Macaulay Amechi Onuigbo
1,2*, Nneoma Agbasi
31 Mayo Clinic College of Medicine, Rochester, MN, USA
2 Department of Nephrology, Mayo Clinic Health System, Eau Claire, WI, USA
3 North East London NHS Foundation Trust, United Kingdom
Abstract
The management of potentially life-threatening brain nocardiosis in an elderly renal transplant
recipient with the relevant specific antimicrobial agents while still continuing anti-rejection
immunosuppressive therapy poses major clinical, pharmaceutical and logistical problems.
This is a case of a 70-plus year old Caucasian male renal transplant recipient on maintenance
immunosuppression, who developed a left flank abscess that was later complicated by the
onset of personality changes from brain nocardiosis. The evolution of the diagnosis, treatment
and recovery in this case presentation highlight the need for microbial susceptibility testing,
the need for pharmacovigilance to monitor drug intolerance and drug resistance as well as
other overarching treatment strategies including a close collaboration between Infectious
Diseases and Transplant Medicine specialties in the management of this complicated case.
Implication for health policy/practice/research/medical education:
A 74-year old Caucasian male renal transplant recipient on maintenance immunosuppression developed a left flank abscess that
was later complicated by the onset of personality changes due to brain nocardiosis. The evolution of the diagnosis, treatment
and recovery highlighted the need for microbial susceptibility testing, pharmacovigilance to monitor drug intolerance, drug
toxicities and drug resistance. Such cases demand a very close and cooperative collaborative relationship between infectious
diseases and transplant medicine specialties.
Please cite this paper as: Onuigbo MA, Agbasi N. Reversible personality changes caused by brain nocardiosis in a 74-year old
Caucasian male renal transplant recipient following disease-specific antimicrobial therapy. J Renal Inj Prev. 2018;7(3):211-214.
10.15171/jrip.2018.49