Nocardial endocarditis in native aortic valve with nocardial sepsis in a case of breast cancer

BMJ Case Rep. 2019 Jul 11;12(7):e229370. doi: 10.1136/bcr-2019-229370.

Abstract

Central venous catheter-associated bacteraemia caused by Nocardia species is very rare; the diagnosis of nocardiosis in patients with cancer is challenging because its clinical presentation is varied, sometimes mimicking metastases, and the high index of clinical suspicion is required for prompt institution of therapy. Herein, we report a case of nocardial sepsis with native aortic valve endocarditis in a patient with breast cancer in whom multidisciplinary team involvement and prompt initiation of therapy have led to successful outcome.

Keywords: breast cancer; infections; oncology.

Publication types

  • Case Reports

MeSH terms

  • Amikacin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / microbiology*
  • Aortic Valve / surgery
  • Breast Neoplasms / therapy*
  • Central Venous Catheters / microbiology*
  • Clopidogrel / therapeutic use
  • Cough
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / etiology
  • Endocarditis, Bacterial / microbiology*
  • Fatigue
  • Female
  • Headache
  • Heart Valve Prosthesis Implantation
  • Humans
  • Meropenem / therapeutic use
  • Middle Aged
  • Nocardia / isolation & purification*
  • Nocardia Infections / diagnosis*
  • Nocardia Infections / pathology
  • Nocardia Infections / therapy
  • Platelet Aggregation Inhibitors / therapeutic use
  • Radiography, Thoracic*
  • Sepsis / drug therapy
  • Sepsis / microbiology*
  • Treatment Outcome
  • Warfarin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Warfarin
  • Amikacin
  • Clopidogrel
  • Meropenem