Fulminant Nocardiosis Due to a Multidrug-Resistant Isolate in a 12-Year-Old Immunocompetent Child

Sénard, Olivia; Blanot, Stéphane; Jouvion, Grégory; Rodríguez-Nava, Verónica; Lortholary, Olivier; Join‐Lambert, Olivier; Toubiana, Julie

doi:10.1542/peds.2016-3131

Cited by 18 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are few documented cases of pulmonary nocardiosis affecting adult immunocompetent patients,7–9 and they are mostly associated with pulmonary chronic disease (such as bronchiectasis, chronic obstructive pulmonary disease or asthma) 10–13. There are also reports of previously healthy children having nocardiosis associated with pneumonia and pleural effusion, central nervous system infection and septic arthritis 14–17…”

Section: Discussionmentioning

confidence: 99%

Nocardialung abscess in an immunocompetent adolescent

Soares¹,

Reis-Melo

Ferraz

et al. 2019

BMJ Case Rep

View full text Add to dashboard Cite

The authors report a case of a lung abscess caused by Nocardia sp. in a previously healthy adolescent. A 17-year-old young man presented with tonsillitis that did not respond to β-lactamic antibiotic, dyspnoea and thoracic pain. The X-ray revealed a cavitation in the right pulmonary upper lobe. He was admitted and completed a 14-day empirical antimicrobial therapy for a pulmonar abscess, although no clinical recovery was observed. He then underwent pulmonary biopsy of the lesion and PCR analysis of the collected pulmonary tissue, which revealed the presence of Nocardia. This case emphasises the importance of considering nocardiosis in the differential diagnosis of a lung abscess, particularly if no response to empirical therapy is obtained.

show abstract

Section: Discussionmentioning

confidence: 99%

Nocardialung abscess in an immunocompetent adolescent

Soares¹,

Reis-Melo

Ferraz

et al. 2019

BMJ Case Rep

View full text Add to dashboard Cite

show abstract

“…Most cases (60 to >80%) of nocardiosis occur in patients with severely impaired cellular immunity. 4,5,19,77 However, infections (sometimes fulminant and lethal) may occur in previously healthy hosts, 5,9,10,12,23,78 particularly in subtropical or tropical regions. 5,16 Nocardiosis is more common in males.…”

Section: Risk Factorsmentioning

confidence: 99%

“…34,175 In one IC patient with brain abscesses and an intracranial aneurysm due to N. abscessus, a combination of antimicrobials and surgical resection of the aneurysm was curative. 183 Severe CNS disease may occur even in previously healthy children 9 and adults. 38,183,186,187 Nocardia paucivorans, which rarely causes diseases in humans, appears to have a predilection for CNS involvement and dissemination.…”

Section: Clinical Features Pulmonarymentioning

confidence: 99%

“…Infections caused by bacteria in the genus Nocardia (termed nocardiosis) may cause pneumonia and other infections, principally in immunosuppressed (IS) patients with severe impairments in cellular immunity. [1][2][3][4][5][6][7][8] However, nocardiosis may occasionally affect immunocompetent (IC) patients, 9,10 especially those with underlying pulmonary disease, 11,12 bronchiectasis, 10,13,14 diabetes mellitus, [15][16][17] or alcohol abuse. 16,18 Pulmonary nocardiosis may mimic communityacquired pneumonia, and this may be more common among individuals with agricultural or outdoor occupations in developing countries.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Nocardia spp.: A Rare Cause of Pneumonia Globally

Lynch

Reid

Clark

2020

Semin Respir Crit Care Med

View full text Add to dashboard Cite

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.

show abstract

“…Furthermore, cases of multi-drug resistance nocardiosis [9,10] and the epidemiology and drug susceptibility of less common Nocardia species have recently been described [11,12]. In HIV-positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3% [13], and it is not considered an AIDSdefining disease.…”

Section: Introductionmentioning

confidence: 99%

Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report

Rita¹

2018

IJIDT

View full text Add to dashboard Cite

The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.

show abstract

Fulminant Nocardiosis Due to a Multidrug-Resistant Isolate in a 12-Year-Old Immunocompetent Child

Cited by 18 publications

References 30 publications

Nocardialung abscess in an immunocompetent adolescent

Nocardialung abscess in an immunocompetent adolescent

Nocardia spp.: A Rare Cause of Pneumonia Globally

Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report

Contact Info

Product

Resources

About