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KMID : 0882420090770010128
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Korean Journal of Medicine
2009 Volume.77 No. 1 p.128 ~ p.132
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Streptococcus salivarius pneumonia with pulmonary nocardiosis in a rheumatoid arthritis patient treated with immunosuppressants
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Jeong In-A
Kim Young-Whan
Kim Hye-Ryoun
Lee Eun-Young
Yang Seok-Chul
Heo Eun-Young
Lee Jae-Seok
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Abstract
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Streptococcus salivarius is a Gram-positive organism that belongs to the viridians group of streptococci. It is a relatively non-virulent bacterium that is part of the normal flora. It is rarely isolated from blood and is usually considered a contaminant. Nevertheless, S. salivarius may cause life-threatening infections, especially in immunocompromised hosts. There have been relatively few reports of S. salivarius pneumonia. Nocardiosis is also a rare opportunistic infection. Pulmonary nocardiosis is difficult to diagnose and, consequently, the diagnosis is often delayed. We report an unusual presentation with multiple pulmonary mass-like consolidations caused by a mixed infection of S. salivarius and Nocardia sp. in a 58-year-old man with rheumatoid arthritis who was taking oral corticosteroid, methotrexate, and leflunomide. The patient’s symptoms and radiographic findings improved after six weeks of antibiotic therapy.
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KEYWORD
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Streptococcus salivarius, Nocardia, Rheumatoid arthritis
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