Disseminated Nocardia farcinica involves the spinal cord: a case report and review of the literature

Abstract

Background Nocardia is a relatively rare opportunistic pathogenic bacteria group, commonly seen in patients with immunocompromised or defective immune system. It can affect multiple organs of the body and cause disseminated infection, among which most occurs in the lung, secondly in the nervous system, soft tissues, rare in the spinal cord and pituitary. No case has been reported involving lung, spinal cord, skin and pituitary gland at the same time. Case presentation We report a 55-year-old female with Nocardia infection involving the lung, skin, spinal cord, and pituitary gland. The patient underwent a full set of imaging examinations and showed typical imaging findings. Chest computed tomography (CT) showed multiple nodules with cavities in the lungs. The magnetic resonance imaging (MRI) of the vertebral body showed abnormal signal of the entire spinal cord with cavity formation and ring enhancement. The subcutaneous nodules of the abdomen were punctured under ultrasound. Through the etiological tissue culture of subcutaneous nodules and the second generation sequencing of cerebrospinal fluid, the diagnosis was finally confirmed. Conclusion Disseminated Nocardiosis is an uncommon disease. This article will report a rare case of disseminated Nocardiosis simultaneously involving the lung, spinal cord, subcutaneous soft tissue and pituitary gland, especially with neuropathy as the initial symptom. Imaging is helpful for the early diagnosis of the disease and pathological and microbiological examinations are helpful for its confirming.

Lumpy jaw caused by Nocardia farcinica in a Holstein cow

“…In 2021, Wu et al reported a 55-year-old woman with disseminated nocardiosis. In MRI, the entire spine of this woman had a cavity formation, and in her cerebrospinal fluid, N. farcinica bacteria were identified by the sequencing method (Wu et al, 2021). In 2021, Tripathi et al reported that an 80-year-old man was examined with signs of left lower posterior chest swelling, dry cough and breath lessness.…”

“…reported a 55‐year‐old woman with disseminated nocardiosis. In MRI, the entire spine of this woman had a cavity formation, and in her cerebrospinal fluid, N. farcinica bacteria were identified by the sequencing method (Wu et al., 2021 ). In 2021, Tripathi et al.…”

Patients with rheumatic immune diseases on immunosuppressants who died of Nocardia farcinica infection - case report

“…Therefore, this is a rare case that deserves attention. Multisystemic Nocardia farreri infection is relatively rare [24]. Nocardia farcinica is a rare but possible cause of pneumonia or brain, renal, liver abscesses or sepsis in patients with rheumatic immune diseases.…”

Disseminated Nocardiosis with Pulmonary Fungus and Secondary Epilepsy: A Case Report

“… 1 , 2 So far, nearly 80 species of Nocardia have been identified, with approximately 33% of them capable of infecting humans. 3 , 4 Nocardia farcinica accounts for 24.5% of nocardiosis. 5 It primarily invades the body through the respiratory tract and results in disseminated nocardiosis.…”