Chronic relapsing neutrophilic meningitis as the sole manifestation of nocardiosis in a patient with mixed connective tissue disease
M. Anthony Albornoz,
Erin K. Threlfall,
Michael Philip Baldassari,
Lawrence J. Livornese, Jr.
Affiliations
M. Anthony Albornoz
Riddle Memorial Hospital/Main Line Health System, Dept. of Rheumatology, l̥1088 West Baltimore Pike Suite 2105, Health Center II, Media, PA 19063, USA; Correspondence to: 1088 West Baltimore Pike, Suite 2105 Health Center II, Media, PA 19063, USA.
Erin K. Threlfall
Riddle Memorial Hospital/Main Line Health System, Dept. of Rheumatology, l̥1088 West Baltimore Pike Suite 2105, Health Center II, Media, PA 19063, USA
Michael Philip Baldassari
Thomas Jefferson University, Dept. of Neurosurgery, 909 Walnut St #3, Philadelphia, PA 19107, USA
Lawrence J. Livornese, Jr.
Lankenau Medical Center/Main Line Health System Dept. of Infectious Disease, 100 E Lancaster Ave, Wynnewood, PA 19096, USA
We describe a rare case of a patient with mixed connective tissue disease maintained on chronic oral corticosteroids, who was hospitalized on five occasions over five consecutive months due to persistent relapsing neutrophilic meningitis caused by Nocardia asteroides. Immunosuppression due to the chronic use of corticosteroids was identified as the underlying mechanism of susceptibility. Our report highlights the challenges associated with systemic Nocardiosis, particularly in the immunocompromised host.
