We identified 5 risk factors for nocardiosis after SOT. Low-dose cotrimoxazole was not found to prevent Nocardia infection. These findings may help improve management of transplant recipients.

We present the first clinical report of a Staphylococcus pseudintermedius infection in a human. Biochemically, S. pseudintermedius can be easily misidentified as S. aureus. Therefore, the final microbiological identification requires the combination of phenotypic and genotypic tests. CASE REPORTA 60-year-old male patient was referred to our center because of ischemic cardiomyopathy and ventricle tachycardia, for which he had received an implantable cardioverter-defibrillator (ICD) in January 2004. In addition, his medical history comprised arterial hypertension, hypercholesterolemia, and a prostate carcinoma. In August 2005, he presented with complaints of migration of the ICD device. No other symptoms of note were elicited. The patient was hemodynamically stable and afebrile (body temperature of 36.7°C). Hematological investigations revealed a hemoglobin level and platelet and leukocyte counts within the normal ranges. His C-reactive protein level was slightly increased, at 1.61 mg/liter (normal, 0 to 5 mg/liter). Clinical examination revealed a perforation of the ICD pocket. Infection was suspected by the presence of pus in the eroded pocket. The infected ICD was surgically removed, and several samples (the ventricular lead, pus, and a tissue sample from the pocket) were sent for culture.Gram staining of the pus showed gram-positive cocci. The specimens were plated onto sheep blood agar (BioMérieux, Benelux S.A./N.V.) and chocolate agar (BioMérieux), both incubated at 37°C in air supplemented with 5% CO 2 , and mannitol salt lipovitellinase agar (homemade), MacConkey agar (BioMérieux), and D-Coccosel agar (BioMérieux), all incubated at 37°C in air. In addition, thioglycolate broth (BD, Belgium) was inoculated and incubated at 37°C in air.

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