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Sidharth Puri, Amir Hadayer, Andrea Breaux, Charles C Barr
Purpose: To report a case of disseminated Nocardiosis with retinal and intracranial lesions. Observations: A 49-year-old woman immunosuppressed because of treatment given for bullous pemphigoid presented with altered mental status and multiple intracranial lesions on imaging. The patient was found to have multiple retinal lesions in both eyes, including a subretinal abscess in the right eye. The patient underwent brain biopsy, confirming Nocardia farcinica histopathologically and in culture...
June 2018: American Journal of Ophthalmology Case Reports
Preet Mukesh Shah, Indraneel Raut, Susheel Kumar Bindroo, Vijay Waman Dhakre
No abstract text is available yet for this article.
May 18, 2018: BMJ Case Reports
D Arrache, H Zait, V Rodriguez-Nava, E Bergeron, T Durand, M Yahiaoui, F Grenouillet, A Amrane, F Chaouche, A Baiod, K Madani, B Hamrioui
Nocardial brain abscess is often occurring in immunocompromised patients. It is uncommon in immunocompetent individuals. Here, the authors describe a case of cerebral and pulmonary nocardiosis mimicking a metastatic tumor in an apparently health 40-year-old Algerian male. The patient presented multiple brain abscess revealed by inaugural epileptic seizure. He was afebrile and presented with left hemiparesis. Staging imaging showed a nodular lung lesion in the apical segment of the right lower lobe. The patient underwent double craniotomy for resection of the lesion...
May 14, 2018: Journal de Mycologie Médicale
Garrett Steinmetz, Kenton Panas, William Puffinbarger
Nocardia species are aerobic gram-positive filamentous organisms that may cause cutaneous or pulmonary disease in humans. Primary cutaneous nocardiosis may manifest as an acute superficial pyogenic infection that can mimic more common organisms such as Staphylococcus or Streptococcus. Acute pyogenic Nocardia infection of the pediatric hand is a rare manifestation of this condition. We present a 17-month-old boy who presented with an acute abscess formation on his left fourth and fifth digits that was found to be secondary to Nocardia brasiliensis...
May 11, 2018: Journal of Hand Surgery
Andrés Tirado-Sánchez, Alexandro Bonifaz
Nodular lymphangitis, also known as sporotrichoid lymphocutaneous infections, is characterized by suppurative inflammatory nodules along the lymphatic vessels. This manifestation is classic of sporotrichosis, however, other infections such as nocardiosis, atypical mycobacteriosis, leishmaniasis, among others, can also express this clinical pattern. Sporotrichosis, which often occurs in gardeners, remains the most recognized cause of nodular lymphangitis. The histopathological studies, as well as the culture are diagnostic standards of lesions that do not respond to empirical treatment...
May 9, 2018: Journal of Fungi (Basel, Switzerland)
Yi You, Wenchief Chen, Baiyu Zhong, Ziqiang Song, Xichuan Yang
BACKGROUND: Disseminated nocardiosis is a rare disease mostly occurring in immunocompromised patients. METHODS: We report a case of disseminated nocardiosis in a diabetic patient with both pulmonary and cutaneous involvement. Nocardia elegans was isolated and identified using the 16s ribosomal RNA gene sequence data. RESULTS: Clinical improvement was observed within 3 months after initiation of antimicrobial treatment with oral doxycycline, trimethoprim-sulfamethoxazole and intravenous penicillin, but the patient died 5 months later after arbitrary discontinuation of the treatment...
May 8, 2018: Infection
Rupak Datta, Erik Kramer, Harald Reinhart, Sheldon Campbell, Ellice Wong, Shaili Gupta
No abstract text is available yet for this article.
May 2, 2018: American Journal of Medicine
H Mehta, J Weng, A Prater, R A L Elworth, X Han, Y Shamoo
Nocardia spp. are Gram positive opportunistic pathogens that affect largely immunocompromised patients leading to serious pulmonary or systemic infections. Combination therapy using the folate biosynthesis pathway inhibitors, trimethoprim and sulfamethoxazole (TMP-SMX) is commonly used as an antimicrobial therapy. Not surprisingly, as antibiotic therapies for nocardiosis can extend for many months, resistance to TMP-SMX has emerged. Using experimental evolution, we surveyed the genetic basis of adaptation to TMP-SMX across 8 strains of Nocardia nova and 2 strains of Nocardia cyriacigeorgica Employing both continuous experimental evolution to provide longitudinal information on the order of changes and characterization of resistant end-point isolates, we observe changes that are consistent with modification of two enzymes of the folate biosynthesis pathway: dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS/FolP) with the mutations often clustered near the active site of the enzymes...
April 23, 2018: Antimicrobial Agents and Chemotherapy
Ridhi Sood, Ruchita Tyagi, Pavneet Kaur Selhi, Gursheen Kaur, Harpreet Kaur, Akashdeep Singh
BACKGROUND: Nocardia, a gram-positive aerobic bacillus of the Actinomycetales family, is a significant opportunistic pathogen in immunocompromised individuals. Clinical and radiological features of pulmonary nocardiosis are nonspecific and can be misdiagnosed as tuberculosis, pneumocystis, staphylococcal or fungal infections, or as malignancy. Aspiration cytology with special stains is a quick and effective approach for accurate diagnosis. MATERIALS AND METHODS: We present 7 cases of pulmonary nocardiosis, admitted to the pathology department in a tertiary-care hospital in Punjab...
April 18, 2018: Acta Cytologica
Aneela Majeed, Norman Beatty, Ahmad Iftikhar, Adeela Mushtaq, Julia Fisher, Pryce Gaynor, Jeeyong C Kim, Jose Luis Marquez, Francisco E Mora, Anca Georgescu, Tirdad Zangeneh
BACKGROUND: Nocardiosis is a life-threatening opportunistic infection. Solid organ transplant (SOT) recipients are at higher risk (incidence 0.04% to 3.5%) of developing nocardiosis. Rate of nocardiosis in the Southwestern US may be high due to environmental factors. METHODS: We performed a retrospective review study on 54 SOT patients diagnosed with Nocardia between 1997 and 2016 at our center. To explore the association of various risk factors with both the development of disseminated disease and mortality, a series of Fisher's exact tests was used...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
George Mwandia, Hari Polenakovik
We describe a rare infection with Nocardia spp. ( N. pseudobrasiliensis species identification based on high-performance liquid chromatography analysis) in a 68-year-old renal transplant recipient. He presented with pneumonia complicated by hypoxic respiratory failure. He was allergic to sulphonamides. He was initially successfully treated with linezolid. However, he suffered severe sensory neuropathy after 4 months of therapy, necessitating linezolid cessation and completion of treatment with azithromycin...
2018: Case Reports in Infectious Diseases
Ping-Yueh Ho, Yao-Chung Chen, Shun Maekawa, Hsiang-Hui Hu, An-Wei Tsai, Yung-Fu Chang, Pei-Chi Wang, Shih-Chu Chen
A reverse vaccinology-based survey of potent antigens associated with fish nocardiosis was conducted using the largemouth bass, Micropterus salmoides, with an aim to develop subunit vaccines. The antigens selected from the virulent strain Nocardia seriolae 961113 include the gene products of NGL2579 (GAPDH), NGL5701 (MMP), NGL4377 (OCTase), NGL4486 (ABC transporter), NGL3372 (LLE), NGL3388 (GHf10), NGL6627 (Antigen-85), NGL6696 (Esterase), and NGL6936 (CBP). These antigens were heterologously expressed in E...
April 14, 2018: Fish & Shellfish Immunology
Megumi Matsumoto, Kyosuke Araki, Sayaka Nishimura, Hideki Kuriyama, Teruyuki Nakanishi, Kazuhiro Shiozaki, Yutaka Takeuchi, Atsushi Yamamoto
Mycobacteriosis and nocardiosis in cultured fish caused by infections with acid-fast bacteria, are responsible for large economic losses globally. In this study, we suggest a novel adjuvant using glycolipids that activates host immune systems. The immune response to glycolipids stimulation was investigated using ginbuna crucian carp. Ginbuna vaccinated with FKC (formalin-killed cells) + glycolipids isolated from Mycobacterium sp., upregulated inflammatory- and Th1-related cytokines, and a DTH (delayed-type hypersensitivity) response was confirmed only in ginbuna vaccinated with FKC + glycolipids...
April 14, 2018: Developmental and Comparative Immunology
Junko Tamakoshi, Risa Kimura, Kosuke Takahashi, Hiroshi Saito
Pulmonary reinfection by Nocardia has been rarely reported. We describe a case of pulmonary reinfection by Nocardia in an immunocompetent patient. An 82-year-old immunocompetent woman with bronchiectasis presented with exacerbation of cough. She had a history of pulmonary nocardiosis three years earlier. At that time, Nocardia species were cultured from the sputum and identified as N. cyriacigeorgica with 16S ribosomal RNA gene sequencing. In the present episode, cultures of sputum and bronchial washing specimens grew N...
March 30, 2018: Internal Medicine
Claire Rouzaud, Véronica Rodriguez-Nava, Emilie Catherinot, Frédéric Méchaï, Emmanuelle Bergeron, Eric Farfour, Anne Scemla, Sylvain Poirée, Christophe Delavaud, Daniel Mathieu, Stéphane Durupt, Fabrice Larosa, Jean-Philippe Lengelé, Jean-Louis Christophe, Felipe Suarez, Olivier Lortholary, David Lebeaux
Background: Diagnosis of nocardiosis, a severe opportunistic infection, is challenging. We assessed the specificity and sensitivity of a 16S Nocardia PCR-based assay performed on clinical samples. Methods: In this multicenter study (January 2014 - April 2015), patients admitted to three hospitals who had an underlying condition favoring nocardiosis, clinical/radiological signs compatible with nocardiosis and a Nocardia PCR performed on a clinical sample were included. Patients were classified as negative control (NC: negative culture for Nocardia and proven alternative diagnosis or improvement at 6 months without anti- Nocardia treatment); positive control (PC: positive culture for Nocardia ); or probable nocardiosis (positive Nocardia PCR, negative culture for Nocardia, no alternative diagnosis)...
March 21, 2018: Journal of Clinical Microbiology
Alfonso Molina, Drew J Winston, Darren Pan, Gary J Schiller
Nocardial infections have been rare after allogeneic hematopoietic stem cell transplantation (HSCT). We report 10 recent cases of late-onset nocardiosis (median time of onset of 508 days after transplantation) primarily in patients on high doses of corticosteroids for graft-versus-host disease (GVHD). All 10 patients had pulmonary infection caused by Nocardia species susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). At time of diagnosis, 8 of 10 patients were not receiving TMP-SMX for prophylaxis of Pneumocystis jiroveci pneumonia (PJP) (7 on atovaquone, 1 on intravenous pentamidine)...
March 16, 2018: Biology of Blood and Marrow Transplantation
Hiroki Tashiro, Koichiro Takahashi, Koji Kusaba, Masahide Tanaka, Kazutoshi Komiya, Tomomi Nakamura, Yosuke Aoki, Shinya Kimura, Naoko Sueoka-Aragane
BACKGROUND: Despite treatment, pulmonary nocardiosis, which is a rare opportunistic disease caused by Nocardia species, has poor clinical outcomes including recurrence and death. Currently, the treatment regimen and duration for pulmonary nocardiosis are not fully understood. The present study aimed to clarify the factors related to the clinical outcome of pulmonary nocardiosis. METHODS: The medical records of 24 patients with pulmonary nocardiosis were retrospectively reviewed...
March 2018: Respiratory Investigation
Ashok Kumar Singh, Aditya Shukla, R Bajwa, Roshni Agrawal, Neha Srivastwa
Pulmonary nocardiosis is a rare disease, which mainly affects immunocompromised hosts such as uncontrolled diabetics; HIV patients; and patients on immunosuppressive therapies such as anticancer drugs, systemic steroids, and transplant recipients. The diagnosis is often missed and delayed, resulting in inappropriate treatment and thus higher mortality. We are reporting a case of pulmonary nocardiosis with acute presentation in an immune-competent host, who presented with community-acquired pneumonia to the Intensive Care Unit...
February 2018: Indian Journal of Critical Care Medicine
D Raszka, S Popelka, J Heřt, D Jahoda, I Landor, P Vavřík
Nocardiosis is a rare infection caused by the aerobic actinomycete of the Nocardia genus. In most cases, nocardiosis manifests as a lung infection or a bone lesion. Due to the nonspecific and mild clinical manifestations of nocardiosis, the establishment of definite diagnosis can be difficult. When antibiotic therapy is incorrectly targeted, only the symptoms of the disease are suppressed. The mainstay in the treatment of Nocardia osteomyelitis has so far been the combined surgical debridement with long-term, initially intravenous, antibiotic administration...
March 5, 2018: Folia Microbiologica
Masoud Keikha
Nocardia spp . are gram-positive, partially acid-fast bacteria which are lives in environmental sources and cause of various infection that called nocardiosis in animals and humans. Identification of this group of bacteria was important due to accurate diagnosis, patient management and prevention of antibiotic resistant among of bacteria. Molecular methods including PCR-RFLP and sequencing using housekeeping genes such as 16S rRNA, hsp65, rpoB and gyrB are recommended to accurate and reliable identification of nocardiosis...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
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