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Volume 356:2429-2430 June 7, 2007 Number 23
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Into the Woods

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by Safdar, N.
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To the Editor: The Clinical Problem-Solving article by Safdar et al. (March 1 issue)1 concerns an immunocompromised woman who received the diagnosis of pulmonary nocardiosis. The authors recommended that if the patient still required immunosuppression after completion of therapy, prophylaxis with trimethoprim–sulfamethoxazole (TMP-SMX) should be given. A role of TMP-SMX prophylaxis has been well established for Pneumocystis carinii pneumonia, but there is no clear evidence that it will prevent patients from acquiring nocardia infections. In two case series, TMP-SMX prophylaxis did not show a benefit in immunocompromised patients with nocardia infection.2,3 In our experience with lung-transplant recipients, all patients with . . . [Full Text of this Article]



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