Intra-Abdominal Nocardiosis—Case Report and Review of the Literature

Abstract

<jats:p>Nocardiosis is primarily an opportunistic infection affecting immunosuppressed individuals, in whom it most commonly presents as pulmonary infection and sometimes cerebral abscesses. Isolated abdominal or retroperitoneal nocardiosis is rare. Here, we report the second case, to our knowledge, of isolated abdominal nocardiosis due to Nocardia paucivorans and provide a comprehensive review of intra-abdominal nocardiosis. The acquisition of abdominal nocardiosis is believed to occur via hematogenous spreading after pulmonary or percutaneous inoculation or possibly via direct abdominal inoculation. Cases of Nocardia peritonitis have been reported in patients on peritoneal dialysis. Accurate diagnosis of abdominal nocardiosis requires histological and/or microbiological examination of appropriate, radiologically or surgically obtained biopsy specimens. Malignancy may initially be suspected when the patient presents with an abdominal mass. Successful therapy usually includes either percutaneous or surgical abscess drainage plus prolonged combination antimicrobial therapy.</jats:p>

The Role of 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in Management of Nocardiosis: A Retrospective Study and Review of the Literature

“…Tissue evaluation led to the diagnosis Playe et al [ 36 ] 2020 M 63 Asthma, on oral low-dose corticosteroid therapy N. brasiliensis CNS, musculocutaneous Assessment of the extent of the infection in an individual with multiple CNS abscesses and dermal lesions Increased FDG uptake in right hilar lymphadenopathy and in multiple cutaneous, subcutaneous, and muscle abscesses: left buttock subcutaneous (SUVmax 6.0), left extensor digitorum longus (SUVmax 8.4), and right leg posterior compartment muscles (SUV = 8.0). Hypermetabolism was not noted in the CNS lesions Revealing disease extent (diffuse musculocutaneous involvement) Guiding skin biopsies that led to the diagnosis Tramèr et al [ 37 ] 2020 M 81 Diffuse large B cell lymphoma, in remission. The patient received no immunosuppressive therapy N. paucivorans A retroperitoneal abscess Suspected lymphoma recurrence Increased FDG uptake in a right adrenal mass with central necrosis Revealing a single focus disease Guiding biopsy that led to the diagnosis Kodaganur Gopinath S et al [ 38 ] 2020 M 34 Apparently immunocompetent Nocardia spp.…”

“…All publications were case reports of individual patients. Nine were published between 2004 and 2014 [19][20][21][22][23][24][25][26][27], five were published in 2015 [28][29][30][31][32] and six were published between 2016 and 2020 [33][34][35][36][37][38]. These 20 case reports are summarized in Table 2.…”

Listeria monocytogenes bacteremia mimicking the systemic metastasis of adrenal cancer: a case report

“…The fact that adrenal carcinoma is difficult to distinguish from abscesses on imaging [ 15 ] and that there were findings in the liver and bone on PET-CT may have accounted for the patient's listeriosis being a great mimicker of malignancy. Actinomycosis, nocardiosis, and mycosis have been reported to form foci reminiscent of malignancy, but all of these diseases are chronic infections [ 18 – 21 ]. We found only one report of multiple liver abscesses in an asymptomatic patient [ 22 ], but most listeriosis patients have symptoms such as fever, and follow an acute course.…”

Pathologie infectieuse du tube digestif : diagnostics à ne pas manquer

“…Il s’agit d’une maladie opportuniste survenant le plus souvent chez des patients immunodéprimés (environ 66 % des cas) [4] . Les atteintes digestives sont rares, la nocardiose se manifestant plus souvent par des abcès cérébraux ou une atteinte pulmonaire mimant une tuberculose ou une aspergillose [5] .…”

“…Les rares cas de nocardiose digestives, rapportés dans la littérature, décrivaient des péritonites chez des patients avec hémodialyse péritonéale, des abcès profonds [5] , [6] sous formes de masses pseudo-tumorales associés à une co-infection à Klebsiella pneumonia e ou des infections péri-anales avec infiltration pelvienne ou du tube digestif bas.…”