Infection and Drug Resistance (Aug 2022)
A Rare Case of Co-Infection with Nocardia farcinica, Pneumocystis jirovecii, and Aspergillus fumigatus Due to Tooth Extraction in a Mildly Immunosuppressed Patient
Abstract
Guo Jinlin,1,* Song Shaohui,2,* Zhang Wenjun,3 Cai Xinfeng4 1Department of Pharmacy, Shanxi Provincial People’s Hospital, Taiyuan, People’s Republic of China; 2Department of Pharmacy, The Maternal and Child Health Hospital of Dadukou District of Chongqing City, Chongqing, People’s Republic of China; 3Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 4Department of Pharmacy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Cai Xinfeng, Shanxi Province Cancer Hospital, Taiyuan, Shanxi, 030012, People’s Republic of China, Tel +86-18835167718, Email [email protected]: We report a case of co-infection with Nocardia farcinica, Pneumocystis jirovecii, and Aspergillus fumigatus due to tooth extraction in a mildly immunosuppressed patient. This patient did not respond well to a meropenem-based regimen, and the number of lesions was significantly reduced after switching to imipenem. The patient’s trough concentration was insufficient when using conventional doses of voriconazole for the treatment of pulmonary aspergillosis. After adding omeprazole, the concentration reached standard levels and symptoms improved. The patient eventually made a full recovery.Keywords: Aspergillus fumigatus, interaction, intracranial infection, Nocardia farcinica, Pneumocystis jirovecii, voriconazole
