Nocardiosis - an emerging complication in the clinical management of HIV infected patients

Nwuba, C; Kogo, Gabriel; Ogbu, Ngozi; Abolarin, Oluwafemi; Okonkwo, R.A

doi:10.1186/1742-4690-9-s1-p134

Cited by 7 publications

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“…Clinical, radiological and histopathological findings are not sufficient for the recognition of pulmonary nocardiosis, suggesting that a considerable percentage of patients presenting symptoms of chronic lung disease could be suffering from pulmonary nocardiosis [5] , [46] . In some African countries, where HIV-related tuberculosis occurs frequently, there are reports of a high prevalence of nocardiosis [33] , [47] , [48] . Another issue for the recognition of pulmonary nocardiosis refers to the difficulty of diagnosing in the laboratory.…”

Section: Discussionmentioning

confidence: 99%

“…Another issue for the recognition of pulmonary nocardiosis refers to the difficulty of diagnosing in the laboratory. Some authors have emphasized that in regions where HIV-related tuberculosis occurs, Nocardia strains are missed or misidentified in clinical specimens and it is possible that some patients diagnosed as smear-negative pulmonary TB actually have nocardiosis [33] , [47] , [48] , [49] , [50] , [51] .…”

Section: Discussionmentioning

confidence: 99%

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Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

et al. 2013

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Background Nocardia sp. causes a variety of clinical presentations. The incidence of nocardiosis varies geographically according to several factors, such as the prevalence of HIV infections, transplants, neoplastic and rheumatic diseases, as well as climate, socio-economic conditions and laboratory procedures for Nocardia detection and identification. In Brazil the paucity of clinical reports of Nocardia infections suggests that this genus may be underestimated as a cause of human diseases and/or either neglected or misidentified in laboratory specimens. Accurate identification of Nocardia species has become increasingly important for clinical and epidemiological investigations. In this study, seven clinical Nocardia isolates were identified by multilocus sequence analysis (MLSA) and their antimicrobial susceptibility was also determined. Most Nocardia isolates were associated to pulmonary disease.Methodology/Principal FindingsThe majority of Brazilian human isolates in cases reported in literature were identified as Nocardia sp. Molecular characterization was used for species identification of Nocardia nova, Nocardia cyriacigeorgica, Nocardia asiatica and Nocardia exalbida/gamkensis. Data indicated that molecular analysis provided a different Nocardia speciation than the initial biochemical identification for most Brazilian isolates. All Nocardia isolates showed susceptibility to trimethoprim-sulfamethoxazole, the antimicrobial of choice in the treatment nocardiosis. N. nova isolated from different clinical specimens from one patient showed identical antimicrobial susceptibility patterns and two distinct clones.Conclusions/SignificanceAlthough Brazil is the world's fifth-largest country in terms of land mass and population, pulmonary, extrapulmonary and systemic forms of nocardiosis were reported in only 6 of the 26 Brazilian states from 1970 to 2013. A least 33.8% of these 46 cases of nocardiosis proved fatal. Interestingly, coinfection by two clones may occur in patients presenting nocardiosis. Nocardia infection may be more common throughout the Brazilian territory and in other developing tropical countries than is currently recognized and MLSA should be used more extensively as an effective method for Nocardia identification.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

et al. 2013

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“…Ninan et al [32], 2016 South India 131 cases: N. asteroides (73), Nocardia spp. (32), N. brasiliensis (2), aerobic actinomycetes (24) Skin (36), eye (36), pulmonary (35), immunosuppressive therapy (48) Nampoory et al [47], 1996 Kuwait 6 cases: N. asteroides (4), N. otitidiscaviarum (1), N. farcinica (1) Pulmonary nocardiosis (3: with 2 cerebral abscess, 1 meningitis); perinephric abscess (1), thigh abscess (1), ischiorectal abscess (1) Lai et al [65], 2011 Taiwan 138 isolates: N. brasiliensis (58), N. cyriacigeorgica (22), N. farcinica (11), N. beijingensis (8), N. otitidiscaviarum (7), N. nova (6), N. puris (6), N. asiatica (5), N. flavorosea (5), N. abscessus (3), others 7Skin and soft-tissue, respiratory tract specimens, brain biopsy, blood, lymph node…”

Section: Casesmentioning

confidence: 99%

“…Nocardiosis in HIV-positive patients is reported to occur in 3.4-16.7% of cases in various centers [22][23][24]. The course of the disease may be localized or disseminated; in a Spanish study on HIV and nocardia coinfection, 44% of cases had disseminated nocardiosis [25].…”

Section: Nocardiosis: a Global Problemmentioning

confidence: 99%

Nocardiosis: A Neglected Disease

Duggal

Chugh²

2020

Med Princ Pract

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is a global problem, though more common in the tropics; disease frequency is increasing due to increases in traveling and immunocompromised patients. • Pulmonary nocardiosis is the commonest presentation but no part of the body is exempt. • Diagnosis can be made by simple microscopy; however, culture and molecular methods provide a definitive diagnosis. • Nocardiae are resistant to many antibiotics, but effective chemotherapies are available in most cases.

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“…Since the clinical and radiological manifestations are non-specific, pulmonary nocardiosis could be mistaken with other infections or other bacterial pneumonia. In addition, nocardiosis may be under reported because it is not among the AIDS-defining criteria ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Nocardia co-Infection in Patients with Pulmonary Tuberculosis

Ekrami

Khosravi

Zadeh

et al. 2014

Jundishapur J Microbiol

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Background:Tuberculosis (TB) remains as one of the most serious infectious diseases in the world. Pulmonary tuberculosis can occur with other pulmonary diseases caused by opportunistic organisms such as Nocardia spp. particularly in immunocompromised patients. Therefore, diagnosis of co-infection at the early stage of the disease could be lifesaving.Objectives:The goal of this study was to detect Mycobacterium tuberculosis and Nocardia spp. in sputum specimens in order to assess the concomitant nocardiosis and tuberculosis in patients with suspected pulmonary tuberculosis.Patients and Methods:From March 2011 to April 2012, 189 sputum specimens were obtained from patients who were suspected of having pulmonary tuberculosis. Out of 189 samples, 32 of the samples belonged to hospitalized HIV-infected patients. Samples were examined by Gram and Ziehl-Nelsen staining, culture and PCR methods.Results:From 157 sputum specimens, positive samples by acid fast staining, culture and PCR for M. tuberculosis were reported for 7.6% (12/157), 10.1% (16/157) and 7% (11/157) of samples, respectively. No results were obtained by the described methods for Nocardia spp. Among 32 samples of HIV-infected patients, four (12.5%) had positive results for acid fast staining, culture and PCR detecting M. tuberculosis while only two samples had positive results for Nocardia spp. by PCR and no results were reported by culture, Gram and acid fast staining for this organism.Conclusions:Concurrent pulmonary nocardiosis and tuberculosis is frequent in HIV-infected patients. Rapid and sensitive methods such as PCR are recommended for detection of such co-infections.

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Nocardiosis - an emerging complication in the clinical management of HIV infected patients

Abstract: Nwuba et al.: Nocardiosis-an emerging complication in the clinical management of HIV infected patients. Retrovirology 2012 9(Suppl 1):P134.

Cited by 7 publications

References 0 publications

Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

Nocardiosis: A Neglected Disease

Nocardia co-Infection in Patients with Pulmonary Tuberculosis

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