003

Summary Nocardia asteroides is a rare pathogen in peritoneal dialysis-related peritonitis. We report on a 13-year-old female with Nocardia asteroides peritonitis complicated by an intra-abdominal abscess. Linezolid was administered intravenously for 3 months and followed by oral therapy for an additional 5 months with close monitoring for adverse effects. The patient was discharged after 3 months of hospitalization on hemodialysis. The diagnosis and management of such cases can be problematic due to the slow growth and difficulty of identifying Nocardia species. The optimal duration of treatment for Nocardia peritonitis is not known. Linezolid can be used for prolonged periods in cases of trimethoprim/sulfamethoxazole-resistant cases with close monitoring for adverse effects.