Disseminated Nocardia cyriacigeorgia causing pancreatitis in a haploidentical stem cell transplant recipient
Jason Chen,
Jonathan Pan,
Joanne Filicko-O’Hara,
Margaret Kasner,
Phyllis Flomenberg
Affiliations
Jason Chen
Department of Medical Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, 834 Chestnut St., Suite 320, Philadelphia, PA 19107, United States
Jonathan Pan
Department of Medical Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, 834 Chestnut St., Suite 320, Philadelphia, PA 19107, United States
Joanne Filicko-O’Hara
Department of Medical Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, 925 Chestnut St., Suite 420A, Philadelphia, PA 19107, United States
Margaret Kasner
Department of Medical Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, 925 Chestnut St., Suite 420A, Philadelphia, PA 19107, United States
Phyllis Flomenberg
Division of Infectious Diseases, Department of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, 1015 Chestnut St., Suite 1020, Philadelphia, PA 19107, United States
We report the first published case of acute pancreatitis secondary to disseminated nocardiosis in a hematopoietic stem cell transplant (HSCT) recipient on chronic immunosuppression for graft-versus-host disease (GVHD). Nocardiosis in the HSCT population is relatively rare, and has not yet been described in haploidentical HSCT recipients. Our patient is a 28-year-old male with a history of haploidentical HSCT and GVHD of the skin and lung who was admitted to the hospital with acute pancreatitis. The workup for the etiology of his pancreatitis was initially unrevealing. He subsequently developed worsening sepsis and respiratory failure despite broad spectrum antimicrobials. After multiple bronchoscopies and pancreatic fluid sampling, he was found to have disseminated nocardiosis with Nocardia cyriacigeorgia.
