Nocardia nova causing empyema necessitatis afterlung re-transplantation: a case report

Abstract

We report herein a case of thoracic infection due to Nocardia nova following lung re-transplantation performed for emphysema related to alpha-1-antitrypsin defi ciency. The infection extended from the lung into the pleural space, thoracic wall, and mediastinum, presenting as pericarditis and empyema necessitatis. Nocardia nova was identifi ed by 16S ribosomal deoxyribonucleic acid (rDNA) sequencing and phylogenetic analysis. According to a literature search of PubMed, LILACS and MEDLINE databases, we describe herein the fi rst case of empyema necessitatis caused by N. nova species in a transplanted patient.

Empyema necessitans with osteomyelitis of fifth rib due to Nocardia farcinica: a case report

“…Our patient was immunocompetent despite that he developed empyema necessitans related to Nocardia. On literature search, only 3 cases of empyema necessitans caused by Nocardia Spp have been reported [ 4 – 6 ]. The first report of Nocardiosis causing EN was published by Cadena et al in 2008 [ 4 ].…”

“…Incidence of empyema necessitans had drastically reduced as compared to the pre antibiotics era with Mycobacterium tuberculosis still remaining the commonest cause (nearly 70%) followed by Methicillin resistant Staphylococcus aureus (MRSA) [ 2 , 3 ]. Bacterial causes of EN are rare particularly Nocardia, with only 3 cases reported in the literature so far [ 4 – 6 ]. Moreover, Nocardia osteomyelitis involving sites other than spine is also rare with only a handful of cases reported to date and only one with rib osteomyelitis [ 7 – 10 ].…”

Culture‐negative group B streptococcal pericarditis: A case report and literature review of the diagnostic use of polymerase chain reaction

“…We reviewed all English language articles and excluded case reports where the diagnosis had already been made with conventional tissue or blood culture before PCR. A total of 19 articles (22 cases) dating from 1991 to 2017 were deemed appropriate for further evaluation and included in the summary (Tables and ).…”

“…Atypical organisms are also technically difficult to isolate with conventional microbiology testing which can further delay appropriate treatment. On review of the published cases seen in Tables and , both immunocompromised and immunocompetent patients developed atypical bacterial infections . Current laboratory facilities have difficulty identifying Streptococcus pneumonia , one of the most common organisms in bacterial pericarditis.…”

“…Published year Age (yo),blood culture before PCR. A total of 19 articles (22 cases) dating from 1991 to 2017 were deemed appropriate for further evaluation and included in the summary[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]…”