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PubMed1978

Mycetoma caused by Nocardia asteroides.

During the last 5 years six cases of mycetoma have been referred to the Razi Hospital, Thehran. Nocardia Asteroides was found to be the causative agent in one case only. Five of the patients were males, all being rice farmers, and one was a female. All of them belonged to Northern Iran which has a mediterranean climate. Treatment of the condition still remains unsatisfactory and ineffective and amputation may have to be performed as a last resort.

Adult↗
PubMed1998

[Unusual bronchial tumor...].

We report a case of atelectasis of the upper right lobe which did not respond to antibiotics. A third bronchial endoscopy with bronchoalveolar lavage was required to make the diagnosis of endobronchial nocardiasis. Search for extension revealed a brain localization. Search for immune deficiency only revealed calcification of the bronchial mucosa in the area of the nocardiasis.

Aged↗
PubMedDate not supplied

[Nocardia otitidiscaviarum, cutaneous infection in a patient receiving long-term corticosteroid treatment].

A 62-year-old man, under long-term corticosteroid therapy for pigeon breeder's disease, was admitted to endocrinology disease department for cutaneous abscess on back, limbs and scalp. Culture of various bacteriological samples (cutaneous abscess, blood culture) isolated Nocardia otitidiscaviarum. The patient was treated by trimethoprime-sulfametoxazole during several weeks with abscess disappearance. Our laboratory quickly identificatied a bacteria belonging to the Nocardia genus, with simple technique, later confirmed by a specialized laboratory (Pr. Boiron Claude Bernard University Lyon I) with identification of Nocardia otitidiscaviarum. The proof of pulmonary nocardiosis could not be established despite the existente of several risk factors. Prognosis is poor for immunocompromised patients, but the secondary cutaneous dissemination phase presented a favourable evolution under antibiotic therapy.

Adrenal Cortex Hormones↗
PubMed1995

[Nocardiosis in patients with human immunodeficiency virus infection in Spain].

BACKGROUND: Nocardia usually infects immunosuppressed patients, particularly with cellular immunity deficiency. Nevertheless, despite severe immunosuppression in patients infected with HIV, nocardiosis is rare among these patients. We report here two cases of nocardiosis in patients with HIV infection and review spanish literature up to 1993, with an analysis of the characteristics of this infection in our country. METHODS AND RESULTS: The two patients consumed drugs parenterally and Nocardia organism were recovered in blood cultures after 48 hours of inoculation in standard culture media. The source of the infection was cutaneous in one patient, over an area of venipuncture, and pulmonary in the other patient. Previously, eleven cases of nocardiosis had been reported in the spanish literature in patients infected with HIV. Eighty-four percent were males, and all of them consumed drugs parenterally and displayed a severe cellular immunodepression; the total CD4 lymphocyte count was lower than 100/mm3 in patients when this finding was available (6/13). At diagnosis only one patient received prophylaxis against other type of infection with antibiotics theoretically effective against Nocardia at diagnosis. The Nocardia species recovered more frequently was asteroides (77%) and the most common location was the skin (54%). Treatments more frequently employed were sulfametoxazole-trimethoprim (45%) and sulfadiazine (36%), with a good response except in those with cerebral involvement. CONCLUSIONS: Nocardiosis in patients with HIV infection is rare in Spain. In contrast with other geographical areas skin involvement was the more common form of infection. Prophylaxis with sulfametoxazole-trimethoprim against other infections could be responsible for a lower than expected incidence among this type of patients.

AIDS-Related Opportunistic Infections↗
PubMed1991

Disseminated nocardiosis.

A middle aged female suffering from idiopathic thrombocytopenic purpura (ITP), on treatment with steroids, developed bronchopneumonia and pyopneumothorax due to opportunistic infection by Nocardia asteroides. Aspirates obtained from the lungs, liver, spleen, kidneys and bone marrow were positive for Nocardia asteroides, confirming disseminated infection in an immunocompromised host. The patient succumbed to the infection.

Adult↗
PubMed1985

Nocardial infection in a renal transplant recipient--a case report.

Report is given about a 50 year old renal transplant recipient who developed signs of a severe pneumonia 37 days post transplantation. The diagnosis following chest X-ray and physical examination was multifocal nodular pneumonia of unknown origin in an immunosuppressed patient. Although a varying antibiotic chemotherapy was administered at high doses he died 4 weeks later without identification of the infective agent. Post-mortem and microbiological examinations revealed a systemic suppurative infection caused by Nocardia asteroides. Percutaneous or open lung biopsy within the first 10 days after onset of clinical symptoms has to be recommended to secure the diagnosis and treatment with sulphonamides.

Abscess↗
PubMed1978

Disseminated Nocardia caviae with positive blood cultures.

Disseminated Nocardia caviae infection with multiple positive blood cultures occurred in a bone marrow transplant recipient. Positive blood cultures are unusual in disseminated Nocardia infections and N caviea is an unusual species of Nocardia to cause infections in man, although its virulence in laboratory animals is similar to N asteroides. Multiple positive blood cultures in this case suggest a continuous or recurrent bacteremia rather than a transient bacteremia as previously has been thought to occur in disseminated Nocardia infections. The marked immunosuppressed state of the patient and an indwelling venous line could also have accounted for the recurrent bacteremia.

Adult↗
PubMed1998

Nocardia farcinica sternotomy site infections in patients following open heart surgery.

Although Nocardia farcinica surgical site infection outbreaks have been reported (though rarely), no source for these has been identified. From May 1992 through June 1993, 5 patients contracted N. farcinica sternotomy site infections following open heart surgery at hospital A. A case-control study comparing case-patients (n=5) with open heart surgery patients without subsequent sternotomy site infections (n=50) identified as risk factors diabetes (4/5 vs. 11/50, P<.02) and exposure to a particular anesthesiologist (anesthesiologist A; 4/5 vs. 9/50, P<.01). Four case-patients' isolates and a hand isolate of anesthesiologist A had an identical ribotype pattern (strain 1); the remaining case-patient's isolate and multiple isolates from anesthesiologist A's hands and home had a different ribotype pattern (strain 2). An intensified hand-washing regimen, barriers (gloves, gowns), and cleaning of anesthesiologist A's house were associated with termination of the outbreak. This is the first reported nosocomial N. farcinica outbreak to document the source and person-to-person transmission epidemiologically and molecularly.

Aged↗
PubMed1992

Infections due to Nocardia transvalensis: clinical spectrum and antimicrobial therapy.

Nocardia transvalensis, a rare Nocardia species, has previously been recognized as a cause of actinomycotic mycetoma. In a retrospective review of N. transvalensis isolates referred to the Centers for Disease Control (Atlanta) during the period January 1981 through January 1990, we identified 15 patient isolates. Four N. transvalensis isolates originated from one Australian reference laboratory; one patient's isolate that was identified by the Australian laboratory but that was not received at the Centers for Disease Control was also included in our study. A review of the cases of these 16 patients found that N. transvalensis caused infection in 10 patients and colonization in two patients. Six (75%) of eight patients with primary pulmonary or disseminated N. transvalensis infections had an underlying immunologic disorder or were receiving immunosuppressive therapy; three patients with disseminated infection died. All nine infected patients for whom specific antimicrobial therapy was prescribed received trimethoprim-sulfamethoxazole. Results of in vitro antimicrobial susceptibility tests of 11 N. transvalensis isolates revealed increased antimicrobial resistance to amikacin and other drugs when compared with that of other Nocardia species. Severely immunocompromised patients are predisposed to N. transvalensis pneumonia or disseminated infection, and the lung may be the portal of entry.

Adolescent↗
PubMed1999

Left leg paralysis in a renal transplant.

The postoperative course of renal transplant patients is often complicated by opportunistic infection. Up to 4% of posttransplant infections are caused by Nocardia species. We present an unusual case of a nocardial spinal cord abscess that caused left leg paralysis.

Abscess↗
PubMed1978

Changes in host resistance caused by Nocardia brasiliensis in mice: cross-protection against Listeria monocytogenes.

Listeria monocytogenes was used to study the rate of development, magnitude, and persistence of the antimicrobial resistance engendered by Nocardia brasiliensis infection in mice. The growth of Listeria in the liver and spleen was more effectively restricted in Nocardia-infected mice than in noninfected animals. The development of delayed-type hypersensitivity to the Nocardia antigen was closely correlated to the increased resistance to Listeria, suggesting that both properties are the consequence of a single immunological event. The antibacterial resistance was also demonstrated in vitro. The results of the foregoing studies indicate that the microbicidal ability of macrophages, very likely activated by cell-mediated immunity, in enhanced in mice infected with Nocardia.

Animals↗
PubMed2002

The first isolation of Nocardia nova from an HIV-1 infected individual in Japan.

Nocardia species are opportunistic pathogens of immunocompromised patients. We report a case of Nocardia nova infection complicating Pneumocystis carinii pneumonia (PCP) in an HIV-1 infected individual. A 27-year-old man with hemophilia A was admitted on October 17, 2000, with fever and dyspnea. CD4 cell counts were 5/microl on admission. Prophylaxis against PCP was administered by inhalation of pentamidine isethionate because he was allergic to sulfamethoxazole-trimethoprim (SMZ-TMP). He was diagnosed with PCP from chest X-ray and bronchoalveolar lavage. The sputum obtained for culture on admission was positive for Gram-positive branching rods; the organism was later identified as Nocardia nova. He died from respiratory failure on November 7, 2000. Although PCP might be a principal factor in respiratory failure, this case shows the need to consider pulmonary nocardiosis as a cause of respiratory illness in patients with advanced HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Uncommon causes of peritonitis in patients undergoing peritoneal dialysis.

In five patients, peritonitis caused by uncommon agents was acquired during continuous ambulatory peritoneal dialysis. Three patients had yeast (two Candida albicans, one C parapsilosis), one Aspergillus fumigatus, and one Nocardia asteroides infections. A review of the literature indicates that yeasts are the most common cause of peritoneal dialysis-associated fungal peritonitis; only one other possible case of Aspergillus sp and no Nocardia infections have been proved, to our knowledge. Observations are recorded in reference to diagnosis and suggested methods of treatment.

Adult↗