Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “NOCARDIA INFECTIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,045 records · Page 58Linked to original sources
PubMed1986

Pulmonary nocardiosis in the acquired immunodeficiency syndrome. Diagnosis with bronchoalveolar lavage and treatment with non-sulphur containing drugs.

A patient with the acquired immunodeficiency syndrome (AIDS) presented with Pneumocystis carinii pneumonia and pulmonary nocardiosis. The nocardial lesions appeared small and localized on chest radiograph. On two separate occasions, nocardial organisms were absent in transbronchial lung biopsy specimens, but were identified in bronchoalveolar lavage fluid probably because the latter specimen sampled a larger area of lung. The patient was initially treated with trimethoprim-sulfamethoxazole (TMP/SMX) for both infections. When TMP/SMX was discontinued because of an adverse reaction, the nocardiosis promptly exacerbated but was then easily controlled with minocycline and amikacin followed by minocycline and cycloserine. Among patients with AIDS who have sulfamethoxazole hypersensitivity during treatment for nocardiosis, alternative drugs may be efficacious and may be particularly important in this setting because they have a lower incidence of toxicity.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Comparison of PCR and culture for detection of Nocardia asteroides in brain specimens from experimentally infected BALB/c mice.

Systemic infection of BALB/c mice with Nocardia asteroides strain GUH-2 results in widespread replication of the organism in the brain, followed by its immune-mediated clearance. The present study compared the sensitivity of polymerase chain reaction (PCR) to bacterial culture for detection of cerebral nocardial infection in this experimental system. Mice (n=4/time point) were administered N. asteroides by intravenous injection, and brain specimens were evaluated for Nocardia by PCR and culture at post-infection days 2, 7, 14 and 21. Nocardia was detected by PCR in all infected animals on post-infection days 2, 7, and 14, and in one of four mice on post-infection day 21; in contrast, the organism was detected by culture only on post-infection days 2 and 7. These findings suggest that PCR may be more sensitive than culture for the detection of low numbers of Nocardia in the brain.

Animals↗
PubMedDate not supplied

Nocardial infections in the immunocompromised host: A detailed study in a defined population.

A retrospective, clinical, epidemiologic, and risk-factor analysis was performed on 21 recipients of cardiac allografts who had experienced nocardiosis since the inception of the cardiac transplantation program at Stanford University Medical Center in 1968. The lung was the primary and only detectable site of infection in 17 (81%) of 21 patients, and there were three cases of disseminated disease. Presenting symptoms were either nonspecific (dry cough and fever) or absent (in 40%). The time of onset of infection following transplantation was variable (range, 43-982 days), and there was no period of peak incidence. Epidemiologic and risk-factor analysis failed to identify a nosocomial point-source or specific parameters that predisposed a patient to nocardial infection. Nocardiosis was not associated with the onset of primary infection with cytomegalovirus following transplantation. However, an association between pulmonary nocardiosis and subsequent development of nontuberculous mycobacteriosis was established in five of the 21 patients. All patients with nocardiosis were treated primarily with sulfisoxazole (6-12 g per day) for a mean of 13.2 months. No deaths were attributable to nocardial infection, nor could acquisition of the infection be shown to affect overall survival. The results of the study support an aggressive approach to diagnosis of infections in the immunocompromised host and suggest that a favorable therapeutic outcome may be anticipated in such individuals who sustain nocardiosis if the diagnosis is made early in the course of the infection and if appropriate antimicrobial therapy is instituted.

Adolescent↗
PubMed1991

Pulmonary nocardiosis in Chulalongkorn Hospital.

From 1982 to 1988, 20 patients with pulmonary nocardiosis were diagnosed at the Department of Medicine, Chulalongkorn Hospital University. The infection was found to be common in immuno-compromised hosts particularly in patients who were suffering from lymphoreticular malignancy, systemic lupus erythematosus, nephrotic syndrome, pulmonary alveolar proteinosis and in patients who were receiving corticosteroids. The clinical manifestations were usually nonspecific. Diagnosis of pulmonary nocardiosis in cases who presented with a short duration of fever and productive cough was often delayed because they were considered to have acute bacterial pneumonia. The findings on chest roentgenogram were nonspecific as nonhomogeneous airspace infiltrates, cavitary lesions, nodule, or miliary infiltrates. The complete blood count frequently showed leukocytosis and neutrophilia. The diagnosis of nocardiosis was suspected if the staining of specimens obtained from the lesions showed typically weakly gram-positive and modified acid-fast branching filament organism and the diagnosis was confirmed by culture. The skin and the central nervous system were the most common hematogenous disseminations. Sulfamethoxazole and trimethoprim in combination were the drugs of choice. The treatment for a minimum of 6 months was appropriate in order to prevent relapse. Poor prognostic factors in nocardiosis were acute infection, Cushing's disease; and disseminated infection involving the central nervous system.

Adolescent↗
PubMed1995

Subcutaneous Nocardia asteroides abscess in a bone marrow transplant recipient.

We describe a case of cutaneous Nocardia asteroides infection in a 13-year-old Venezuelan boy with aplastic anemia, following allogeneic BMT. He was receiving immunosuppressive therapy with corticosteroids for GVHD and trimethoprim/sulfamethoxazole (TMP/SMX) for prophylaxis against Pneumocystis carinii pneumonia (PCP). He was not neutropenic and gave no history of cutaneous inoculation or trauma. He developed an abscess on the plantar surface of his right big toe from which Nocardia asteroides was isolated. He was successfully treated with a combination of TMP/SMX and minocycline. Despite prolonged immunosuppressive therapy for GVHD, the infection responded and did not recur. TMP/SMX prophylaxis for PCP in BMT recipients with GVHD does not always prevent nocardial infection but may prevent or delay the development of dissemination.

Abscess↗
PubMed1995

Ocular lesions in AIDS: a report of first two cases in India.

Although 444 cases of AIDS have been officially registered till July 1993 from various parts of India, ocular lesions in these cases have not been reported. Till May 1994, ELISA test for HIV 1 and HIV 2 had been done in 12 cases of suspicious ocular lesions which include viral retinitis, endogenous endopthalmitis and active chorioretinitis. Two patients had seropositivity for HIV 1. Ocular lesions include subretinal yellow mass in the first case and cytomegalovirus retinitis and cotton-wool spots in the second case. These two patients also had several systemic infections which include tuberculosis in both and nocardia in one. To the best of our knowledge, these two cases are the first report of ocular lesions in AIDS from India.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Behçet's-like syndrome associated with idiopathic CD4+ T-lymphocytopenia, opportunistic infections, and a large population of TCR alpha beta+ CD4- CD8- T cells.

Herein we report a patient with Behçet's like syndrome, idiopathic CD4+ T-lymphocytopenia, opportunistic infections, and a large polyclonal population of TCR alpha beta + CD4- CD8- T cells. Microfluorimetric analysis of peripheral blood mononuclear cells revealed CD4+ T-cell counts of 10 +/- 5/mm3. The CD3+ T cells were 99% TCR alpha beta +, of which 74 +/- 5% were CD4- CD8-. No clonal populations were detected by southern analysis for T-cell receptor V beta gene rearrangements. No evidence of human immunodeficiency virus infection was present, although nocardia, candida, pneumocystis, cytomegalovirus, and herpes infections were documented. The concomitant presence of opportunistic infections and a large population of TCR alpha beta + CD4- CD8- T cells suggests a pathogenic association and an intense immune response to microbial lipid or lipoglycan antigens presented in the context of CD1 molecules. This case demonstrates the potential for idiopathic CD4+ T-lymphocytopenia to occur in Behçet's-like syndrome with lethal consequences.

Behcet Syndrome↗
PubMed1993

[Generalized nocardiosis with meningoencephalitis in a nonimmunosuppressed female patient].

Four weeks after an attack of pneumonia of unknown aetiology a 40-year-old woman was hospitalized because of a nonpurulent, predominantly basal meningoencephalitis and infratentorial abscesses. She had dysarthria, mild right-sided motor hemiparesis and central paresis affecting the 7th cranial nerve. An area of fluctuating resistance, about 3 cm in diameter, was noticed over the left thigh. Serology indicated inflammatory disease, but there was no immunodeficiency. The CSF showed lymphocytic pleocytosis with mild protein increase but no evidence of infective agent. As tubercular meningitis was suspected she was treated with rifampicin (300 mg i.v. twice daily), isoniazid (300 mg i.v. once daily), streptomycin (800 mg i.m. once daily), cefotaxime (2.0 g i.v. three times daily), fluconazole (200 mg i.v. once daily) and dexamethasone (16-8-8 mg i.v.). She suddenly died two days after admission, probably as the result of central regulatory failure. Generalized nocardiosis involving lung, subcutaneous tissue and brain was revealed at autopsy. Although nocardiosis occurs predominantly in patients under immunosuppression, this infection should be considered in the differential diagnosis of treatment-resistant pneumonia and meningoencephalitis without obvious predisposition.

Adult↗
PubMed2005

Nocardiosis following solid organ transplantation: a single-centre experience.

Nocardiosis is a localized or disseminated bacterial infection caused by aerobic Actinomyces that commonly affects immunocompromised hosts. The aim of this study was to retrospectively review clinical course and outcome of nocardiosis in solid organ recipients at our centre. Five cases of nocardiosis were identified in a series of more than 4000 consecutive solid organ transplants performed at Innsbruck university hospital during a 25-year period. Of the five patients with nocardiosis, two had undergone multivisceral, one liver, one kidney and one lung transplantation. Three patients with Nocardia asteroides infection were treated successfully and recovered from their infectious disease, however, one lost his renal graft following withdrawal of immunosuppression. The lung recipient recovered from nocardiosis but died later on from Pseudomonas pneumonia. One multivisceral recipient died from Nocardia farcinica-disseminated infection. Nocardiosis is a rare, difficult-to-diagnose-and-treat complication following solid organ transplantation. Intestinal recipients might be at increased risk to develop this infection.

Adult↗
PubMed1976

Pulmonary nocardiosis in an orangutan.

Pulmonary nocardiosis was diagnosed in an adult male orangutan (Pongo pygmaeus) being maintained in an outdoor facility. Periodically, the orangutan had had clinical signs of an upper respiratory tract infection, as evidenced by slight nasal discharge and cough. At the terminal stage, the orangutan had acute respiratory embarrassment, with epistaxis, and died before diagnosis could be made and treatment initiated. Gross necropsy findings included fibrosis of the pulmonary parenchyma as well as evidence of air sac infection, extensive pneumonia, and extensive chronic pleuritis. Microscopically, some of the lung sections had alveoli filled with polymorphonuclear cells, with other sections being diffusely fibrotic; the areas of fibrosis contained interspersed foci of polymorphonuclear cell infiltration. Many of the latter areas contained organism colonized in the form of granules that resembled those seen in actinomycosis. These organisms were gram-positive and branched, and measured close to 1 mum in diameter. Nocardia asteroides was isolated from the pulmonary tissue.

Animals↗
PubMed2006

A case of isolated Nocardia asteroides brain abscess in a kidney transplant recipient.

UNLABELLED: Because of the immunosuppressive drugs used after organ transplantation, there is an increased rate of certain infections and malignancies. Nocardia brain abscess is a rare condition, seen most commonly among immunocompromised patients. It may be confused with intracranial tumors and requires long-term combined antibiotic therapy after drainage. CASE REPORT: A patient who underwent renal transplantation because of end-stage renal disease of unknown origin was shown to have a nocardial brain abscess while she was taking immunosuppressive drugs. The patient was given combined antibiotics and the abscess drained surgically. After 2 months, antibiotic therapy was continued with one drug. Neither a complication nor clinical or radiological sequelae occurred in this patient. CONCLUSIONS: When central nervous system findings are observed in renal transplant recipients, nocardial brain abscess must be considered in the differential diagnosis. Recommended treatment duration is 6 to 12 months with frequent imaging.

Adult↗
PubMed1995

Unusually located lymphocutaneous nocardiosis caused by Nocardia brasiliensis.

We report a patient with primary lymphocutaneous Nocardia brasiliensis infection affecting the face and left arm. The mode of infection was via skin abrasions which occurred 2 weeks prior to the development of the skin lesions. Treatment with intravenous minocycline for 4 weeks resulted in a cure. We also review 12 previously reported Japanese cases of lymphocutaneous nocardiosis.

Aged↗
PubMedDate not supplied

Nocardiosis. A literature review with selected case reports in two dogs.

Two dogs with systemic nocardiosis are presented and the pathobiology, diagnosis, and treatment of nocardial infections are discussed. Both dogs had nonspecific respiratory signs and depression. The diagnosis was made by isolation of the organism only after surgical drainage was established and appropriate tissues were cultured. The response to surgical drainage and antimicrobial therapy was dramatic in both dogs, but one dog experienced a drug reaction to trimethoprim-potentiated sulfonamide. Although systemic nocardial infections traditionally have had a grave prognosis, through early diagnosis, surgical intervention, and the use of newer, safer and synergistically acting antimicrobials, the prognosis has improved. This article reviews current human and veterinary literature regarding the microbiology, pathogenesis, and treatment of nocardiosis and reports on the successful treatment of systemic nocardiosis in two dogs.

Animals↗