Disseminated Nocardia asiatica infection in an immunocompromised individual: A rare entity needs careful vigilance

Banerjee, Barnini; Gupta, Rohit; Varma, Muralidhar; Mukhopadhyay, Chiranjay; Shaw, Tushar

doi:10.1016/j.jiph.2018.12.008

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…Nocardiosis cutis, which is mainly caused by infection with Nocardia, can be divided into primary and secondary infection (primary superficial nocardiosis and lymphocutaneous nocardiosis ) (4,6). Lymphocutaneous nocardiosis initially presents as ulcerative plaques at the site of inoculation, before the infection diffuses through the lymphatics, causing lymphangitis and subcutaneous erythematous nodules, which upon rupturing may discharge pus and sulfur-like particles (7).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of lymphocutaneous dermatosis caused by Nocardia brasiliensis: a case report

et al. 2020

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Primary cutaneous nocardiosis caused by Nocardia brasiliensis is an uncommon disease in clinical practice (1). The clinical and radiological characteristics of the disease mean that misdiagnosis is common, which often leads to the condition becoming aggravated, or even death (2-4). Here, we report a case of lymphocutaneous dermatosis in an 87-year-old Chinese man infected with Nocardia brasiliensis.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of lymphocutaneous dermatosis caused by Nocardia brasiliensis: a case report

et al. 2020

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“…Interestingly, in every case, it was nearly missed. [33][34][35][36][37] Due to its rarity and complexity of its detection, there is no clear recommendation nor protocol for its screening and therapy in HIV-positive patients.…”

Section: Unique Cases Of Co-infections With Hiv In the Kingdom Of Saudi Arabiamentioning

confidence: 99%

HIV in the Kingdom of Saudi Arabia: Can We Change the Way We Deal with Co-Infections

Al-Mozaini

Alrahbeni

Dirar

et al. 2021

IDR

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The first incidence of acquired immunodeficiency syndrome (AIDS) from the Kingdom of Saudi Arabia (KSA) was reported back in 1984, and by the end of 2013, around 1509 patients were diagnosed with HIV infection. Recently in 2018, the Saudi ministry of health released that the incidence of HIV in Saudi Arabia is 3 cases of HIV for every 10,000 of the population. Having said that, the surveillance of HIV will face a range of challenges in KSA despite proper medical care, counseling, family planning, diagnostic, evaluation, and the use of effective anti-retroviral therapy. Patients who underwent anti-retroviral therapy showed significant reduction in morbidity as well as mortality. On the other hand, further targeted treatment and preventive strategies are warranted to control HIV co-infections in the KSA. In addition, progress towards meeting the WHO 90-90-90 goals for HIV not only at KSA but at the MENA region too, which is that of the population, 90% are diagnosed, 90% undergoing treatment, and 90% under viral control, is not being systematically monitored. In this review, we discuss the common co-infections with HIV infections that are reported in KSA, which when compared to international trends, it is similar for both viral hepatitis and tuberculosis. Although those co-infections exist, they are presented in different ratios and percentages when compared to the international reported data. These differences mandates defining and introducing new resilient methods of treatment and preventive measures. In this review, we offer an insight into healthcare policymakers to be compliant with UNAIDS 2020 vision program. We also discuss some of the gaps and recommendations to achieve the WHO 90-90-90 goal.

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“…38,183,186,187 Nocardia paucivorans, which rarely causes diseases in humans, appears to have a predilection for CNS involvement and dissemination. 38,184,188 Similarly, N. asiatica 33 and N. farcinica have a proclivity for CNS involvement. 34,178,185,189 Bone Bone involvement is rare in nocardiosis, but spine abscesses, 190 epidural abscesses, 191 paravertebral abscesses, 112 mycetomas of the feet, 168 osteomyelitis, 192 and septic arthritis 100,193 have been described.…”

Section: Clinical Features Pulmonarymentioning

confidence: 99%

“…Rare sites of involvement (e.g., salivary glands, 203 parotids, 204 thyroid gland, 205,206 adrenal glands, 207 liver, 137,147 pancreas, 33,208 gastrointestinal tract, 199 and testicles 209 ) usually reflect hematogenous dissemination. Bloodstream infections due to contaminated CVCs have also been described.…”

Section: Rare Sitesmentioning

confidence: 99%

“…16,18 Pulmonary nocardiosis may mimic communityacquired pneumonia, and this may be more common among individuals with agricultural or outdoor occupations in developing countries. 10,12,16 Nocardiosis primarily involves the lungs, 5,[19][20][21] but skin and soft tissue infections (SSTIs), [21][22][23][24][25][26][27][28][29] central nervous system (CNS) infection (brain abscesses, meningitis), 7,[30][31][32][33][34] and dissemination 4,11,12,21,35 may occur. Given the rarity of the disease, the diagnosis and initiation of appropriate antimicrobial therapy are often delayed.…”

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confidence: 99%

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Nocardia spp.: A Rare Cause of Pneumonia Globally

Lynch

Reid

Clark

2020

Semin Respir Crit Care Med

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AbstractMembers of the Nocardia genus are ubiquitous in the environment. These aerobic, gram-positive organisms can lead to life-threatening infection, typically in immunocompromised hosts such as solid organ transplant recipients or those receiving immunosuppressive medications for other reasons. This current review discusses the microbiology of nocardiosis, risk factors for infection, clinical manifestations, methods for diagnosis, and treatment. Nocardiosis primarily affects the lung but may also cause skin and soft tissue infection, cerebral abscess, bloodstream infection, or infection involving other organs. Although rare as a cause of community-acquired pneumonia, Nocardia can have severe morbidity and mortality, particularly in patients with comorbidities or compromised immunity. Early diagnosis and timely initiation of therapy are critical to optimizing patient outcomes. Species identification is important in determining treatment, as is in vitro susceptibility testing. Sulfonamide therapy is usually indicated, although a variety of other antimicrobials may be useful, depending on the species and susceptibility testing. Prolonged therapy is usually indicated, for 6 to 12 months, and in some cases surgical debridement may be required to resolve infection.

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Disseminated Nocardia asiatica infection in an immunocompromised individual: A rare entity needs careful vigilance

Cited by 12 publications

References 21 publications

Diagnosis and treatment of lymphocutaneous dermatosis caused by Nocardia brasiliensis: a case report

Diagnosis and treatment of lymphocutaneous dermatosis caused by Nocardia brasiliensis: a case report

HIV in the Kingdom of Saudi Arabia: Can We Change the Way We Deal with Co-Infections

Nocardia spp.: A Rare Cause of Pneumonia Globally

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