DisseminatedNocardia farcinica infection in an AIDS patient

Miralles, G. Diego

doi:10.1007/bf01974641

Cited by 21 publications

(14 citation statements)

References 26 publications

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“…infection can be observed and confirmed by subculture and positive microscopic detection of a branching gram-positive rod and modified acid-fast stain. It is clinically imperative that the species be identified, as N. farcinica is resistant to third generation cephalosporins and tobramycin, and N. brasiliensis is resistant to minocycline (35). Although there is no uniform standard or recommended application method from the National Committee for Standardization of Clinical Trials, the majority of previous studies have used the diameter of a zone of inhibition to determine antimicrobial susceptibility (36).…”

Section: Discussionmentioning

confidence: 99%

Disseminated nocardiosis caused by Nocardia otitidiscaviarum in an immunocompetent host: A case report and literature review

Jiang

Huang

Fang

2016

Experimental and Therapeutic Medicine

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The aim of the present study was to summarize the clinical characteristics of nocardiosis caused by in order to improve the knowledge of nocardiosis. A case of dissemination nocardiosis caused by in an immunocompetent host is reported and the associated literature reviewed. Informed consent for publication of this case report was provided by the patient. The present patient was a young immunocompetent man suffering from disseminated nocardiosis induced by infection with . Following a poor response to β-lactam antibiotic, a combination of sulfonamide with minocycline was administered, which successfully ameliorated the symptoms. Previous studies published in English were retrieved from PubMed with 'Nocardia otitidiscaviarum' used as the search keyword. A total of 23 articles were retrieved from the PubMed database, supporting the assertion that is a rare species. Among these 23 cases, there were 11 cases of lymphocutaneous (48%), 5 of pulmonary (22%), 2 of brain (9%) and 1 of pyothorax (4%) infection, and 4 cases of disseminated infections (17%). Analysis of the immune state of these patients demonstrated that 9 were immunocompetent (39%), 7 of whom had cutaneous infections (30%) with a predominant history of trauma (6/7), and 14 were immunosuppressed, 9 of whom were treated with prednisolone. Microbiology and histopathology were necessary in all cases for definite diagnosis. Among the 13 cases who underwent drug susceptibility testing, 10 cases were sensitive to trimethoprim-sulfamethoxazole (TMP-SMX) and 12 cases were sensitive to aminoglycoside. In conclusion, although is one of the less commonly isolated species of , it is capable of inducing localized or disseminated infection, even in an immunocompetent host. The majority of cases respond well to TMP-SMX and aminoglycoside, but the therapeutic action of cephalosporin is weak. Identification of bacteria and drug sensitivity tests for is critical for guiding clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Disseminated nocardiosis caused by Nocardia otitidiscaviarum in an immunocompetent host: A case report and literature review

Jiang

Huang

Fang

2016

Experimental and Therapeutic Medicine

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“…Genitourinary nocardiosis is rare. To date, there were 17 reports of genitourinary nocardiosis (Table 2) [3,[6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20]], and 94.6% of the patients harbored risk factors. Testes and kidneys were more likely to be infected, and N. asteroides was the most common causative pathogen.…”

Section: Discussionmentioning

confidence: 99%

Prostate abscess caused by Nocardia farcina

Sakamaki

Ueno

Kawasuji

et al. 2019

IDCases

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Nocardia farcinica usually infects the respiratory tract and can sometimes cause central nervous system infections; however, it rarely infects the prostate. Here we report the first case of N. farcinica detected in the purulence specimen drained from a prostate abscess. A 70-year-old Japanese male receiving steroid and cyclosporine treatment came to our department with chief complaint of turbid urine. Computed tomography revealed a low-density lesion in his prostate. Antibiotic administration and prostatic drainage were effective. N. farcinica was detected in the cultures of urine and prostatic drainage purulence specimens. Nocardiosis should be included in the differential diagnosis in immunosuppressive patients with prostate abscess.

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“…The risk of CNS infection is higher for N. farcinica than for other species (from 15% to 30%) associated with high mortality rates. It seems to be more virulent and tends to disseminate more frequently [20]. So, it is vital to identify specific nocardia species because many strains are multidrug resistant to antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Nocardiosis in a Patient With Rheumatoid Arthritis Under Treatment With Tocilizumab

et al. 2018

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The use of biological therapy has revolutionized the treatment of various autoimmune diseases. Tocilizumab (TCZ) is a recombinant humanized antiinterleukin-6 (IL-6) receptor monoclonal antibody approved for the treatment of patients with rheumatoid arthritis, as monotherapy or in combination with other disease-modifying antirheumatic drugs (DMARDs). Clinical and post-marketing surveillance studies of TCZ indicate that infections are the most frequent adverse events. Most of the serious infections described are bacterial and viral, with no uncommon pathogens. The authors report a case of a patient with destructive rheumatoid arthritis under TCZ that presented with neurological symptoms and a right cerebellar lesion with marked diffusion restriction suggestive of cerebellar abscess. The microbiologic studies from aspirative cerebral biopsy revealed Nocardia farcinica. With adequate antibiotics, the patient evolved with resolution of all symptoms and brain abscess at 5 months of followup. According to published reports, this is the first case of nocardial infection in patients under TCZ. The case highlights the importance of being aware of risk infection in these patients and need of an early diagnosis allowing a prompt treatment.

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DisseminatedNocardia farcinica infection in an AIDS patient

Cited by 21 publications

References 26 publications

Disseminated nocardiosis caused by Nocardia otitidiscaviarum in an immunocompetent host: A case report and literature review

Disseminated nocardiosis caused by Nocardia otitidiscaviarum in an immunocompetent host: A case report and literature review

Prostate abscess caused by Nocardia farcina

Cerebral Nocardiosis in a Patient With Rheumatoid Arthritis Under Treatment With Tocilizumab

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