Pulmonary nocardiosis due to Nocardia otitidiscaviarum in an immunocompetent host- A rare case report

Ramamoorthi, Kusugodlu; Pruthvi, Baise Chandrappagouda; Rao, Neeleshwara Radhakrishna; Jayaprakash, B; Chawla, Kiran

doi:10.1016/s1995-7645(11)60116-8

Cited by 22 publications

(13 citation statements)

References 8 publications

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“…[4] Similarly, Kageyama et al [14] reported that out of more than 303 pathogenic Nocardia strains isolated from nocardiosis patients in Japan from 1992 to 2001, only 14 were identified as N otitidiscaviarum . This low incidence of N otitidiscaviarum may be attributed to its lower prevalence in the environment when compared with other Nocardia species, [15,16] although it has been found to be native to the soil. [17] In this case, the cotton farmer had intimate contact with the soil, which increased the risk for N. otitidiscaviarum infection.…”

Section: Discussionmentioning

confidence: 99%

Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer

Liu¹,

Feng²,

Zhu³

et al. 2017

Medicine

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Rationale:Nocardia species are aerobic saprophytic bacilli. Among Nocardia species, Nocardia otitidiscaviarum (N otitidiscaviarum) is rarely reported in pulmonary infection.Patient concerns:We reported a case of N otitidiscaviarum pneumonia in a cotton farmer.Diagnoses:N otitidiscaviarum pneumonia was identified by mass spectroscopy.Interventions:Combined treatments (amikacin, imipenem and trimethoprim-sulfamethoxazole) were administered after identification of N otitidiscaviarum.Outcomes:The patient eventually died from severe respiratory insufficiency in the hospital.Lessons:Early precise diagnosis and prompt combined therapy are of vital importance in severe Nocardia pulmonary infection.

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Section: Discussionmentioning

confidence: 99%

Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer

Liu¹,

Feng²,

Zhu³

et al. 2017

Medicine

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“…In recent years, many researchers have focused on Nocardia infections in immunocompromised hosts as this organism is reemerging as an important opportunistic pathogen (10). Only a few cases of Nocardia infection in hosts with normal immune function have been reported, indicating a lack of systematic research on Nocardia infections in the Yantai area.…”

Section: Introductionmentioning

confidence: 99%

Microbiological and clinical data analysis of 32 patients with Nocardia infections in Yantai

Yu¹,

Liu²,

Pu³

et al. 2018

Turk J Med Sci

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Background/aim: Nocardia is an opportunistic pathogen that mostly affects hosts with immune deficiencies. Recently, the widespread use of immunosuppressive agents and antitumor drugs has led to an increasing number of Nocardia infections being reported. However, it is difficult to confirm this diagnosis owing to the slow growth of the bacterium and its complex resultant clinical manifestations, potentially delaying treatment and increasing mortality. Thus, further knowledge on the clinical characteristics of Nocardia infection is required. Hence, this study aimed to review the demographics, comorbidities, clinical presentation, microbiology, treatment, and outcomes of Nocardia infections in Yantai. Materials and methods:This is a retrospective study including 32 patients identified to have Nocardia infection from the Yantai Yuhuangding Hospital. The relevant patient samples were collected by two researchers, while the other researchers analyzed the relevant data. Results:The male to female ratio among the 32 patients was 3:5, and 23 patients (71.9%) were immunocompromised. Pulmonary sites of infection were the most common (65.6% of patients). N. brasiliensis infections were present in 25.0% and N. asteroides infections were present in 21.9% of patients. Because of limited biotechnological resources, Nocardia spp. in 50.0% of cases were not classified. The TMP-SMX resistance rate among isolates was 9.4%. All isolates were susceptible to amikacin, ceftriaxone, and imipenem. Conclusion:In Yantai, immunocompromised patients predominate among cases of Nocardia infection. The rate of occurrence was higher in females than in males. Because of potential TMP-SMX resistance, treatment for Nocardia infection should be based on drug susceptibility or should include combination therapy.

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“…The Pubmed and Google scholar database was searched with 'Nocardia otitidiscaviarum', 'lung infection', 'pulmonary' and 'pneumonia' and 23 cases have been reported [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37], which are presented in Table 3. Sixteen cases were male and seven were female patients.…”

Section: Discussionmentioning

confidence: 99%

“…The remaining cases were reported in immunocompetent patients. Four of these otherwise healthy patients were engaged in farming where inhalation of dust and hay were postulated as a source of infection [22,27,30,35]. Only in a single case reported by Savitha et al no associated risk factors like immunocompromised state, underlying lung disease or farming was observed [20].…”

Section: Discussionmentioning

confidence: 99%

Fatal pulmonary infection by trimethoprim-sulfamethoxazole resistant Nocardia otitidiscaviarum: report of two cases and review

Saksena

Rynga

Rajan

et al. 2020

J Infect Dev Ctries

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Introduction: Nocardia otitidiscaviarum is a rare cause of human infections, mostly causing cutaneous and lymphocutaneous infections of mild severity. We report two cases of fatal pulmonary infection caused by Nocardia otitidiscaviarum in elderly patients. Methodology: Case 1: A 70-year old woman presented with fever and cough with expectoration for a month. On physical examination, she had tachypnea and inspiratory crepitations in bilateral basal regions. Case 2: A 74-year old man presented with productive cough with foul smelling expectoration, fever and shortness of breath for one week. On examination, he had tachypnea, bilateral wheezing and inspiratory crepitations. In both cases, sputum was sent to microbiology laboratory. On direct microscopy Gram-positive, finely branching filaments were observed which were acid fast with 1% sulphuric acid. Chalky white opaque wrinkled colonies with musty basement type odour were seen on blood agar. Both patients were treated empirically with trimethoprim-sulfamethoxazole for Nocardia infection after notification of microscopy findings however both expired on Day 2 and Day 5 of admission, respectively. Both isolates were susceptible to amikacin, linezolid, ciprofloxacin and gentamicin. They were resistant to trimethoprim-sulfamethoxazole, ampicillin, amoxicillin-clavulanic acid, erythromycin, and imipenem. Based on biochemical identification and antimicrobial susceptibility pattern, the organism was identified as Nocardia otitidiscaviarum. The identification was confirmed using MALDI-TOF (Vitek MS, Biomerieux, France). Conclusion: Our report highlights the importance of early identification of Nocardia to species level to improve treatment outcomes especially in critically ill patients. Mass spectrometry can become an integral part of diagnostic algorithms for nocardiosis.

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Pulmonary nocardiosis due to Nocardia otitidiscaviarum in an immunocompetent host- A rare case report

Cited by 22 publications

References 8 publications

Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer

Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer

Microbiological and clinical data analysis of 32 patients with Nocardia infections in Yantai

Fatal pulmonary infection by trimethoprim-sulfamethoxazole resistant Nocardia otitidiscaviarum: report of two cases and review

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