Elevated serum β-d-glucan levels in cavitary pulmonary nocardiosis.

Abstract

An 86-year-old woman with Borrmann type III colorectal cancer (Union for International Cancer Control pT4aN2bM1c, pStage IVc) had received dexamethasone for the last 6 months as palliative care. She presented with a low-grade fever, chest pain and cough. Chest radiography on admission showed cavities and consolidations bilaterally in the upper lobes. A blood examination on admission revealed highly elevated serum β-d-glucan levels. The diagnosis by bronchoscopy was pulmonary nocardiosis. With trimethoprim/sulfamethoxazole and imipenem/cilastatin, the β-d-glucan levels were decreased, and chest X-ray showed improvement after 1 month. β-d-glucan is known to be a biomarker of fungal infection. It is possible that β-d-glucan levels also indicate a pulmonary infection by Nocardia.

• Authors: Kyoko Yagyu, Yuko Nakatsuji, Haruhiko Matsushita
• Journal: BMJ case reports (BMJ Case Rep) Vol. 13 Issue 7 (Jul 22 2020) ISSN: 1757-790X [Electronic] England
• PMID: 32699055 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Anti-Bacterial Agents
• Antineoplastic Agents
• Proteoglycans
• beta-Glucans
• polysaccharide-K
• Dexamethasone
• Trimethoprim, Sulfamethoxazole Drug Combination
• Cilastatin, Imipenem Drug Combination

Topics

• Aged, 80 and over
• Anti-Bacterial Agents (therapeutic use)
• Antineoplastic Agents (adverse effects, therapeutic use)
• Cilastatin, Imipenem Drug Combination (therapeutic use)
• Colorectal Neoplasms (drug therapy)
• Dexamethasone (adverse effects, therapeutic use)
• Female
• Humans
• Nocardia Infections (chemically induced, drug therapy)
• Proteoglycans
• Treatment Outcome
• Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use)
• beta-Glucans (blood)