Long-term treatment of persistent disseminated Nocardia cyriacigeorgica infection

Özgenç, Onur; Avcı, Meltem; Arı, Alpay; Çelebi, İsmail Yunus; Coskuner, Seher Ayten

doi:10.1016/j.bjid.2014.03.007

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…Persistent and disseminated human infection with Nocardia cyriacigeorgica in an otherwise immunocompetent individual was reported recently in the literature which was treated employing a strategic combination therapy that lasted for more than a year. It has been noted that a delay in diagnosis among immunosuppressed patients infected with Nocardia may be responsible for treatment failure and poor prognosis [ 25 ]. Another report which reviewed the history of human nocardiosis has revealed that clinicians should suspect infection with Nocardia and notify the same to the laboratory so that the necessary steps are taken by laboratory specialists to isolate, identify, and sensitivity pattern of the Nocardia spp [ 26 ].…”

Section: Reviewmentioning

confidence: 99%

Human Nocardia Infections: A Review of Pulmonary Nocardiosis

Kandi¹

2015

Cureus

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Human nocardiosis may present as an acute or a chronic infection. Although a saprophyte Nocardia spp are responsible for superficial skin infections, pulmonary infections, and disseminated nocardiosis usually involving patients who are immunosuppressed and debilitated. Infections in immunocompetent individuals are usually chronic and present non-specific symptoms. Invasive and disseminated nocardiosis is common among patients with weakened cellular immune systems. Clinical diagnosis of pulmonary nocardiosis is difficult owing to the similarity of its presentation with other respiratory pathogens that include Actinomycetes members and Mycobacterium tuberculosis. Laboratory diagnosis of human nocardiosis is plagued by the fact that a culture of Nocardia spp requires prolonged incubation periods for isolation which most laboratories fail to follow. The lack of clinical, laboratory, and epidemiological data on the incidence of nocardiosis in humans undermines its significance as a potential pathogen. This review attempts to reexamine the pathogenic potential of Nocardia in human infections

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Section: Reviewmentioning

confidence: 99%

Human Nocardia Infections: A Review of Pulmonary Nocardiosis

Kandi¹

2015

Cureus

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“… 45 , 46 Tetracyclines were used in 9 cases (always in association except for 1 patient) with favorable outcome in 7 cases. 9 , 10 , 27 , 31 , 33 , 47 Macrolides were prescribed in association in 4 cases with favorable outcome in 3 cases. 13 , 32 , 34 …”

Section: Treatment and Outcomementioning

confidence: 99%

Nocardia Arthritis

et al. 2015

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Nocardia are Gram-positive filamentous bacteria responsible for infections ranging from opportunistic life-threatening disseminated diseases to chronic skin and soft-tissue infections.Even if virtually all organs can be infected, articular involvement is rare. Therefore, we report 3 recent cases and performed a literature review of cases of Nocardia arthritis in order to describe clinical features, therapeutic challenges, and outcome of these patients.Among 34 patients (31 in the literature plus our 3 cases), 21 (62%) were due to hematogenous dissemination, 9 (26%) were due to direct bacterial inoculation through the skin, and in 4 cases, the mechanism of infection was unknown. Four out of these 34 cases occurred on prosthetic joints.Whereas hematogenous infections mostly occurred in immunocompromised hosts (17 of 21, 81%), direct inoculation was mostly seen in immunocompetent patients.Eighty-two percent of patients (28 out of 34) received trimethoprim-sulfamethoxazole-containing regimens and median antibiotic treatment duration was 24 weeks (range, 12–120) for hematogenous infections and 12 weeks (range, 6–24) for direct inoculations. Outcome was favorable in 27 cases despite unsystematic surgical management (17 cases) without sequelae in 70% of the cases.Nocardia arthritis is rare but its management is complex and should rely on a combined approach with rheumatologist, infectious diseases expert, and surgeon.

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“…In PubMed/MEDLINE search of nocardial infections in patients with Crohn's disease, although infrequent, there are few reported cases [17,18], and this is the only described case of ACS in relation to nocardial infection. In the present case the bacterium is isolated from the cutaneous infection with suspicion of the authors, who are clinical microbiologists with previous experience with Nocardia bacteria [19,20].…”

Section: Discussionmentioning

confidence: 91%