Disseminated nocardiosis: report of five cases

Nocardia yamanashiensis causing skin abscess in an immunocompetent child

“…7 Other antimicrobials with clinical benefit are extended spectrum cephalosporins, fluoroquinolones (especially moxifloxacin), clindamycin, erythromycin, ampicillin, aminoglycosides (particularly amikacin), tetracycline (including minocycline) and linezolid. 9 Regarding the duration of treatment, 6-12 month is recommended for many cases corresponding to the underlying disease and infectious lesions. 7 Patients with primary cutaneous nocardiosis respond very well to medical therapy.…”

Brain Abscess Due To Asian Nocardia in a 63 Years-Old Patient with Adult Still´S Disease: A Rare Case Report and Literature Review

“…There is a strong association between chronic glucocorticoid therapy and nocardiosis [6,16]. And it can be attributed to effects inherent in the host's immune mechanisms and particularly to decreased cellular immunity, making patients vulnerable to this type of infections [9], like in our patient with history of AOSD diagnosed 3 years ago with treatment with oral corticosteroids (prednisone) and methotrexate in a chronic way + etanercept 2 cycles. The host's cellular immune deficit allows the maturation of nocardia, which develops a state of accelerated multiplication associated with biological changes that enables it to cross the blood-brain barrier without altering it, causing single or multiple brain lesions [5,19].…”

“…Among the frequent sites affected by systemic spread, the Central nervous system (CNS) is the most common with 25-45%, [9,13] and can manifest as a single brain abscess, spread to the brain or spinal cord, diffuse encephalitis, and meningitis that simulates neoplasm, vasculitis and infarction [5,16,18]. Nocardia spp.…”

“…Nocardiosis is an opportunistic infection in immunocompromised patients. It can disseminate to lung, skin and affect the CNS producing abscess formation [6,9,10,11]. The genus Nocardia is composed of 85 species.…”

“…According to several studies, the optimal treatment time is 6-12 months, which complicates the adherence of patients to treatment [6,9,12,16,24,25]. In patients with disseminated infection, monotherapy is not recommended [9,12,26]. therefore at least two drugs are recommended, including imipenem or amikacin in conjunction with cotrimoxazole.…”