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PubMedDate not supplied

Nocardia infection in renal transplant recipient: diagnostic and therapeutic considerations.

In the present report the authors discuss the diagnostic difficulties, therapeutic measures and the clinical course of Nocardia infection which occurred among renal transplant recipients at the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (UH-FRP), from 1968 to 1991. Among 500 individuals submitted to renal transplant, 9 patients developed Nocardiosis at varying times after transplant (two months to over two years). All the patients had pulmonary involvement and their most common symptoms were fever, cough and pleural pain. Dissemination of the process is common and three patients presented cutaneous abscesses, four CNS involvement and one had pericarditis due to Nocardia. The diagnostic is quite difficult since there is no specific clinical picture, concomitant infections are frequent and the microorganism presents slow growth in culture (ranging from four to forty days, in our experience). In this report, three cases were only diagnosed by necropsy. The treatment of choice is a combination of Sulfamethoxazole and Trimethoprim (SMX-TMP). In the present series, overall mortality was 77% (7 cases) and in five of the patients who died the diagnosis was late. All the patients who had CNS involvement died.

Adult↗
PubMed1992

[Cerebral and spinal nocardia infection. A case report].

We report a case of multiple cerebral and spinal abscesses due to Nocardia asteroides in a non-immunocompromised patient. The initial central nervous system manifestation was a sterile meningitis, with secondary development of multiple cerebral and spinal abscesses. Since the location of the abscesses did not allow neurosurgical exploration and the cultures remained negative, the diagnosis was finally established by raised antibody titres to Nocardia asteroides. After specific antibiotic therapy, resolution of the spinal and cerebral abscesses was documented on the basis of serial magnetic resonance tomography and computed tomography controls.

Abscess↗
PubMed1977

Nocardia infections in congenitally athymic (nude) mice and in other inbred mouse strains.

The mortality rate and histopathological features of Nocardia asteroides and Nocardia brasiliensis infections in congenitally athymic (nude) mice of ICR and C3H/eB origins were quite different from what we found for Swiss white mice and other inbred mouse strains (namely, C57/BL/6J, New Zealand Black, BALB/c, CBA/LAC, and C3H/eB). The immunocompetent littermates of the congenitally athymic mice occupied an intermediate position between their athymic siblings and Swiss white mice in terms of their responses to both these organisms. Macrophage ingestion and destruction of N. brasiliensis, as demonstrated by electron microscopy, was found to occur. The T-lymphocyte appears to be an essential component in normal mouse resistance to infection by both N. asteroides and N. brasiliensis.

Animals↗
PubMed2000

Nocardia infection of a joint prosthesis complicating systemic lupus erythematosus.

The authors report the case of a 43-year-old woman suffering from severe systemic lupus erythematosus treated with long-term prednisone, who developed Nocardia nova infection on a hip prosthesis. Sepsis occurred about two years after an episode of pulmonary nocardiosis with the same Nocardia species, that was successfully treated by 12 months of antibiotics. A good outcome of the joint infection was observed in response to antibiotics and removal of the prosthesis. Nocardiosis is a rare infection, acting as an opportunistic infection, facilitated in the present case by systemic lupus erythematosus and chronic corticosteroid therapy. Nocardia infections mainly affect the lungs, skin and central nervous system; these last two sites are mostly due to haematogenous spread, a frequent event. Treatment is based on antibiotics, usually continued for 3-12 months, especially because of the risk of relapse. The imipenem-amikacin combination appears to be more effective than trimethoprim sulfamethoxazole. To our knowledge, this is the first case report of Nocardia nova joint prosthesis infection also presenting as late septic spread of pulmonary nocardiosis, complicating corticosteroid-treated systemic lupus erythematosus.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Nocardia infection following phacoemulsification.

Infection of a self-sealing tunnel incision is a rare but vision-threatening complication of cataract surgery. We describe two cases of side port infection following an uneventful phacoemulsification. Nocardia was isolated in one case. Both the cases were worsening on medical treatment and were successfully treated by therapeutic keratoplasty.

Aged↗
PubMed1992

[Systemic Nocardia infection in an AIDS patient].

We report the case of a patient with Aids, Kaposi's sarcoma and a systemic nocardial infection. After surgical drainage and adequate antibiotic treatment the infection was cured. Under secondary antimicrobial prophylaxis no relapse has occurred to date. Generalized N. asteroides infections have been rarely described in patients with Aids and the possible reasons for this are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Amyloidosis developing in experimental nocardia infections.

Swiss white and C57/BL/6J mice inoculated repeatedly with either Nocardia asteroides or Nocardia brasiliensis organisms developed amyloidosis over a 7-month period. Amyloidosis also developed in these mice within 6 weeks following a single large inoculum of either organism, but not in other in-bred mouse strains, suggesting a genetic influence in the pathogenesis of this form of secondary amyloidosis.

Amyloidosis↗
PubMed1999

Actinomyces and nocardia infections in immunocompromised and nonimmunocompromised patients.

A retrospective survey of nocardia and actinomyces infections in five local hospitals was conducted over a 3-year period in El Paso, Texas, a border city, in the southwestern United States. The medical records of 42 patients with suspected nocardiosis or actinomycosis were reviewed. One patient was diagnosed with actinomyces and 12 patients with nocardia. Microbiological data included morphologic characteristics, biochemical profile, and susceptibility testing. Predisposing factors included leukemia, renal insufficiency, renal transplant, and lymphoma. No predisposing factors were found in 67% (n = 8) of patients (including the patient with actinomycosis). Twenty-three percent (n = 3) of patients had disseminated disease without evidence of underlying disease or immunosuppression. The mortality and morbidity of these infections appeared to be low.

Actinomycosis↗