Complications
Sulfonamide treatment requires high doses and long treatment duration. Gastrointestinal intolerance can affect 30% of patients and is more frequent at the beginning of treatment.[63]
Sulfonamide treatment requires high doses and long treatment duration. Cutaneous hypersensitivity may be severe enough to require replacing sulfonamides with other drugs.[63]
Sulfonamide treatment requires high doses and long treatment duration; thus, patients are exposed to the nephrotoxic effect of these drugs. If amikacin is administered in combination with the sulfonamide, the risk of developing renal dysfunction is higher.
The duration of treatment for nocardiosis is usually long. In a recent review, 45% of patients developed myelosuppression (particularly thrombocytopenia) and 18% developed neuropathy during treatment with linezolid for nocardiosis.[68] If trimethoprim/sulfamethoxazole is administered in combination with linezolid, the risk of developing myelosuppression is higher.
Patients with pulmonary nocardiosis are at risk of dissemination. The central nervous system (CNS) is the most frequent site and the location with the highest mortality. Thus, in every patient with pulmonary or disseminated nocardiosis, CNS involvement must be ruled out with neuroradiological techniques, even in the absence of symptoms.[43] In some cases invasive diagnostic techniques, particularly brain biopsy, must be performed to confirm or exclude the diagnosis.[8]
Use of this content is subject to our disclaimer