Disseminated infection caused by Nocardia farcinica with primary nephrotic syndrome is exceedingly rare. A 66-year-old female visited the outpatient department due to fever and fatigue who had been diagnosed as membranous nephropathy and with a longterm prednisone and immunosuppressive therapy. After lung biopsy for many times, culture from space-occupying lesion of the right lung and species identification by mass spectrometry-based methods (MALDI-TOF) revealed Nocardia farcinica. By imaging examination, space-occupying lesions from the lungs, brain, abdominal cavity and kidney were found. After 2 weeks of meropenem intravenous and up to 6 months of trimethoprimsulfamethoxazole (TMP-SMX) therapy, our patient has remained relapse-free at that time of writing. Disseminated infection caused by Nocardia farcinica is usually subacute with complex clinical manifestations. In addition, it can be easily confused with diseases such as tumor and mycobacterial infection, and lead to fatal consequences. Therefore, we hope that we can remind clinicians considering by discussing common features of disseminated Nocardia farcinica infection.
A 23-year-old woman was admitted to the hospital with proteinuria and mildly elevated creatinine, and a renal biopsy confirmed the diagnosis of oligomeganephronia (OMN). OMN is an extremely rare bilateral renal hypoplastic disease, and its diagnosis mainly relies on the pathological results obtained from renal biopsy. At present, there is no effective treatment for OMN. Here, we report a case with mild renal insufficiency and proteinuria as the main symptom and present a summary of the clinical characteristics of ON along with a review of the literature on OMN.
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