[Acute abdomen-Rare cause in an 80-year-old female patient under immunosuppressive treatment]. / Akutes Abdomen ­ seltene Ursache bei einer 80-jährigen Patientin unter immunsuppressiver Therapie.

An 80-year-old woman presented to the emergency department due to abdominal pain. She had a history of opportunistic pneumonia under the effects of immunosuppression after the diagnosis of autoimmune hepatitis. The imaging showed an omental cake formation and the suspicion of peritoneal carcinomatosis. The patient developed an acute abdomen during the hospital stay, followed by exploratory laparotomy. In the presence of extensive intra-abdominal abscess formation both surgically acquired material and blood culture revealed disseminated nocardiosis. The course was fatal due to fulminant septic shock.