Nocardial Cerebral Abscess in the Acquired Immunodeficiency Syndrome

Adair, John C.; Beck, Anna; Apfelbaum, Ronald I.; Baringer, J. Richard

doi:10.1001/archneur.1987.00520170074026

Cited by 55 publications

(10 citation statements)

References 23 publications

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“…Coexistent infections with mycobacteria were found for two patients in this study (263). Kim et al described six cases of nocardiosis in HIV-infected patients (289) and included in their report an additional eight cases identified from a review of the English literature (5,263,289,358,362,377,483). The three most common sites of involvement in these patients were the lungs, brain, and pericardium (289).…”

Section: Epidemiologic Aspects Of Infection In Humansmentioning

confidence: 78%

“…Despite no clearly defined optimal therapy, several reports have suggested that HIV-infected patients diagnosed as having nocardiosis may be treated successfully with a variety of antimicrobial regimens (some without sulfonamides), sometimes in combination with surgery (usually a drainage procedure) (5,270,280,289,290,483,542,584). Frequently, in these patients, the cessation of specific antinocardial drug therapy may be followed by a recurrence of the infection, so that lifelong maintenance antimicrobial therapy is generally recommended.…”

Section: Epidemiologic Aspects Of Infection In Humansmentioning

confidence: 99%

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The medically important aerobic actinomycetes: epidemiology and microbiology

1994

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The aerobic actinomycetes are soil-inhabiting microorganisms that occur worldwide. In 1888, Nocard first recognized the pathogenic potential of this group of microorganisms. Since then, several aerobic actinomycetes have been a major source of interest for the commercial drug industry and have proved to be extremely useful microorganisms for producing novel antimicrobial agents. They have also been well known as potential veterinary pathogens affecting many different animal species. The medically important aerobic actinomycetes may cause significant morbidity and mortality, in particular in highly susceptible severely immunocompromised patients, including transplant recipients and patients infected with human immunodeficiency virus. However, the diagnosis of these infections may be difficult, and effective antimicrobial therapy may be complicated by antimicrobial resistance. The taxonomy of these microorganisms has been problematic. In recent revisions of their classification, new pathogenic species have been recognized. The development of additional and more reliable diagnostic tests and of a standardized method for antimicrobial susceptibility testing and the application of molecular techniques for the diagnosis and subtyping of these microorganisms are needed to better diagnose and treat infected patients and to identify effective control measures for these unusual pathogens. We review the epidemiology and microbiology of the major medically important aerobic actinomycetes.

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Section: Epidemiologic Aspects Of Infection In Humansmentioning

confidence: 78%

Section: Epidemiologic Aspects Of Infection In Humansmentioning

confidence: 99%

The medically important aerobic actinomycetes: epidemiology and microbiology

1994

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“…Unfortunately, there are too few published data to address these impressions adequately. Nevertheless, approximately 50 confirmed cases have been described in the literature in the United States, and many more cases have been noted in publications concerning nocardiosis in AIDS patients in Australia, England, France, Germany, Japan, Spain, and Uganda (4,7,40,122,124,125,148,174,184,214,217,252,263,324,330,346,351,373,374,390,393,400,435,438,449,453,493,513,559,585,593,602,610,664,680,708). Furthermore, we are aware of numerous unpublished cases of nocardiosis in AIDS patients from many different regions of the United States (Fig.…”

Section: Cns Nocardiosismentioning

confidence: 99%

Nocardia species: host-parasite relationships

1994

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The nocardiae are bacteria belonging to the aerobic actinomycetes. They are an important part of the normal soil microflora worldwide. The type species, Nocardia asteroides, and N. brasiliensis, N. farcinica, N. otitidiscaviarum, N. nova, and N. transvalensis cause a variety of diseases in both normal and immunocompromised humans and animals. The mechanisms of pathogenesis are complex, not fully understood, and include the capacity to evade or neutralize the myriad microbicidal activities of the host. The relative virulence of N. asteroides correlates with the ability to inhibit phagosome-lysosome fusion in phagocytes; to neutralize phagosomal acidification; to detoxify the microbicidal products of oxidative metabolism; to modify phagocyte function; to grow within phagocytic cells; and to attach to, penetrate, and grow within host cells. Both activated macrophages and immunologically specific T lymphocytes constitute the major mechanisms for host resistance to nocardial infection, whereas B lymphocytes and humoral immunity do not appear to be as important in protecting the host. Thus, the nocardiae are facultative intracellular pathogens that can persist within the host, probably in a cryptic form (L-form), for life. Silent invasion of brain cells by some Nocardia strains can induce neurodegeneration in experimental animals; however, the role of nocardiae in neurodegenerative diseases in humans needs to be investigated.

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“…crease in infections due to the Bataviae serogroup, a relative persistence of infections due to the Icterohemorrhagiae group serovars, and the emergence of serovars of the Australis serogroup (5,6). Eleven serovars belong to the Australis serogroup.…”

mentioning

confidence: 99%

“…Leptospira australis causes mild and severe forms of leptospirosis, including Well's disease (7). In particular, Crevatin et al (6) have shown a 35 % agglutinin prevalence, serovar bratislava being predominant in healthy people and in persons exposed to occupational hazards (abattoir workers). Seroepidemiological data from two studies performed in northern Italy (alpine areas) have shown that Leptospira icterohemorrhagiae and Leptospira attstralis serovar bratislava were the most predominant serovars in healthy people (6).…”

mentioning

confidence: 99%

DisseminatedNocardia farcinica infection in an AIDS patient

Miralles

1994

Eur. J. Clin. Microbiol. Infect. Dis.

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This report describes an AIDS patient presenting with disseminated Nocardia farcinica infection diagnosed by percutaneous kidney biopsy. The isolate was initially identified as Nocardia asteroides. Though Nocardia asteroides remains sensitive to most antimicrobial agents, Nocardia farcinica is resistant to gentamicin, tobramycin and cephalosporins and is indistinguishable from Nocardia asteroides by regular laboratory methods. In view of the rising incidence of infections with Nocardia farcinica, third-generation cephalosporins should not be used in the initial management of Nocardia infections, and all isolates should be submitted for antibiotic susceptibility testing.

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Nocardial Cerebral Abscess in the Acquired Immunodeficiency Syndrome

Cited by 55 publications

References 23 publications

The medically important aerobic actinomycetes: epidemiology and microbiology

The medically important aerobic actinomycetes: epidemiology and microbiology

Nocardia species: host-parasite relationships

DisseminatedNocardia farcinica infection in an AIDS patient

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