Cutaneous Nocardia asteroides infection of nontraumatic origin

Lopes, Jorge O.; Bassanesi, Maria Cristina; Alves, Sydney Hartz; Salla, Adenilde; Benevenga, J. P.; Castro, Milton S.

doi:10.1590/s0036-46651994000500003

Cited by 7 publications

(5 citation statements)

References 24 publications

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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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“…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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“…Minor disease such as this may resolve without specific drug therapy or may go undiagnosed. Secondary cutaneous involvement as a result of disseminated disease also occurs, and is relatively common (102,129).…”

Section: Primary Cutaneous Diseasementioning

confidence: 99%

Clinical and Laboratory Features of theNocardiaspp. Based on Current Molecular Taxonomy

et al. 2006

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SUMMARY The recent explosion of newly described species of Nocardia results from the impact in the last decade of newer molecular technology, including PCR restriction enzyme analysis and 16S rRNA sequencing. These molecular techniques have revolutionized the identification of the nocardiae by providing rapid and accurate identification of recognized nocardiae and, at the same time, revealing new species and a number of yet-to-be-described species. There are currently more than 30 species of nocardiae of human clinical significance, with the majority of isolates being N. nova complex, N. abscessus, N. transvalensis complex, N. farcinica, N. asteroides type VI (N. cyriacigeorgica), and N. brasiliensis. These species cause a wide variety of diseases and have variable drug susceptibilities. Accurate identification often requires referral to a reference laboratory with molecular capabilities, as many newer species are genetically distinct from established species yet have few or no distinguishing phenotypic characteristics. Correct identification is important in deciding the clinical relevance of a species and in the clinical management and treatment of patients with nocardial disease. This review characterizes the currently known pathogenic species of Nocardia, including clinical disease, drug susceptibility, and methods of identification.

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“…Chest radiographic manifestations are variable, showing as large irregular nodules, nodules, pleural effusions ( 17 ), etc., in which pleural effusions account for one-third of all the manifestations ( 5 ). Other common Nocardia infections have also been reported as central nervous system (CNS) nocardiosis ( 18 ) and cutaneous nocardiosis ( 1 , 19 ) and may be the secondary infection of pulmonary nocardiosis through hematogenous dissemination in immunosuppression patients ( 20 ). Primary cutaneous infections tends more common in immunocompetent patient due to the open injury ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: A Severe and Multi-Site Nocardia farcinica Infection Rapidly and Precisely Identified by Metagenomic Next-Generation Sequencing

et al. 2021

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Nocardia genus is an aerobic, gram-positive, and opportunistic pathogen, which mainly affects cell-mediated immunosuppressed patients. Early diagnosis and treatment greatly improve prognosis. However, the limitation of golden standard-bacterial culture exists. Here, we report a 61-year-old male with pneumonia, sepsis and intermuscular abscesses induced by Nocardia farcinica. Venous blood culture reported negative results. Former improper diagnosis and treatment did not improve his condition. With the assistant of metagenomic next-generation sequencing, the pathogen was identified as Nocardia farcinica. He was then applied with accurate treatment and had a remarkable clinical and radiological improvement.

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Cutaneous Nocardia asteroides infection of nontraumatic origin

Cited by 7 publications

References 24 publications

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

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

Clinical and Laboratory Features of theNocardiaspp. Based on Current Molecular Taxonomy

Case Report: A Severe and Multi-Site Nocardia farcinica Infection Rapidly and Precisely Identified by Metagenomic Next-Generation Sequencing

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