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Triple-drug antibiotic therapy for disseminated nocardial abscess in the mediastinum and brain of an immunocompetent patient: a case report.

BMC Infect Dis

January 2025

Department of Oncology, General Hospital of Western Theatre Command, No. 270, Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan, 610000, People's Republic of China.

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, a rapidly growing non-tuberculous mycobacterium, rarely causes pulmonary diseases. A patient was admitted to our hospital with a fever and cough. Chest radiography revealed consolidation in the right middle lung.

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Despite the high sepsis-associated mortality, effective and specific treatments remain limited. Using conventional antibiotics as TIENAM (imipenem and cilastatin sodium for injection, TIE) is challenging due to increasing bacterial resistance, diminishing their efficacy and leading to adverse effects. We previously found that aloe-emodin (AE) exerts therapeutic effects on sepsis by reducing systemic inflammation and regulating the gut microbiota.

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Objectives: Imipenem/cilastatin/relebactam (IMI/REL) is a β-lactam/β-lactamase inhibitor combination effective against gram-negative pathogens. Efficacy and safety of IMI/REL were studied in critically ill adults with hospital-acquired bacterial pneumonia (HABP) or ventilator-associated bacterial pneumonia (VABP).

Methods: In this phase III, double-blind, multinational, randomized trial (NCT03583333), adults with HABP/VABP were randomized 1:1 to receive intravenous IMI/REL (500 mg/250 mg) or piperacillin/tazobactam (PIP/TAZ; 4000 mg/500 mg) every 6 h for 7-14 days.

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Background: In April 2024, our hospital confirmed a rare case of intra-abdominal infection by Kodamaea ohmeri. The patient sought medical attention at our hospital after taking painkillers orally for one month, experiencing recurrent abdominal pain for 17 days and worsening for 7 days. In March 2024, the patient received symptomatic treatment with oral analgesics (diclofenac sodium) for arthritis.

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