Pulmonary Nocardiosis in a Multiple Myeloma Patient Treated with Proteasome Inhibitors
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Updated: Mar 26, 2026

Repression of Multiple Myeloma Cell Growth In Vivo by Single-wall Carbon Nanotube SWCNT-delivered MALAT1 Antisense Oligos
Published on: December 13, 2018
Nikolai P Mendonca1, Deepak K Kadayakkara1, Inga C Forde1
1Department of Internal Medicine, Bridgeport Hospital - Yale New Haven Health, Bridgeport, CT, USA.
Background:
The use of proteasome inhibitors like Bortezomib to treat multiple myeloma has been associated with increased rates of opportunistic infections, including Nocardia, especially when lymphopenia is present. The prevalence or association of such infections with newer agents like Carfilzomib is not known.
Case Report:
A 71-year-old man with multiple myeloma presented with a 6-week history of respiratory symptoms and cyclic fevers. He was undergoing chemotherapy with Carfilzomib. Work-up revealed severe lymphopenia and a CT chest showed multiple lung nodules and a mass-like consolidation. He underwent a bronchoscopy, and respiratory cultures grew Nocardia species. He responded well to intravenous antibiotics with resolution of symptoms and CT findings.
Conclusions:
With the introduction of newer agents like Carfilzomib for the treatment of multiple myeloma, clinicians must maintain a high degree of suspicion for opportunistic infections to achieve early diagnosis and treatment.
Insights
Newer multiple myeloma treatments like Carfilzomib may increase Nocardia infection risk, especially with lymphopenia. Early suspicion and treatment are crucial for patients undergoing novel chemotherapy.
Area of Science:
- Oncology
- Infectious Diseases
Background:
- Proteasome inhibitors (e.g., Bortezomib) for multiple myeloma are linked to opportunistic infections like Nocardia, particularly with lymphopenia.
- The association of Nocardia infections with newer agents like Carfilzomib remains unclear.
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