Sulfonamide-Resistant Nocardia Isolated from Alveolar Dental Abscesses in a Child with ALL: A Case Report

Abstract

Introduction: Nocardia is a catalase-positive and gram-positive bacillus. This organism causes skin, lung, and brain infections more frequently in immunocompromised hosts. Objectives: We report a 10-year-old child with a history of lymphoma relapse undergoing chemotherapy several times. There was no improvement after a dental abscess, outpatient surgery, and oral antibiotics. The child was hospitalized with trismus and respiratory distress. In the CT scan, periodontitis and masticatory abscess were reported. Results: The culture results showed Nocardia otitidiscaviarum resistant to experimental antibiotics such as sulfonamides. Clinical symptoms improved with surgical intervention and appropriate antibiotics. The child is in good condition and is currently receiving treatment for the primary illness. Conclusions: Nocardia should be considered in patients with infectious complications following malignancy or other immunocompromised conditions, as failure to correct diagnosis results in inadequate response.