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Open Access Case report

Abscess of adrenal gland caused by disseminated subacute Nocardia farcinica pneumonia. A case report and mini-review of the literature

Michael Tachezy1*, Philipp Simon2, Corina Ilchmann3, Yogesh K Vashist1, Jakob R Izbicki1 and Karim A Gawad1

Author Affiliations

1 Department of General-, Visceral- and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Germany, Martinistraße 52, 20246 Hamburg, Germany

2 Diagnostic and Interventional Radiology Department and Clinic, University Medical Center Hamburg-Eppendorf, Germany, Martinistraße 52, 20246 Hamburg, Germany

3 Department of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Germany, Martinistraße 52, 20246 Hamburg, Germany

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BMC Infectious Diseases 2009, 9:194  doi:10.1186/1471-2334-9-194

Published: 2 December 2009

Abstract

Background

Infections caused by Nocardia farcinica are uncommon and show a great variety of clinical manifestations in immunocompetent and immunocompromised patients. Because of its unspecific symptoms and tendency to disseminate it may mimic the clinical symptoms and radiologic findings of a tumour disease and the diagnosis of nocardiosis can easily be missed, because there are no characteristic symptoms.

Case presentation

We present a case of an adrenal gland abscess caused by subacute disseminated N. farcinica pneumonia.

Conclusion

An infection with N. farcinica is potentially lethal because of its tendency to disseminate -particularly in the brain- and its high resistance to antibiotics. Awareness of this differential diagnosis allows early and appropriate treatment to be administered.