Pulmonary nocardiosis caused by Nocardia exalbida complicating Pneumocystis pneumonia in an HIV-infected patient

Imai, K.; Koibuchi, Tomohiko; Kimura, Tadashi; Koga, Michiko; Nakamura, Hitomi; Miura, Toshiyuki; Gonoi, Tohru; Yazawa, Kazunaga; Iwamoto, Aikichi; Fujii, Takeshi

doi:10.1007/s10156-011-0211-8

Cited by 11 publications

(15 citation statements)

References 22 publications

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“…This difference in the prevalence of Nocardia in studies included in the current review from Iran possibly can be attributed to geographical location, the methods used for detection (phenotypic and molecular methods), and also patient groups (patients suspected of TB or HIV patients who suffered from TB) (32). Nocardiosis is a global concern, as Nocardia infections are not rare with an annual prevalence rate between 500-1,000 cases, 85% of which are pulmonary or systemic infections (33).…”

Section: Discussionmentioning

confidence: 90%

Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Mehrabadi

Taraghian

Pirouzi

et al. 2020

Ethiop J Health Sci

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BACKGROUND: nocardiosis is an opportunistic infectious disease in immunocompromised patients. The most common form of nocardiosis infection in humans is pulmonary nocrdiosis caused by inhaling Nocardia species from the environment. Thus, this study aimed to evaluate the pulmonary nocardiosis in patients with suspected tuberculosis using systematic review and meta-analysis.METHODS: We conducted a systematic search for cross-sectional studies focused on the pulmonary nocardiosis among patients with pulmonary tuberculosis based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) published from January 2001 to October 2019. The search was conducted in MEDLINE/PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, Science Direct databases, and Iranian databases. Medical subject headings (MeSH) and text words were searched: “pulmonary nocardiosis”, “nocardiosis”, OR “nocardial infection”, “pulmonary nocardial infections/agents”, AND “pulmonary tuberculosis”, OR “pulmonary TB”, AND “Iran”. Two of the reviewers enrolled independently articles published in English and Persian languages according to the inclusion and the exclusion criteria. Comprehensive Meta-Analysis software (Version 3.3.070) was used for meta-analysis.RESULTS: Only 4 studies met the eligibility criteria. The pulmonary nocardiosis prevalence varied from 1.7% to 6.7%. The combined prevalence of nocardiosis among patients with suspected pulmonary tuberculosis in Iran was 4.8% (95% CI: 3-7.3, Q=5.8, Z=12.7). No heterogeneity was observed between studies because I2 was 48.3. N. cyriacigeorgica and N. asteroides were reported as the prevalent isolates, respectively.CONCLUSIONS: This review showed in patients suspected TB when they were negative in all diagnosis laboratory tests, nocardiosis cases which be considered.

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Section: Discussionmentioning

confidence: 90%

Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Mehrabadi

Taraghian

Pirouzi

et al. 2020

Ethiop J Health Sci

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“…Early diagnosis and treatment of Nocardia bacteremia are highly important to patients' prognosis. TMP-SMZ is widely used as the mainstay drug in the treatment of nocardiosis [16][17][18]. Carbapenems, levofloxacin, amikacin, minocycline, ceftriaxone, and linezolid also have activity against Nocardia [10,17,18].…”

Section: Discussionmentioning

confidence: 99%

Nocardia Bloodstream Infection: A Retrospective Clinical Analysis of Seven Cases in a Single Centre

Liang

Wang

Cui

et al. 2020

Cureus

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Objective: Nocardiosis is a rare opportunistic infection caused by the Nocardia species. Nocardia bacteremia is a life-threatening presentation of disseminated nocardiosis that presents diagnostic and therapeutic challenges. We performed this retrospective analysis in a Chinese hospital from 2010 to 2019 to describe the characteristics of this rare bloodstream infection. Methods: We searched the database of the real-time nosocomial infection surveillance system and identified patients whose blood cultures showed Nocardia bacteria growth. The medical records of these patients were extracted and analyzed by two independent researchers. The data included age, gender, complicating disease, duration from blood drawing to reporting, clinical signs and symptoms, blood routine and C-reactive protein results, radiological examinations, sites of involvement, antibiotic treatments, and outcomes. Results: Seven patients with Nocardia bacteremia were found. There were four male and three female patients, whose ages ranged from 41 to 75 years. Six (85.7%) patients had predisposing conditions and were administrated corticosteroids for various reasons before the identification of Nocardia infection. The most common symptom was fever (100%). Five patients presented with lung or skin involvement; meanwhile, three patients presented with brain involvement. One patient presented with pelvic and peritoneum involvement, respectively. The most common findings of chest CT imaging were consolidation, followed by nodules and cavitations. Trimethoprim/sulfamethoxazole was prescribed to all patients after the diagnosis of Nocardia bacteremia. Six patients recovered, and one patient ultimately died. Conclusions: Nocardia bacteremia is a rare bloodstream infection that usually occurs in immunocompromised patients. Clinical manifestations of patients are nonspecific. It often causes multiple organ involvement, and early diagnosis and prompt aggressive interventions are important to improve the outcome of this disease.

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“…In addition, several other antibiotics, including cefotaxime, imipenem, minocycline and amikacin, showed good activity against the examined strains, indicating that these agents may be used in place of TMP/SMX for treatment of N. exalbida infection. Indeed, pulmonary N. exalbida infection occurring in an HIV-1-infected patient having hypersensitivity to TMP/SMX was successfully treated with intravenous imipenem plus amikacin and subsequent oral garenoxacin (Imai et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…To date, six other cases of N. exalbida recovery from human materials have been described in the English literature (Table 1): two from patients with pulmonary infection (Iida et al, 2006;Imai et al, 2011), one each with endogenous endophthalmitis (Milman et al, 2011), keratitis (Mizota et al, 2007) and brain abscess (Ono et al, 2008), and one with an undescribed location (Iida et al, 2006). Interestingly, five of the six cases were reported from Japan, suggesting that N. exalbida is more prevalent in this country than in other areas (Ono et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…first recovered from materials of immunocompromised humans and characterized by Iida et al (2006). Since then, only a few cases of N. exalbida infection have been described in the literature (Mizota et al, 2007;Ono et al, 2008;Imai et al, 2011;Milman et al, 2011). Here, we report a case of pulmonary infection caused by N. exalbida in a human immunodeficiency virus type 1 (HIV-1)-infected patient, which became evident after treatment of antecedent pneumococcal pneumonia.…”

Section: Introductionmentioning

confidence: 93%

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Pulmonary infection due to Nocardia exalbida complicated with pneumococcal pneumonia

et al. 2015

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Introduction: Nocardia exalbida is an uncommon Nocardia sp., first described in 2006. We report a case of pulmonary infection due to this organism, which became evident after treatment of antecedent pneumococcal pneumonia.Case presentation: A 68-year-old man was hospitalized because of pneumococcal pneumonia. Although his symptoms improved immediately after administration of antipneumococcal antibiotics, patchy opacity on the chest X-ray remained and pyrexia recurred. Administration of trimethoprim/sulfamethoxazole, given after seropositivity against human immunodeficiency virus type 1 was confirmed and Nocardia-like organisms were detected from the sputa, completely resolved his symptoms. The recovered organism was identified as N. exalbida by comparison of 16S rRNA gene sequences. Conclusion:To the best of our knowledge, only six other cases of N. exalbida infection have been described. Most of these cases were reported from Japan, suggesting that the organism is more prevalent in this country than in other areas. The present case also highlights that underlying nocardiosis should be considered when an immunocompromised patient with acute bacterial pneumonia demonstrates refractory respiratory manifestations, despite receiving appropriate treatments.

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Pulmonary nocardiosis caused by Nocardia exalbida complicating Pneumocystis pneumonia in an HIV-infected patient

Cited by 11 publications

References 22 publications

Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Nocardia Bloodstream Infection: A Retrospective Clinical Analysis of Seven Cases in a Single Centre

Pulmonary infection due to Nocardia exalbida complicated with pneumococcal pneumonia

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