A Diagnostic Challenge: A Case of Disseminated Nocardiosis Presenting With Generalized Lymphadenopathy in a Patient With Interleukin-12 Deficiency

Deficiency in interleukin-12 (IL-12) can result in susceptibility to opportunistic infection, with IL-12 deficiency being a rare genetic cause. is a gram-positive aerobic actinomycete that can cause disseminated and potentially lethal nocardiosis in immunocompromised patients. This report describes...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-06, Vol.16 (6), p.e62396
Main Authors: Mitwalli, Hussam, Alekrish, Yazeed, Nafisah, Faris, Alkhamshi, Abdullah
Format: Article
Language:English
Subjects:
Abdomen
Abscesses
Biopsy
Bone marrow
Cytokines
Endoscopy
Hemodynamics
Infections
Infectious Disease
Intensive care
Lymphatic system
Medical diagnosis
Medical imaging
Pleural effusion
Teenagers
Tomography
Urine
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Summary:Deficiency in interleukin-12 (IL-12) can result in susceptibility to opportunistic infection, with IL-12 deficiency being a rare genetic cause. is a gram-positive aerobic actinomycete that can cause disseminated and potentially lethal nocardiosis in immunocompromised patients. This report describes a 16-year-old male adolescent with IL-12 deficiency presenting with generalized lymphadenopathy due to disseminated The subject of our study is a male adolescent who exhibited clinical manifestations consistent with cholestasis. He underwent extensive workup for malignancy, suspecting cholangiocarcinoma initially. The workup turned out unremarkable, and later during his hospital stay, he deteriorated and required intensive care unit (ICU) admission, as he developed superior vena cava (SVC) syndrome from massive enlargement of mediastinal and cervical lymph nodes. During the patient's admission, it was found that he had a deficiency of interleukin-12 (IL-12). Later on, a blood culture revealed the presence of species. Subsequently, the patient was initiated and improved drastically on an empirical antibiotic regimen consisting of amikacin, co-trimoxazole, meropenem, and moxifloxacin. Following that, the susceptibility results came out, and he was switched to oral co-trimoxazole and oral moxifloxacin as he no longer required inpatient care. This report highlights the importance of accurate diagnosis of causes of immunosuppression and early investigation, diagnosis, and management of potentially fatal opportunistic infections such as disseminated
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.62396