OpenLB
Open Library of Bioscience
Advanced Search
Frontiers in medicine
2024;11 1423895.

Myasthenia gravis complicated with pulmonary infection by : a case report and literature review.

Huifen Zuo, Jiaqing Ye, Chenfei Li, Shijie Li, Jingxin Gu, Na Dong, Yihan Zhao, Jiahao Hao, Minghui Song, Yumei Guo, Weili Gao, Zhenjun Zhao, Lijie Zhang
Author Information
  1. Huifen Zuo: Department of Clinical Laboratory, Hebei Yiling Hospital, Shijiazhuang, China.
  2. Jiaqing Ye: Department of Clinical Laboratory, Hebei Medical University Third Hospital, Shijiazhuang, China.
  3. Chenfei Li: Department of Orthopedics, Hebei Medical University Third Hospital, Shijiazhuang, China.
  4. Shijie Li: Department of Myasthenia Gravis, Hebei Yiling Hospital, Shijiazhuang, China.
  5. Jingxin Gu: Department of Clinical Laboratory, Hebei Yiling Hospital, Shijiazhuang, China.
  6. Na Dong: Department of Clinical Laboratory, Hebei Yiling Hospital, Shijiazhuang, China.
  7. Yihan Zhao: Department of Clinical Laboratory, Hebei Yiling Hospital, Shijiazhuang, China.
  8. Jiahao Hao: Department of Clinical Laboratory, Hebei Medical University Third Hospital, Shijiazhuang, China.
  9. Minghui Song: Department of Clinical Laboratory, Hebei Medical University Third Hospital, Shijiazhuang, China.
  10. Yumei Guo: Hebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, China.
  11. Weili Gao: Hebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, China.
  12. Zhenjun Zhao: Department of Clinical Laboratory, Hebei Yiling Hospital, Shijiazhuang, China.
  13. Lijie Zhang: Department of Clinical Laboratory, Hebei Medical University Third Hospital, Shijiazhuang, China.
PMID: 39416864 DOI: 10.3389/fmed.2024.1423895

Abstract

Myasthenia gravis (MG) is an autoimmune disease. Patients with MG due to compromised autoimmune regulation, progressive muscle weakness, and prolonged use of immunosuppressants and glucocorticoid, often present with concomitant infections. However, cases of MG complicated by infection are rare. In this case, we report MG complicated with pulmonary infection by . A 71-year-old male farmer who was admitted for management of MG. After 7 weeks of treatment of MG, the patient reported improvement. However, clinical presentation, inflammatory markers, and imaging findings supported a diagnosis of pulmonary infection. To further elucidate the etiology, was identified in sputum smear microscopy and sputum culture, with 16S rRNA gene sequencing confirming . The patient was prescribed trimethoprim-sulfamethoxazole. After 1 month of treatment, clinical symptoms of MG and pulmonary nocardiosis showed significant improvement. Additionally, we searched PubMed for case reports of pulmonary infection from 2010 to 2024 and conducted a statistical analysis of the case information. This report aims to highlights the increased risk of pulmonary Nocardia infection in MG patients after the use of steroids and immunosuppressants, thereby enhancing clinical awareness.

Keywords

Nocardia cyriacigeorgica immunosuppression myasthenia gravis pulmonary infection trimethoprim-sulfamethoxazole

References

  1. Medicina (Kaunas). 2022 Mar 28;58(4): [PMID: 35454327]
  2. Cureus. 2024 Apr 21;16(4):e58686 [PMID: 38770507]
  3. World J Clin Cases. 2021 Apr 6;9(10):2367-2372 [PMID: 33869615]
  4. J Neurol. 2016 Aug;263(8):1473-94 [PMID: 26886206]
  5. Intern Med. 2022 Apr 15;61(8):1285-1290 [PMID: 34670879]
  6. BMC Infect Dis. 2014 Dec 10;14:684 [PMID: 25491030]
  7. Pract Neurol. 2019 Feb;19(1):62-63 [PMID: 30242096]
  8. BMJ Case Rep. 2022 Mar 8;15(3): [PMID: 35260408]
  9. Clin Microbiol Rev. 2022 Dec 21;35(4):e0002721 [PMID: 36314911]
  10. Oxf Med Case Reports. 2020 Oct 23;2020(10):omaa088 [PMID: 33133621]
  11. Medicine (Baltimore). 2018 Oct;97(43):e13023 [PMID: 30412142]
  12. World J Surg. 2016 Nov;40(11):2681-2687 [PMID: 27312319]
  13. Neurology. 2020 Jan 21;94(3):e299-e313 [PMID: 31801833]
  14. Infection. 2010 Apr;38(2):89-97 [PMID: 20306281]
  15. Acta Clin Croat. 2019 Sep;58(3):540-545 [PMID: 31969769]
  16. BMJ Case Rep. 2015 Jul 06;2015: [PMID: 26150643]
  17. Cureus. 2021 Nov 8;13(11):e19373 [PMID: 34786274]
  18. Neuromuscul Disord. 2023 Apr;33(4):358-366 [PMID: 36990040]
  19. Ugeskr Laeger. 2014 Sep 29;176(40): [PMID: 25294520]
  20. Clin Transplant. 2019 Sep;33(9):e13509 [PMID: 30817024]
  21. Mil Med. 2011 May;176(5):586-8 [PMID: 21634308]
  22. Pediatr Pulmonol. 2023 Sep;58(9):2656-2658 [PMID: 37294079]
  23. Zhonghua Jie He He Hu Xi Za Zhi. 2023 Nov 12;46(11):1127-1130 [PMID: 37914426]
  24. Medicine (Baltimore). 2023 Dec 22;102(51):e36692 [PMID: 38134116]
  25. New Microbiol. 2021 Apr;44(2):129-134 [PMID: 34151993]
  26. Int J Infect Dis. 2008 May;12(3):335-8 [PMID: 18023385]
  27. Respir Med Case Rep. 2016 Mar 11;18:14-21 [PMID: 27144111]
  28. J Clin Immunol. 2017 Feb;37(2):109-112 [PMID: 28035544]
  29. Rev Esp Quimioter. 2017 Apr;30(2):123-126 [PMID: 28176520]
  30. Folia Microbiol (Praha). 2014 Jul;59(4):277-81 [PMID: 24385294]
  31. BMC Infect Dis. 2020 Nov 17;20(1):856 [PMID: 33203355]
  32. BMJ Case Rep. 2020 Dec 31;13(12): [PMID: 33384345]
  33. World J Clin Cases. 2023 Feb 16;11(5):1175-1181 [PMID: 36874428]
  34. Clin Microbiol Rev. 2006 Apr;19(2):259-82 [PMID: 16614249]
  35. Medicine (Baltimore). 2020 Jul 17;99(29):e21294 [PMID: 32702924]
  36. Access Microbiol. 2023 Nov 8;5(11): [PMID: 38074108]
  37. Expert Opin Pharmacother. 2013 Dec;14(17):2387-98 [PMID: 24093436]
  38. J Med Microbiol. 2010 Feb;59(Pt 2):224-230 [PMID: 19797466]
  39. Curr Opin Pulm Med. 2008 May;14(3):219-27 [PMID: 18427245]
  40. Acta Neurol Belg. 2020 Feb;120(1):59-64 [PMID: 30972663]
  41. Cureus. 2022 Apr 11;14(4):e24023 [PMID: 35547411]
  42. Infect Drug Resist. 2020 Dec 22;13:4601-4613 [PMID: 33376366]
  43. Neurologia. 2017 Jan - Feb;32(1):1-5 [PMID: 25449965]
  44. Oxf Med Case Reports. 2017 Dec 11;2017(12):omx061 [PMID: 29255613]
  45. Nat Rev Neurol. 2019 Feb;15(2):113-124 [PMID: 30573759]
  46. BMC Pulm Med. 2018 Aug 22;18(1):142 [PMID: 30134888]
  47. J Clin Neurol. 2016 Jul;12(3):340-4 [PMID: 27165426]
  48. Nihon Kokyuki Gakkai Zasshi. 2011 Aug;49(8):592-6 [PMID: 21894775]
  49. BMJ Case Rep. 2013 May 08;2013: [PMID: 23661649]
  50. J Pediatr Surg. 2012 May;47(5):E21-3 [PMID: 22595605]
  51. BMJ Case Rep. 2020 Aug 25;13(8): [PMID: 32843458]
  52. Ann Biol Clin (Paris). 2013 May-Jun;71(3):345-8 [PMID: 23747674]
  53. Proc (Bayl Univ Med Cent). 2022 Apr 12;35(4):555-556 [PMID: 35754570]
Case Reports Journal Article

Word Cloud

Created with Highcharts 10.0.0MGinfectionpulmonarycasegraviscomplicatedreportclinicalMyastheniaautoimmuneuseimmunosuppressantsHowevertreatmentpatientimprovementsputumtrimethoprim-sulfamethoxazoleNocardiadiseasePatientsduecompromisedregulationprogressivemuscleweaknessprolongedglucocorticoidoftenpresentconcomitantinfectionscasesrare71-year-oldmalefarmeradmittedmanagement7 weeksreportedpresentationinflammatorymarkersimagingfindingssupporteddiagnosiselucidateetiologyidentifiedsmearmicroscopyculture16SrRNAgenesequencingconfirmingprescribed1 monthsymptomsnocardiosisshowedsignificantAdditionallysearchedPubMedreports20102024conductedstatisticalanalysisinformationaimshighlightsincreasedriskpatientssteroidstherebyenhancingawareness:literaturereviewcyriacigeorgicaimmunosuppressionmyasthenia

Similar Articles

Cited By

No available data.