CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1595190
Case Report: Bloodstream infection with Nocardia cyriacigeorgica in a patient with Diffuse Large B-cell Lymphoma
Provisionally accepted
- 1Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
- 2Department of Pharmacy, Qiqihar Hospital of Traditional Chinese Medicine, Qiqihar, China
- 3Department of Hematology, The First Hospital of Qiqihar, Qiqihar, China
- 4Department of Pharmacy, The First Hospital of Qiqihar, Qiqihar, China
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Nocardia bacteremia is a rare but life-threatening opportunistic infection associated with high mortality rates. Early diagnosis and prompt initiation of appropriate treatment are crucial for improving patient outcomes. In our study, we report a patient with diffuse large B-cell lymhoma who unfortunately had a bloodstream infection with Nocardia cyriacigeorgica. The patient presented with characteristic clinical manifestations of septic shock, including persistent high-grade fever, hypotension, and acute renal insufficiency. Despite receiving empirical treatment with imipenem for six days following admission, the patient remained febrile with temperatures reaching 39℃.Subsequent blood cultures identified N. cyriacigeorgica, prompting a modification of the antimicrobial regimen to a triple-drug combination of imipenem, linezolid, and trimethoprimsulfamethoxazole (TMP-SMX). Following the initiation of therapy, the patient demonstrated significant clinical improvement and was subsequently discharged. Based on this clinical experience and the severity of nocardial infections, we recommend combination therapy with two to three antimicrobial agents for the management of Nocardia infections.
Keywords: Nocardia cyriacigeorgica, Nocardiosis, Bloodstream infection, septic shock, Diffuse large B-cell lymphoma
Received: 17 Mar 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 Du, Xu, Wang, Tang, Li, Meng and You. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jun Meng, Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
Dan You, Department of Pharmacy, The First Hospital of Qiqihar, Qiqihar, China
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