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Pemphigus vulgaris and disseminated nocardiosis
F J Martín1, A M Pérez-Bernal, F Camacho
1Department of Dermatology, University Hospital Virgen Macarena, Seville, Spain.
Abstract:
Infectious diseases, in particular septicaemia from Staphylococcus aureus, Proteus vulgaris and Pseudomonas aeruginosa, are the most severe and frequent complications for the immunosuppressive therapy of pemphigus. Infection by Nocardia asteroides in subjects with pemphigus vulgaris is rare. We report the sixth case found of such an association; the subject died of disseminated nocardiosis while receiving steroids and immunosuppressive drugs, 4 years after being diagnosed with chronic pemphigus vulgaris.
Insights
Nocardia asteroides infection is a rare but severe complication in patients with pemphigus vulgaris undergoing immunosuppressive therapy. This case highlights the risk of disseminated nocardiosis leading to fatal outcomes in such vulnerable individuals.
Area of Science:
- Immunology
- Infectious Diseases
- Dermatology
Background:
- Pemphigus vulgaris is an autoimmune blistering disease often managed with immunosuppressive therapy.
- Immunosuppression increases the risk of severe infectious complications, including bacterial sepsis from common pathogens like Staphylococcus aureus.
Observation:
- This report details the sixth known case of Nocardia asteroides infection in a patient with pemphigus vulgaris.
- The patient was undergoing treatment with steroids and other immunosuppressive agents for chronic pemphigus vulgaris.
Findings:
- The patient developed disseminated nocardiosis, a rare infection caused by Nocardia asteroides.
- Despite medical intervention, the infection proved fatal, underscoring the severity of Nocardia infections in immunocompromised individuals.
Implications:
- This case emphasizes the critical need for vigilant monitoring and prompt diagnosis of opportunistic infections like nocardiosis in pemphigus patients on immunosuppressants.
- Early recognition and treatment of Nocardia infections may improve outcomes and potentially prevent fatal disseminated disease in this high-risk population.