1
|
Huang L, Jia L. Disseminated nocardiosis caused by Nocardia otitidiscaviarum-A case report. Diagn Microbiol Infect Dis 2024; 110:116347. [PMID: 38878341 DOI: 10.1016/j.diagmicrobio.2024.116347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/19/2024] [Accepted: 05/09/2024] [Indexed: 07/30/2024]
Abstract
In this article we report a case of disseminated nocardiosis caused by Nocardia otitidiscaviarum in an immunocompetent patient with chronic obstructive pulmonary disease (COPD) who complained of a cough, followed by skin and intracranial lesions. On metagenomic next-generation sequencing (mNGS) technology of respiratory samples (bronchoalveolar lavage fluid, BALF) Nocardia otitidiscaviarum was identified. The patient was treated with therapy combined with a low dose of TMP-SMX and imipenem cilastatin sodium and had a favorable outcome. The timely diagnosis of Nocardia with the help of mNGS technology and early rational treatment of TMP-SMX can help improve the prognosis.
Collapse
Affiliation(s)
- Linyue Huang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu Sichuan 610041, PR China
| | - Lian Jia
- Pulmonary and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu Sichuan 610041, PR China; State Key Laboratory of Respiratory Health and Multimorbidity, Chengdu Sichuan 610041, PR China.
| |
Collapse
|
2
|
Erbaş İC, Çakil Güzin A, Özdem Alataş Ş, Akyildiz C, Üçüncü Egeli T, Belet N. Newborn With Branchial Cleft Cyst Infection Due to Nocardia otitidiscaviarum. Pediatr Infect Dis J 2024; 43:e222-e224. [PMID: 38380935 DOI: 10.1097/inf.0000000000004296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- İrem Ceren Erbaş
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University
| | - Ayşe Çakil Güzin
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University
| | - Şilem Özdem Alataş
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University
| | - Can Akyildiz
- Department of Neonatology, Faculty of Medicine, Dokuz Eylül University
| | | | - Nurşen Belet
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University, Izmir, Türkiye
| |
Collapse
|
3
|
Zhang LY, Wang L, Umar Z, Huang YH, Gu B. Weathering the storm: diagnosis and treatment of a life-threatening disseminated Nocardia otitidiscaviarum infection. Front Cell Infect Microbiol 2024; 14:1397847. [PMID: 38881735 PMCID: PMC11179430 DOI: 10.3389/fcimb.2024.1397847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Nocardiosis demonstrates a temporal categorization that includes acute, subacute, and chronic stages alongside distinct typical localizations such as pulmonary, cutaneous, and disseminated forms. Disseminated nocardiosis, commonly caused by Nocardia asteroides, N. brasiliensis, and N. farcinica, continues to result in substantial morbidity and mortality. Herein, we report a life-threatening disseminated nocardiosis caused by Nocardia otitidiscaviarum in a patient with minimal change disease. This study emphasizes the difficulty in the diagnosis and treatment of unknown infections in clinical settings and highlights the important role played by laboratories in solving infectious diseases caused by rare pathogens.
Collapse
Affiliation(s)
- Li-Yan Zhang
- Laboratory Medicine, Ganzhou Municipal Hospital, Guangdong Provincial People’s Hospital Ganzhou Hospital, Ganzhou, Guangdong, China
- Laboratory Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Liang Wang
- Laboratory Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Zeeshan Umar
- Laboratory Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Yuan-Hong Huang
- Laboratory Medicine, Ganzhou Municipal Hospital, Guangdong Provincial People’s Hospital Ganzhou Hospital, Ganzhou, Guangdong, China
| | - Bing Gu
- Laboratory Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
4
|
Song RJ, Zhang GL. A Rare Case Report of Disseminated Nocardia Farcinica Granulomatous Hepatitis and Clinical Management Experience. Infect Drug Resist 2024; 17:1523-1528. [PMID: 38645888 PMCID: PMC11032677 DOI: 10.2147/idr.s461494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024] Open
Abstract
Background Nocardiosis is primarily an opportunistic infection affecting immunocompromised individuals, with a predilection for the lungs, brain, or skin in those with compromised immune function. Granulomatous hepatitis caused by Nocardia is a rare clinical manifestation. This study aims to provide a systematic overview of the clinical features of Nocardiosis caused by Nocardia farcinica, enhancing our understanding of this disease. Methods We report a case of a 75-year-old male with no underlying diseases presenting with a history of "recurrent fever for more than 4 months", along with fatigue, poor appetite, and pleural and abdominal effusion. Despite treatment at multiple hospitals, the patient showed little improvement. Chest CT revealed chronic inflammation, small nodules, bilateral pleural effusion, and pleural thickening. Abdominal CT indicated multiple low-density lesions in the liver, multiple small calcifications, and abdominal effusion. Results Liver biopsy suggested inflammatory changes, with focal granuloma formation. Metagenomic next-generation sequencing (mNGS) of liver tissue indicated Nocardia farcinica, leading to the final diagnosis of disseminated Nocardia farcinica granulomatous hepatitis. Conclusion Nocardia infection is a rare disease primarily observed in immunocompromised patients but can also occur in those with normal immune function. The clinical and radiological features lack specificity; however, the utilization of mNGS technology enables rapid identification of the pathogenic microorganism. Nocardia farcinica is generally susceptible to sulfonamide drugs and amikacin, offering viable treatment options.
Collapse
Affiliation(s)
- Rui Juan Song
- Department of Infectious Diseases, Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Hefei, People’s Republic of China
| | - Guang Lin Zhang
- Department of Infectious Diseases, Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Hefei, People’s Republic of China
| |
Collapse
|
5
|
Pérez Ramos IS, Gurruchaga Yanes ML, Fernández Vecilla D, Oiartzabal Elorriaga U, Unzaga Barañano MJ, Díaz de Tuesta Del Arco JL. Cavitary pneumonia and empyema thoracis caused by multidrug resistant Nocardia otitidiscaviarum in an elderly patient. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2024; 37:97-99. [PMID: 37960833 PMCID: PMC10874667 DOI: 10.37201/req/042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/05/2023] [Accepted: 09/15/2023] [Indexed: 11/15/2023]
Affiliation(s)
| | | | - D Fernández Vecilla
- Domingo Fernández Vecilla, Clinical microbiology service. Laredo Regional Hospital. Av. Derechos Humanos, 40, 39770, Laredo, Cantabria (Spain).
| | | | | | | |
Collapse
|
6
|
Qi DD, Zhuang Y, Chen Y, Guo JJ, Zhang Z, Gu Y. Interstitial pneumonia combined with nocardia cyriacigeorgica infection: A case report. World J Clin Cases 2023; 11:7920-7925. [DOI: 10.12998/wjcc.v11.i32.7920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Nocardia infection is a relatively uncommon disease, with no reports among patients with interstitial pneumonia. Due to its atypical clinical symptoms and chest computed tomography (CT) findings and the frequent yielding of negative results by conventional cultures, it poses challenges for timely diagnosis and treatment.
CASE SUMMARY A 63-year-old female patient presented to our hospital in July 2022 with a 3-mo history of intermittent cough and poor appetite, accompanied by a 2-wk long duration of headaches. She had a previous medical history of interstitial pneumonia and was on oral prednisone and cyclosporine. Chest CT revealed the presence of newly developed round nodules. The diagnosis of Nocardia cyriacigeorgica infection was confirmed through metagenomic next-generation sequencing (mNGS) performed on bronchoalveolar lavage fluid. Targeted anti-infection therapy was initiated, resulting in symptom improvement and radiological resolution, further validating the mNGS results.
CONCLUSION Nocardia cyriacigeorgica infection is a clinically rare condition that is primarily observed in immunocompromised patients. Its clinical and radiological manifestations lack specificity, but mNGS can aid in rapidly obtaining pathogenic information. Early initiation of targeted antimicrobial therapy based on mNGS results can improve patient prognosis.
Collapse
Affiliation(s)
- Dao-Da Qi
- Department of Geriatrics, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu Province, China
| | - Yi Zhuang
- Department of Respiratory and Critical Care Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210006, Jiangsu Province, China
| | - Yang Chen
- Department of Geriatrics, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu Province, China
| | - Jing-Jing Guo
- Department of Geriatrics, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu Province, China
| | - Ze Zhang
- Department of Geriatrics, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu Province, China
| | - Yan Gu
- Department of Geriatrics, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu Province, China
| |
Collapse
|
7
|
Barry M, AlShehri S, Alguhani A, Barry M, Alhijji A, Binkhamis K, Al-Majid F, Al-Shahrani FS, Muayqil T. A fatal case of disseminated nocardiosis due to Nocardia otitidiscaviarum resistant to trimethoprim-sulfamethoxazole: case report and literature review. Ann Clin Microbiol Antimicrob 2022; 21:17. [PMID: 35578282 PMCID: PMC9112502 DOI: 10.1186/s12941-022-00511-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Disseminated nocardiosis still causes significant morbidity and mortality and is often caused by Nocardia asteroides, N. basiliensis, and N. farcinica and are often treated with trimethoprim–sulfamethoxazole (TMP–SMX). Nocardia otitidiscaviarum (N. otitidiscaviarum) rarely causes disseminated disease and resistance to TMP–SMX is even more rare. Case presentation A 37-year-old woman with metastatic breast cancer and right ear deafness with recent occupational gardening and manipulating soil, presented to the hospital with first time seizure and multiple skin nodules. Magnetic resonance imaging (MRI) showed ring enhancing lesions, biopsy of the skin and brain lesions grew N. otitidiscaviarum. She was empirically treated with TMP–SMX and Imipenem–Cilastatin, however, almost three weeks into therapy, susceptibility results revealed it to be resistant to both antimicrobials, she was subsequently changed to Amikacin, Linezolid, Moxifloxacin, and Doxycycline but ultimately died. Conclusions This case report highlights the importance of suspecting a rare Nocardia species in patients at risk with proper occupational exposure, moreover, TMP–SMX resistance should be suspected with lack of clinical response, this may have important implications on clinical practice when facing similar infections.
Collapse
Affiliation(s)
- Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia. .,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia. .,Division of Infectious Diseases, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Shahad AlShehri
- Infectious Diseases Unit, Internal Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ahlam Alguhani
- Infectious Diseases Unit, Internal Medicine Department, King Abdullah Medical City National Guard, Riyadh, Saudi Arabia
| | - Mohammad Barry
- Medical Imaging Department, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Ali Alhijji
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Khalifa Binkhamis
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Al-Majid
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fatimah S Al-Shahrani
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Taim Muayqil
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.,Division of neurology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Cheng Y, Wang TY, Yuan HL, Li W, Shen JP, He ZX, Chen J, Gao JY, Wang FK, Gu J. Nocardia Infection in Nephrotic Syndrome Patients: Three Case Studies and A Systematic Literature Review. Front Cell Infect Microbiol 2022; 11:789754. [PMID: 35141169 PMCID: PMC8819730 DOI: 10.3389/fcimb.2021.789754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/29/2021] [Indexed: 01/23/2023] Open
Abstract
Objective The multicenter literature review and case studies of 3 patients were undertaken to provide an updated understanding of nocardiosis, an opportunistic bacterial infection affecting immunosuppressed nephrotic syndrome (NS) patients receiving long-term glucocorticoid and immunosuppressant treatment. The results provided clinical and microbiological data to assist physicians in managing nocardiosis patients. Methods Three cases between 2017 and 2018 from a single center were reported. Additionally, a systematic review of multicenter cases described in the NCBI PubMed, Web of Science, and Embase in English between January 1, 2001 and May 10, 2021 was conducted. Results This study described three cases of Nocardia infection in NS patients. The systematic literature review identified 24 cases with sufficient individual patient data. A total of 27 cases extracted from the literature review showed that most patients were > 50 years of age and 70.4% were male. Furthermore, the glucocorticoid or corticosteroid mean dose was 30.9 ± 13.7 mg per day. The average time between hormone therapy and Nocardia infection was 8.5 ± 9.7 months. Pulmonary (85.2%) and skin (44.4%) infections were the most common manifestations in NS patients, with disseminated infections in 77.8% of patients. Nodule/masses and consolidations were the major radiological manifestations. Most patients showed elevated inflammatory biomarkers levels, including white blood cell counts, neutrophils percentage, and C-reactive protein. Twenty-five patients received trimethoprim-sulfamethoxazole monotherapy (18.5%) or trimethoprim-sulfamethoxazole-based multidrug therapy (74.1%), and the remaining two patients (7.4%) received biapenem monotherapy. All patients, except the two who were lost to follow-up, survived without relapse after antibiotic therapy. Conclusions Nephrotic syndrome patients are at high risk of Nocardia infection even if receiving low-dose glucocorticoid during the maintenance therapy. The most common manifestations of nocardiosis in NS patients include abnormal lungs revealing nodules and consolidations, skin and subcutaneous abscesses. The NS patients have a high rate of disseminated and cutaneous infections but a low mortality rate. Accurate and prompt microbiological diagnosis is critical for early treatment, besides the combination of appropriate antibiotic therapy and surgical drainage when needed for an improved prognosis.
Collapse
Affiliation(s)
- Yan Cheng
- Department of Basic Medical Laboratory, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Tian-yi Wang
- Department of Respiratory Medicine, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Hong-li Yuan
- Department of Radiology, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Wei Li
- Department of Clinical Laboratory, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Jing-ping Shen
- Department of Nutrition, Beidaihe Rehabilitation and Recuperation Center, Qinhuangdao, China
| | - Zheng-xin He
- Department of Basic Medical Laboratory, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Jing Chen
- Department of Clinical Laboratory, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Jie-ying Gao
- Department of Clinical Laboratory, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Fu-kun Wang
- Department of Clinical Laboratory, The 980th Hospital of the PLA Joint Logistical Support Force (Bethune International Peace Hospital), Shijiazhuang, China
| | - Jiang Gu
- Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Army Medical University, Chongqing, China
- *Correspondence: Jiang Gu,
| |
Collapse
|
9
|
Parengal J, Alebbi SM, Hamed MMM, Alqatami HM, Ben Abid F. Disseminated life threatening Nocardia otitidiscaviarum infection in a young female with newly diagnosed systemic lupus erythematosus, case report and review of literature. IDCases 2021; 26:e01265. [PMID: 34589411 PMCID: PMC8461374 DOI: 10.1016/j.idcr.2021.e01265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/08/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022] Open
Abstract
Infection due to Nocardia is reported mainly in immunocompromised patients. It usually presents as a pulmonary or disseminated disease with a predilection for the brain. Infections are a rare etiology of intracranial vascular aneurysms. Herein we report a case of disseminated Nocardia otitidiscaviarum (N. otitidiscaviarum) in a young female newly diagnosed with systemic lupus erythematosus (SLE) complicated by the development of an infectious intracranial aneurysm. To the best of our knowledge this is the fourth case of nocardial infection-related intracranial aneurysm and the second case of N. otitidiscaviarum infection to be reported in a patient with systemic lupus erythematosus. Features of previously reported N. otitidiscaviarum related intracranial aneurysm are reviewed.
Collapse
Affiliation(s)
- Jabeed Parengal
- Department of Medicine, Division of Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
| | - Seham Mohsin Alebbi
- Department of Medicine, Division of Rheumatology, Hamad Medical Corporation, Doha, Qatar
| | - Manal Mahmoud Mohamed Hamed
- Department of Microbiology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medical College, Doha, Qatar
| | | | - Fatma Ben Abid
- Department of Medicine, Division of Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medical College, Doha, Qatar
| |
Collapse
|
10
|
Lin J, Wu XM, Peng MF. Nocardia cyriacigeorgica infection in a patient with pulmonary sequestration: A case report. World J Clin Cases 2021; 9:2367-2372. [PMID: 33869615 PMCID: PMC8026832 DOI: 10.12998/wjcc.v9.i10.2367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/23/2020] [Accepted: 01/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nocardia cyriacigeorgica (N. cyriacigeorgica) infection is uncommon in clinical practice. Pulmonary sequestration complicated with N. cyriacigeorgica has not been reported in the literature. Here, we present a case of pulmonary se-questration complicated with N. cyriacigeorgica infection in an immunocom-petent woman.
CASE SUMMARY A 37-year-old woman complaining of a recurrent cough was admitted to our hospital. Pulmonary sequestration in the lower lobe of the left lung was diagnosed by enhanced computed tomography. Bronchoalveolar lavage fluid was then collected, which showed gram positive bacilli with weakly positive modified acid-fast staining. The pathogen was identified as N. cyriacigeorgica after bacterial culture and mass spectrometry analysis. The patient was diagnosed with pulmonary sequestration complicated with N. cyriacigeorgica infection, and her symptoms quickly improved following anti-infective therapy.
CONCLUSION Nocardiosis is considered to be an opportunistic infection. This is the first report of pulmonary sequestration complicated with N. cyriacigeorgica infection in a patient with normal immunity.
Collapse
Affiliation(s)
- Jian Lin
- Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Xiao-Mai Wu
- Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Min-Fei Peng
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| |
Collapse
|
11
|
Iatrogenic Nocardia otitidiscaviarum after PICC line placement. IDCases 2020; 22:e00986. [PMID: 33163361 PMCID: PMC7607419 DOI: 10.1016/j.idcr.2020.e00986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/22/2022] Open
Abstract
Background Nocardia otitidiscaviarum is an aerobic, gram positive bacteria with low virulence and incidence. Despite being uncommon, N. otitidiscaviarum has been associated with skin, lung, and disseminated infections. Case report A 56-year-old male with past medical history of type 2 diabetes mellitus and recent travel to the Bahamas presented to the emergency room with complains of abdominal pain, nausea, vomiting, and non-bloody diarrhea for four days. He ultimately required a PICC line for total parenteral nutrition. 2 days after line placement, he developed high fevers and severe right arm pain. Diagnostic imaging revealed venous thrombosis of cephalic vein and abscess formation within the soft tissue of right axilla with cultures ultimately growing Nocardia otitidiscaviarum. He underwent surgical incision and drainage of the abscess followed up with complete excision of the right cephalic vein and antecubital vein as well as sharp excisional debridement of skin, subcutaneous tissue and muscle fascia and was treated with trimethoprim-sulfamethoxazole for 3 months. Conclusion Nocardia otitidiscaviarum treatment of cutaneous disease consists of trimethoprim- sulfamethoxazole for three to six months. While guidelines for surgical intervention for cutaneous infection are not specified, our patient required surgical incision and drainage of abscess, along with excision of vein due to necrosis in addition to antibiotic treatment for 3 months with successful outcomes.
Collapse
|
12
|
Sah R, Khadka S, Neupane S, Nepal G, Singla S, Kumari P, Sah S, Sah R, Sah SS, Adhikari M, Shah NP, Pokharel BM, Rijal B, Shah DS. Disseminated infection with Nocardia otitidiscaviarum in a patient under steroid therapy. Clin Case Rep 2020; 8:369-373. [PMID: 32128191 PMCID: PMC7044388 DOI: 10.1002/ccr3.2640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/29/2019] [Accepted: 12/09/2019] [Indexed: 12/28/2022] Open
Abstract
Corticosteroid recipients with lung infections should be suspected of having nocardiosis; however, nocardiosis can easily mimic malignancy, tuberculosis, or fungal infection. Though cultural identification is possible, it might be missed due to its slow growth pattern.. Therefore, if filamentous bacteria are seen during staining, plate incubation time should be extended.
Collapse
Affiliation(s)
- Ranjit Sah
- Tribhuvan University Institute of MedicineKathmanduNepal
- Medanta The MedicityGurgaonIndia
| | - Shusila Khadka
- Tribhuvan University Institute of MedicineKathmanduNepal
| | | | - Gaurav Nepal
- Tribhuvan University Institute of MedicineKathmanduNepal
| | | | | | - Sanjit Sah
- Tribhuvan University Institute of MedicineKathmanduNepal
| | - Ranjana Sah
- Tribhuvan University Institute of MedicineKathmanduNepal
| | | | | | | | | | - Basista Rijal
- Tribhuvan University Institute of MedicineKathmanduNepal
| | | |
Collapse
|
13
|
Princess I, Ebenezer R, Ramakrishnan N, Nandini S. Pulmonary Nocardiosis and Scrub Typhus in an Immunocompromised Host. J Glob Infect Dis 2018; 10:108-111. [PMID: 29910572 PMCID: PMC5987364 DOI: 10.4103/jgid.jgid_105_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Pulmonary infections are not uncommon in patients with an underlying immunocompromised condition. Unusual combination of microorganisms causing concomitant infections among these patients has also been reported. However, certain rare dual occurrences are usually unanticipated as in the case we present here. This case highlights the importance of being aware of the possible coexistence of infections in immunocompromised patients. To the best of our knowledge, this is the first report of coinfection with Nocardia otitidiscaviarum and Orientia tsutsugamushi in a critically ill immunocompromised patient from South India.
Collapse
Affiliation(s)
- Isabella Princess
- Department of Microbiology, Apollo Speciality Hospitals, Vanagaram, Chennai, Tamil Nadu, India
| | - R Ebenezer
- Department of Critical Care Medicine, Apollo Speciality Hospitals, Vanagaram, Chennai, Tamil Nadu, India
| | - Nagarajan Ramakrishnan
- Department of Critical Care Medicine, Apollo Hospitals, Greams Road, Chennai, Tamil Nadu, India
| | - S Nandini
- Department of Microbiology, Apollo Hospitals, Greams Road, Chennai, Tamil Nadu, India
| |
Collapse
|
14
|
Erratum: Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer: A case report and literature review: Erratum. Medicine (Baltimore) 2017; 96:e7646. [PMID: 31305694 PMCID: PMC5521952 DOI: 10.1097/md.0000000000007646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
[This corrects the article DOI: 10.1097/MD.0000000000006526.].
Collapse
|