Clinical analysis of 11 cases of nocardiosis

Li, Yiqing; Tang, Ting; Xiao, Jie; Wang, Jieyu; Li, Boqi; Ma, Liang; Xie, Shuangfeng; Nie, Danian

doi:10.1515/med-2020-0196

Cited by 5 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PN could be acute, subacute, or chronic, and its symptoms are diverse and nonspecific. 15 Patients with subacute or chronic disease often postponed seeing a doctor because of the slow development of symptoms, and diagnosis was often delayed because of atypical symptoms. At the time of onset, CRP and ESR were significantly increased.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of Pulmonary Nocardiosis in Patients with Different Underlying Diseases: A Case Series Study

Zhong¹,

Huang²,

Zhan³

et al. 2022

IDR

View full text Add to dashboard Cite

Objective To investigate the clinical features of pulmonary nocardiosis (PN) in patients with different underlying diseases. Methods Clinical, imaging, treatment and prognosis data from patients diagnosed with PN from July 2011 to June 2021 at the First Affiliated Hospital, Zhejiang University School of Medicine were collected and analyzed. According to different underlying diseases, patients were grouped into immunocompromised host (ICH) group and immunocompetent host (ICO) group, and clinical characteristics were compared between the two groups. Results There were 64 patients with PN, including 42 males, aged from 21 to 86 (57.1 ± 15.7) years. The most common clinical manifestations were cough, expectoration, fever. There were 41 cases in the ICH group and 23 cases in the ICO group. There were 11 cases with underlying pulmonary diseases in the ICH group, including 2 cases of bronchiectasis, 4 cases of chronic obstructive pulmonary disease (COPD), etc. There were 11 cases of underlying pulmonary basic diseases in ICO group, including 7 cases of bronchiectasis and COPD, 1 case of bronchiectasis, 1 case of COPD, etc. The proportion of patients with bronchiectasis and COPD in the ICO group was significantly higher (P < 0.05). Extrapulmonary nocardiosis infection occurred in 6 patients of the ICH group. During the period of hospitalization, 87.0% patients in ICO group received SMZ/TMP therapy, 73.2% of patients in ICH group received two drug combination therapy. In the ICH group, mortality at 28 days was 14.6% and 8.7% in the ICO group. Conclusion PN mainly occurred in ICH patients, but also occurred in the ICO cases to a lesser extent, especially in patients with bronchiectasis and/or COPD. Complicated with extrapulmonary infections mainly occurred in ICH population and combination of two antibiotics was often used in ICH group. The case fatality rates were 14.6% in ICH and 8.7% in ICO cases, respectively.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Features of Pulmonary Nocardiosis in Patients with Different Underlying Diseases: A Case Series Study

Zhong¹,

Huang²,

Zhan³

et al. 2022

IDR

View full text Add to dashboard Cite

show abstract

“…Currently, it is still very challenging to make an early diagnosis of Nocardia infections in clinical settings. Because of the insufficient specificity of clinical features and strict requirement of laboratory detection, a 2- to 3-week duration could be required from specimen collection to Nocardia identification ( Li et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Weathering the storm: diagnosis and treatment of a life-threatening disseminated Nocardia otitidiscaviarum infection

Zhang,

Wang,

Umar

et al. 2024

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

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.

show abstract

“…To date, the existence of 109 different species of Nocardia with confirmed names is known [2]. Nocardia infections is characterized by the development of purulent-necrotic inflammation of the lungs, brain, internal organs, rarelyskin, subcutaneous fat tissue, mucous membranes [3]. According to various estimates, several thousand new cases of nocardiosis infection are registered in the world every year [4].…”

Section: Introductionmentioning

confidence: 99%

Clinico-pathological analysis of a rare case of pulmonary nocardiosis under the mask of disseminated tuberculosis

Kuzyk

2022

SR:MS

View full text Add to dashboard Cite

Nocardiosis is a rare infectious disease caused by bacteria of the genus Nocardia and characterized by the development of foci of purulent-necrotic inflammation of the lungs, brain, and internal organs. Clinical diagnosis of nocardiosis has objective difficulties. The aim of the study is to highlight a rare clinical case of pulmonary nocardiosis, to analyze mistakes in the clinical diagnostics of the main disease, to discuss the differential diagnosis of nocardiosis. Materials and methods. A clinico-pathological analysis of an inpatient and outpatient medical record card, and the results of an autopsy of a 58-year-old patient who died in an anti-tuberculosis institution from pulmonary nocardiosis has been carried out. Results. According to the anamnesis, the patient suffered from COPD and chronic polyposis rhinitis with hypertrophy of the nasal turbinates for many years. Polypectomy and submucosal resection of the nasal septum were performed in the otolaryngology department. Wegener's granulomatosis was suspected during the intravital pathomorphological examination of nasal polyps, and glucocorticoids were prescribed in the hospital. Histological preparations and biological material of the patient were examined in clinics in Berlin, the diagnosis of “Wegener's granulomatosis” was not confirmed, however, domestic doctors recommended Medrol, which the patient received continuously for 5 years at a dose of 12 mg/day. After 5 years, the patient was admitted to the hospital of a specialized anti-tuberculosis institution in serious condition with a clinical diagnosis: newly diagnosed disseminated tuberculosis of both lungs with disintegration, right-sided spontaneous tension pneumothorax, respiratory insufficiency of the III degree. According to urgent indications, thoracentesis and drainage of both pleural cavities were performed. Despite intensive therapy, the condition worsened, and biological death occurred 11 days after hospitalization. During the post-mortem pathological examination, signs of tuberculosis of both lungs were not detected, nocardiosis of both lungs was diagnosed, which pathomorphologically manifested as multiple foci of purulent-necrotic bronchopneumonia with disintegration. Pathological diagnosis was confirmed by bacteriological and PCR examination of the post-mortem material. The disease developed on the background of wrongly prescribed long-term glucocorticosteroid therapy, which was carried out for the misdiagnosis “Wegener's granulomatosis”. No signs of Wegener's granulomatosis were found at autopsy. The direct cause of death was acute respiratory failure. Conclusion. Thus, pulmonary nocardiosis was not diagnosed in the hospital, the reason for the misdiagnosis was the rarity of the disease and the objective difficulties of diagnostics. A decisive role in the development of nocardiosis was played by erroneously prescribed long-term glucocorticosteroid therapy, which should be considered as a pathology of the therapy

show abstract

Clinical analysis of 11 cases of nocardiosis

Cited by 5 publications

References 19 publications

Clinical Features of Pulmonary Nocardiosis in Patients with Different Underlying Diseases: A Case Series Study

Clinical Features of Pulmonary Nocardiosis in Patients with Different Underlying Diseases: A Case Series Study

Weathering the storm: diagnosis and treatment of a life-threatening disseminated Nocardia otitidiscaviarum infection

Clinico-pathological analysis of a rare case of pulmonary nocardiosis under the mask of disseminated tuberculosis

Contact Info

Product

Resources

About