Mycetoma by Nocardia asteroides: a 9 year folow-up

Saraça, Giani; Towersey, Loan; Hay, Roderick J.; Londero, A. T.; Martins, Eunice de Castro Soares; Amora, Alberto Torres; Reis, Kátia Maria Pereira Nunes; Mendonça, Ana Maria; Estrella, Rogério Ribeiro

doi:10.1590/s0036-46651993000200013

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…brasiliensis , predominated and in the eumycetoma group, Scedosporium apiospermum . From 1980 to 2014, the main bacterial agents identified in Brazil were Nocardia brasiliensis [15,26,27–32], Nocardia asteroides [15,33], Nocardia caviae [34], Actinomadura madurae [13,35,36], Actinomadura pelletieri [14], and Streptomyces somaliensis [15]. For eumycetoma were Madurella mycetomatis [15,25,37,38], Madurella grisea [39–45], Acremonium falciforme [46], Acremonium kiliense [47], Scedosporium apiospermum [12,18,48,49,50], Fusarium solani [51], Exophiala jeanselmei [44,52,53] and Aspergillus sp.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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Mycetoma is caused by the subcutaneous inoculation of filamentous fungi or aerobic filamentous bacteria that form grains in the tissue. The purpose of this study is to describe the epidemiologic, clinic, laboratory, and therapeutic characteristics of patients with mycetoma at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, between 1991 and 2014. Twenty-one cases of mycetoma were included in the study. There was a predominance of male patients (1.3:1) and the average patient age was 46 years. The majority of the cases were from the Southeast region of Brazil and the feet were the most affected anatomical region (80.95%). Eumycetoma prevailed over actinomycetoma (61.9% and 38.1% respectively). Eumycetoma patients had positive cultures in 8 of 13 cases, with isolation of Scedosporium apiospermum species complex (n = 3), Madurella mycetomatis (n = 2) and Acremonium spp. (n = 1). Two cases presented sterile mycelium and five were negative. Six of 8 actinomycetoma cases had cultures that were identified as Nocardia spp. (n = 3), Nocardia brasiliensis (n = 2), and Nocardia asteroides (n = 1). Imaging tests were performed on all but one patients, and bone destruction was identified in 9 cases (42.68%). All eumycetoma cases were treated with itraconazole monotherapy or combined with fluconazole, terbinafine, or amphotericin B. Actinomycetoma cases were treated with sulfamethoxazole plus trimethoprim or combined with cycles of amikacin sulphate. Surgical procedures were performed in 9 (69.2%) eumycetoma and in 3 (37.5%) actinomycetoma cases, with one amputation case in each group. Clinical cure occurred in 11 cases (7 for eumycetoma and 4 for actinomycetoma), and recurrence was documented in 4 of 21 cases. No deaths were recorded during the study. Despite of the scarcity of mycetoma in our institution the cases presented reflect the wide clinical spectrum and difficulties to take care of this neglected disease.

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Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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“…Mycetomas cases caused by Nocardia sp. have been described in São Paulo and other cities [41], [66], [67], [68], [69], [70], [71], [72], [73], [74], [75].…”

Section: Discussionmentioning

confidence: 99%

Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

et al. 2013

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Background Nocardia sp. causes a variety of clinical presentations. The incidence of nocardiosis varies geographically according to several factors, such as the prevalence of HIV infections, transplants, neoplastic and rheumatic diseases, as well as climate, socio-economic conditions and laboratory procedures for Nocardia detection and identification. In Brazil the paucity of clinical reports of Nocardia infections suggests that this genus may be underestimated as a cause of human diseases and/or either neglected or misidentified in laboratory specimens. Accurate identification of Nocardia species has become increasingly important for clinical and epidemiological investigations. In this study, seven clinical Nocardia isolates were identified by multilocus sequence analysis (MLSA) and their antimicrobial susceptibility was also determined. Most Nocardia isolates were associated to pulmonary disease.Methodology/Principal FindingsThe majority of Brazilian human isolates in cases reported in literature were identified as Nocardia sp. Molecular characterization was used for species identification of Nocardia nova, Nocardia cyriacigeorgica, Nocardia asiatica and Nocardia exalbida/gamkensis. Data indicated that molecular analysis provided a different Nocardia speciation than the initial biochemical identification for most Brazilian isolates. All Nocardia isolates showed susceptibility to trimethoprim-sulfamethoxazole, the antimicrobial of choice in the treatment nocardiosis. N. nova isolated from different clinical specimens from one patient showed identical antimicrobial susceptibility patterns and two distinct clones.Conclusions/SignificanceAlthough Brazil is the world's fifth-largest country in terms of land mass and population, pulmonary, extrapulmonary and systemic forms of nocardiosis were reported in only 6 of the 26 Brazilian states from 1970 to 2013. A least 33.8% of these 46 cases of nocardiosis proved fatal. Interestingly, coinfection by two clones may occur in patients presenting nocardiosis. Nocardia infection may be more common throughout the Brazilian territory and in other developing tropical countries than is currently recognized and MLSA should be used more extensively as an effective method for Nocardia identification.

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“…Mycetoma and pulmonary infections appears to be predominant clinical manifestations of nocardiosis in this country, followed by neurologic signs 10,15,35 . Severe mycetoma produced by N. asteroides was reported in a 9-year-old child that in virtue of severity and evolution of the inflammatory process was submitted to amputation member for resolution of infectious process 43 . Clinical and epidemiological aspects of 41 cases of mycetoma in the city of São Paulo revealed that 68% were caused by actinomycetes, and from these, N. brasiliensis was responsible by 13 cases 13 .…”

Section: Discussionmentioning

confidence: 99%

Nocardiosis: an overview and additional report of 28 cases in cattle and dogs

Ribeiro

Salerno

Mattos‐Guaraldi

et al. 2008

Rev. Inst. Med. trop. S. Paulo

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SUMMARYPhenotypic characteristics, antimicrobial susceptibility profile, and clinical-epidemiological features of 28 Nocardia strains isolated from 19 cases of bovine mastitis, eight cutaneous-subcutaneous lesions and one case of pneumonia in dogs were evaluated. Microbiological, biochemical, cytological and scanning electron microscopy methods were used in diagnosis. Nocardia asteroides type IV, Nocardia otitidiscaviarum, Nocardia nova (type III) and Nocardia farcinica (type V) were isolated from bovine milk, bronchial lavage and/or cutaneous-subcutaneous abscesses in dogs. Nocardial bovine mastitis was diagnosed predominantly in clinical cases, in dairy herds with poor environmental hygienic conditions between milking and inappropriate intramammary therapy. Canine nocardiosis was observed commonly in animals co-infected with distemper virus. Sulphamethoxazole-trimethoprim (92.8%), amikacin (92.8%) and ceftiofur (92.8%) were the most effective drugs in 28 isolates. Multiple drug resistance to three or more and five or more antimicrobials was observed in ten (35.7%) and three (10.7%) strains, respectively, predominantly with use of cloxaxillin, cefoperazone and ampicillin. The species (type) classification, clinical-epidemiological characteristics, diagnosis, multiple drug resistance and public health considerations in Nocardia strains isolated from cattle and dogs in Brazil are discussed, with special reference to report of bovine mastitis by N. otitidiscaviarum by first time in Brazil and the similarity between Nocardia species isolated from human and animal origin.

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Mycetoma by Nocardia asteroides: a 9 year folow-up

Cited by 6 publications

References 11 publications

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

Nocardiosis: an overview and additional report of 28 cases in cattle and dogs

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