Nocardia arthritidis as a cause of disseminated nocardiosis in a patient with chronic lymphocytic leukemia

Abstract

A case of disseminated nocardiosis caused by Nocardia arthritidis in an immunocompromised patient with a history of chronic lymphocytic leukemia and rheumatoid arthritis is presented. This report highlights the use for multilocus sequence typing (MLST) in addition to single gene molecular sequencing to identify rare Nocardia species.

Genomic Virulence Features of Two Novel Species Nocardia barduliensis sp. nov. and Nocardia gipuzkoensis sp. nov., Isolated from Patients with Chronic Pulmonary Diseases

“…The clade housing these strains was next to the one which encompasses mainly clinical Nocardia species which are classified as risk group 2 bacteria (RG2): Nocardia araoensis NBRC 100135 T (isolated from human) [ 56 ], Nocardia beijingensis NBRC 16342 T (isolated from mud but members of this species were also found in human infectious samples) [ 57 , 58 ], Nocardia niwae DSM 45340 T (isolated from lung biopsy) [ 59 ], Nocardia arthritidis NBRC 100137 T (isolated from human sputum) [ 60 ], Nocardia exalbida NBRC 100660 T ( isolated from the bronchoalveolar lavage of a patient with lung nocardiosis) [ 61 ] and Nocardia gamkensis NBRC 108242 T (isolated from soil) [ 62 ]. It has been reported that all these species were involved in human disease (except N. gamkensis ) and they clustered together based on different phylogenetic studies [ 63 , 64 ]. These phylogenetic results highlighted the pathogenicity potential that both isolates may have.…”

Cutaneous Nocardia arthritidis infection in an orthotopic liver transplant recipient

“…Four of the five patients were immunocompromised and/or on immunosuppressive medications. One patient had no documented immunosuppressive condition; however, the patient was known to have underlying silicosis [ [3] , [4] , [5] , [6] , [7] ]. The demographics, comorbid conditions, medications, and site of involvement have been summarized in Table 1 .…”

“…To summarize, four of the five reported cases of N. arthritidis infection, including the patient described above, had impairment of cellular immunity, which has been described as a key risk factor for developing nocardiosis [ [3] , [4] , [5] , [6] , [7] ]. Steroid use, chronic hematologic malignancy, and/or chronic iatrogenic immune suppression to prevent graft rejection in solid organ transplantation all contribute to impairment in cellular immunity and thus are known risk factors for nocardiosis [ 1 ].…”

“…Commonly encountered Nocardia species in clinical practice are N. abscessus, N. ostitidiscaviarum, N. brasiliensis, N. cyriacigeorgica, N. pseudobrasiliensis, N. farcinica, N. wallaei, and N. nova [ 1 , 2 ] . Nocardia arthritidis is a recently identified distinct species of Nocardia that has been reported to cause human disease, primarily in immunosuppressed hosts [ 2 , 3 ]. N. arthritidis was first identified in 2004 when two different Nocardia species were identified in sputum and inflammatory exudates collected from a patient with rheumatoid arthritis [ 4 ].…”