Mycetoma caused by <i>Nocardia brasiliensis</i> in an immunocompetent patient

Sousa, João; Wachholz, Patrick Alexander; Sette, Christiane Salgado; Marques, Gabriela Franco; Barreto, Jaison Antônio

doi:10.1111/ddg.12331

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…brasiliensis , predominated and in the eumycetoma group, Scedosporium apiospermum . From 1980 to 2014, the main bacterial agents identified in Brazil were Nocardia brasiliensis [15,26,27–32], Nocardia asteroides [15,33], Nocardia caviae [34], Actinomadura madurae [13,35,36], Actinomadura pelletieri [14], and Streptomyces somaliensis [15]. For eumycetoma were Madurella mycetomatis [15,25,37,38], Madurella grisea [39–45], Acremonium falciforme [46], Acremonium kiliense [47], Scedosporium apiospermum [12,18,48,49,50], Fusarium solani [51], Exophiala jeanselmei [44,52,53] and Aspergillus sp.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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Mycetoma is caused by the subcutaneous inoculation of filamentous fungi or aerobic filamentous bacteria that form grains in the tissue. The purpose of this study is to describe the epidemiologic, clinic, laboratory, and therapeutic characteristics of patients with mycetoma at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, between 1991 and 2014. Twenty-one cases of mycetoma were included in the study. There was a predominance of male patients (1.3:1) and the average patient age was 46 years. The majority of the cases were from the Southeast region of Brazil and the feet were the most affected anatomical region (80.95%). Eumycetoma prevailed over actinomycetoma (61.9% and 38.1% respectively). Eumycetoma patients had positive cultures in 8 of 13 cases, with isolation of Scedosporium apiospermum species complex (n = 3), Madurella mycetomatis (n = 2) and Acremonium spp. (n = 1). Two cases presented sterile mycelium and five were negative. Six of 8 actinomycetoma cases had cultures that were identified as Nocardia spp. (n = 3), Nocardia brasiliensis (n = 2), and Nocardia asteroides (n = 1). Imaging tests were performed on all but one patients, and bone destruction was identified in 9 cases (42.68%). All eumycetoma cases were treated with itraconazole monotherapy or combined with fluconazole, terbinafine, or amphotericin B. Actinomycetoma cases were treated with sulfamethoxazole plus trimethoprim or combined with cycles of amikacin sulphate. Surgical procedures were performed in 9 (69.2%) eumycetoma and in 3 (37.5%) actinomycetoma cases, with one amputation case in each group. Clinical cure occurred in 11 cases (7 for eumycetoma and 4 for actinomycetoma), and recurrence was documented in 4 of 21 cases. No deaths were recorded during the study. Despite of the scarcity of mycetoma in our institution the cases presented reflect the wide clinical spectrum and difficulties to take care of this neglected disease.

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Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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“…This report highlights a case of primary cutaneous nocardiosis featuring multiple fi stulae and ulcers on the patient's back, which were more severe than in previously published cases of nocardiosis (which is extremely rare in this region of the body) [ 5 ] . The diagnosis of nocardiosis is a challenge for all healthcare providers for three reasons.…”

Section: Conflict Of Interestmentioning

confidence: 55%

Primary cutaneous nocardiosis

Bandeira

Guimarães-Silva

Cedro-Filho

et al. 2019

J Deutsche Derma Gesell

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Sehr geehrte Herausgeber, das Myzetom ist eine klinische Entität mit einer lokalisierten, indolenten tumorförmigen Anschwellung (Pseudotumor) von subkutanem Gewebe mit Fistelgängen, aus dessen Öffnungen sich putrides oder seröses Sekret entleert. Mit dem Sekret werden Granula (Körnchen, Drusen) nach außen abgegeben, die entweder durch Pilze (Eumyzetom) oder durch fadenförmige Bakterien (Aktinomyzetom) verursacht sind. Die wesentlichen histologischen Unterschiede zwischen den verschiedenen Myzetomen bestehen in der Morphologie der Granula, der Abszessgröße und der Intensität der granulomatösen Reaktion. Anders als bei den mykotischen Infektionen finden sich bei aktinomykotischen Myzetomen (AM) überwiegend neutrophile Granulozyten (insbesondere bei Nocardia spp.) und Granula, die sich aus einem Konglomerat sehr dünner Filamente (1 μm oder weniger im Durchmesser) zusammensetzen [1]. Bei der primär kutanen Nokardiose sind die Granula kleiner als bei anderen AM und sie erweisen sich in der Kinyoun-Färbung, einer modifizierten Ziehl-Neelsen-Färbung, als säurefest [1, 2]. Eine weitere wichtige, bei AM zu berücksichtigende Differenzialdiagnose ist die Botryomykose, eine Erkrankung, bei der die Granula aus einer Agglomeration von Kokken bestehen [1]. Es ist wichtig zu betonen, dass Eumyzetom-artige Läsionen nicht ausschließlich durch Nocardia spp. verursacht werden, sondern auch durch ähnliche Bakterien wie Actinomadura spp.

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Isolated Nocardiosis, an Unrecognized Primary Immunodeficiency?

Martı́nez-Barricarte

2020

Front. Immunol.

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Nocardiosis is an infectious disease caused by the gram-positive bacterium Nocardia spp. Although it is commonly accepted that exposure to Nocardia is almost universal, only a small fraction of exposed individuals develop the disease, while the vast majority remain healthy. Nocardiosis has been described as an "opportunistic" disease of immunocompromised patients, suggesting that exposure to the pathogen is necessary, but a host predisposition is also required. Interestingly, increasing numbers of nocardiosis cases in individuals without any detected risk factors, i.e., without overt immunodeficiency, are being reported. Furthermore, a growing body of evidence have shown that selective susceptibility to a specific pathogen can be caused by a primary immunodeficiency (PID). This raises the question of whether an undiagnosed PID may cause nocardiosis affecting otherwise healthy individuals. This review summarizes the specific clinical and microbiological characteristics of patients with isolated nocardiosis published during the past 30 years. Furthermore, it gives an overview of the known human immune mechanisms to fend off Nocardia spp. obtained from the study of PIDs and patients under immunomodulatory therapies.

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Mycetoma caused by Nocardia brasiliensis in an immunocompetent patient

Cited by 3 publications

References 8 publications

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

Primary cutaneous nocardiosis

Isolated Nocardiosis, an Unrecognized Primary Immunodeficiency?

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