Infección pulmonar por Aspergillus fumigatus y Nocardia asteroides como complicación del tratamiento con glucocorticoides

Rare occurrence of pulmonary coinfection involving Aspergillus fumigatus and Nocardia cyriacigeorgica in immunocompetent patients based on NGS: A case report and literature review

“…[ 1 ] The most common among these is A fumigatus , whose spores or hyphae infiltrate tissues upon inhalation, leading to granuloma formation and progression to invasive aspergillosis. [ 2 ] PN and PA share several attributes and common risk factors. Both primarily stem from respiratory tract infections, predominantly affecting hosts with immunosuppression or underlying lung diseases.…”

“…Revealing a predominance of immunocompromised hosts. The instances encompassed cases of immunosuppressive drug therapy, [ 2 , 21 , 31 ] hematologic malignancies, [ 18 , 24 , 25 ] organ transplantation, [ 15 , 16 , 19 , 20 ] chronic granulomatous disease, [ 9 , 14 ] and systemic lupus erythematosus, [ 29 ] and a case of a tooth extraction in a mildly immunosuppressed patient. [ 30 ] Such cases were also observed in nonimmunosuppressed hosts, including patients with diabetes, [ 28 ] allergic disorders, [ 26 ] bronchial thermoplasty therapy [ 27 ] ulcerative colitis during golimumab therapy, [ 23 ] and even accidental drowning incidents.…”

“…Casale TB, [14] 1984 chronic granulomatous disease Carter JM, [15] 1990 Kidney transplant, immunosuppressive therapy Monteforte JS, [16] 1993 heart transplant Fernández Peláez JM, [2] 2000…”

“…Adult onset Still disease with steroid tacrolimus therapy Yamawaki S, [22] 2016 Drowning incident Alonso-Sierra M, [23] 2016 Ulcerative Colitis with Golimumab Therapy, mild chronic obstructive pulmonary disease, bronchiectasis and Hodgkin lymphoma Trastoy R, [24] 2017 B-cell Hodgkin lymphoma and diabetes mellitus. Dotson J, [25] 2018 Chronic Lymphocytic Leukaemia with Ibrutinib therapy Wu J, [26] 2018 Allergic bronchopulmonary aspergillosis, Repeatedly coughed up sputum for 20 y, and history of tuberculosis Matsubayashi S, [27] 2018 Severe asthma with Bronchial thermoplasty therapy and systemic steroids therapy Raj R, [28] 2020 High blood pressure, diabetes Tian X, [9] 2022 X-linked chronic granulomatous disease Roy M, [29] 2022 Systemic lupus erythematosus with hydroxychloroquine and prednisone therapy Jinlin G, [30] 2022 A Mildly Immunosuppressed Patient who had a Tooth Extraction Yan H, [31] 2022 Chronic viral hepatitis B and type 2 diabetes mellitus, highdose glucocorticoids therapy Casale TB, [14] 1984 USA/15/man Pulmonary Not available Carter JM, [15] 1990 USA/49/man Pulmonary Died Monteforte JS, [16] 1993 USA/63/man Pulmonary Recovered well Fernández Peláez JM, [2] 2000 Spain/39/man Pulmonary Died van Dam AP, [17] 2005 Netherlands/22/ man Pulmonary Recovered well Al-Anazi KA, [18] 2008 Saudi Arabia/67/ man Pulmonary Recovered well Hamadani M, [19] 2008 USA/50/woman Pulmonary Recovered well Cabada MM, [20] 2010 USA/65/man Pulmonary Recovered well Misra DP, [21] 2014 India/37/man Pulmonary Recovered well Yamawaki S, [22] 2016 Japan/84/man Pulmonary Died Alonso-Sierra M, [23] 2016 Spain/53/man Pulmonary Not available Trastoy R, [24] 2017 Spain/81/woman Pulmonary Not available Dotson J, [25] 2018 USA/64/woman Bronchopulmonary, subcutaneous tissues, lymph nodes central nervous system Died Wu J, [26] 2018 China/55/woman Pulmonary Recovered well Matsubayashi S, [27] 2018 Japan/35/woman Pulmonary Recovered well Raj R, [28] 2020 India/59/man Pulmonary Recovered well Tian X, [9] 2022 China/3/man Pulmonary, oral maxillofacial, perianal Died Roy M,…”

Case of coexistingNocardia cyriacigeorgicaandAspergillus fumigatuslung infection with metastatic disease of the central nervous system

“…Interestingly, Rivera et al in 2017 reported a case of paramediastinal abscess in an immunocompetent patient with no known lung disease 8. There have been several case reports of co-infection with Nocardia and Aspergillus to date, but coexisting N. cyriacigeorgica and Aspergillus infection is rarely reported 9–19. This may be partly because N. cyriacigeorgica is a newly identified strain of Nocardia .…”