An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case report
Abstract Background Nocardia infections are rare infections in immunocompetent patients and occur mostly in immunocompromised individuals. Usually, nocardia affects skin, brain, and lungs, but in disseminated forms, which occurred mostly in immunocompromised patients, it can involve every organ. Noc...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s13256-025-05037-0 |
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| author | Maedeh Najafizadeh Fatemeh Kourkinejad Gharaei Reza Manouchehri Ardekani Mahdi Rafiyan |
| author_facet | Maedeh Najafizadeh Fatemeh Kourkinejad Gharaei Reza Manouchehri Ardekani Mahdi Rafiyan |
| author_sort | Maedeh Najafizadeh |
| collection | DOAJ |
| description | Abstract Background Nocardia infections are rare infections in immunocompetent patients and occur mostly in immunocompromised individuals. Usually, nocardia affects skin, brain, and lungs, but in disseminated forms, which occurred mostly in immunocompromised patients, it can involve every organ. Nocardia sinusitis is extremely rare as our searches returned only a very few related studies. Case presentation In this case report, we present, for the first time, a 55-year-old Iranian male patient diagnosed with chronic lymphocytic leukemia who was receiving chemotherapeutic drugs and developed a fever. Further laboratory tests and imaging revealed pansinusitis. Following rhinoendoscopy, the sinus mucosal biopsy pathology report showed sever inflammation accompanied by aggregation of filamentous thin-walled bacteria. The patient was treated with co-trimoxazole and meropenem. Following good clinical improvement the patient was discharged and advised to continue oral co-trimoxazole for 3 months. Conclusion This case highlights that patients with febrile neutropenia should be assessed for rare infectious disease etiologies, especially those with chronic lymphocytic leukemia, as they have humeral immunodeficiency, and in the later stages of the disease, cellular immunodeficiency may also be involved. Therefore, a multisystem evaluation of patients with febrile neutropenia is necessary, particulary when no obvious source is identified in initial surveys, to uncover rare etiologies. |
| format | Article |
| id | doaj-art-2142fedf505245be8034edff189897aa |
| institution | Kabale University |
| issn | 1752-1947 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj-art-2142fedf505245be8034edff189897aa2025-01-26T12:35:29ZengBMCJournal of Medical Case Reports1752-19472025-01-011911810.1186/s13256-025-05037-0An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case reportMaedeh Najafizadeh0Fatemeh Kourkinejad Gharaei1Reza Manouchehri Ardekani2Mahdi Rafiyan3Infectious Diseases Research Center, Kashan University of Medical SciencesInfectious Diseases Research Center, Kashan University of Medical SciencesAutoimmune Disease Research Center, Kashan University of Medical SciencesInfectious Diseases Research Center, Kashan University of Medical SciencesAbstract Background Nocardia infections are rare infections in immunocompetent patients and occur mostly in immunocompromised individuals. Usually, nocardia affects skin, brain, and lungs, but in disseminated forms, which occurred mostly in immunocompromised patients, it can involve every organ. Nocardia sinusitis is extremely rare as our searches returned only a very few related studies. Case presentation In this case report, we present, for the first time, a 55-year-old Iranian male patient diagnosed with chronic lymphocytic leukemia who was receiving chemotherapeutic drugs and developed a fever. Further laboratory tests and imaging revealed pansinusitis. Following rhinoendoscopy, the sinus mucosal biopsy pathology report showed sever inflammation accompanied by aggregation of filamentous thin-walled bacteria. The patient was treated with co-trimoxazole and meropenem. Following good clinical improvement the patient was discharged and advised to continue oral co-trimoxazole for 3 months. Conclusion This case highlights that patients with febrile neutropenia should be assessed for rare infectious disease etiologies, especially those with chronic lymphocytic leukemia, as they have humeral immunodeficiency, and in the later stages of the disease, cellular immunodeficiency may also be involved. Therefore, a multisystem evaluation of patients with febrile neutropenia is necessary, particulary when no obvious source is identified in initial surveys, to uncover rare etiologies.https://doi.org/10.1186/s13256-025-05037-0SinusitisCase reportNocardiaCLLChemotherapy |
| spellingShingle | Maedeh Najafizadeh Fatemeh Kourkinejad Gharaei Reza Manouchehri Ardekani Mahdi Rafiyan An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case report Journal of Medical Case Reports Sinusitis Case report Nocardia CLL Chemotherapy |
| title | An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case report |
| title_full | An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case report |
| title_fullStr | An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case report |
| title_full_unstemmed | An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case report |
| title_short | An unveiling case of Nocardia pansinusitis in a patient with chronic lymphocytic leukemia: a case report |
| title_sort | unveiling case of nocardia pansinusitis in a patient with chronic lymphocytic leukemia a case report |
| topic | Sinusitis Case report Nocardia CLL Chemotherapy |
| url | https://doi.org/10.1186/s13256-025-05037-0 |
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