Nocardiosis in the south of France over a 10-years period, 2004–2014

Haussaire, Delphine; Fournier, Pierre‐Edouard; Djiguiba, Karamoko; Moal, Valérie; Legris, Tristan; Purgus, Raj; Bismuth, J.; Elharrar, Xavier; Reynaud‐Gaubert, Martine; Vacher-Coponat, Henri

doi:10.1016/j.ijid.2017.01.005

Cited by 58 publications

(65 citation statements)

References 35 publications

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“…Most cases (60 to >80%) of nocardiosis occur in patients with severely impaired cellular immunity. 4,5,19,77 However, infections (sometimes fulminant and lethal) may occur in previously healthy hosts, 5,9,10,12,23,78 particularly in subtropical or tropical regions. 5,16 Nocardiosis is more common in males.…”

Section: Risk Factorsmentioning

confidence: 99%

“…Infections caused by bacteria in the genus Nocardia (termed nocardiosis) may cause pneumonia and other infections, principally in immunosuppressed (IS) patients with severe impairments in cellular immunity. [1][2][3][4][5][6][7][8] However, nocardiosis may occasionally affect immunocompetent (IC) patients, 9,10 especially those with underlying pulmonary disease, 11,12 bronchiectasis, 10,13,14 diabetes mellitus, [15][16][17] or alcohol abuse. 16,18 Pulmonary nocardiosis may mimic communityacquired pneumonia, and this may be more common among individuals with agricultural or outdoor occupations in developing countries.…”

mentioning

confidence: 99%

“…16,18 Pulmonary nocardiosis may mimic communityacquired pneumonia, and this may be more common among individuals with agricultural or outdoor occupations in developing countries. 10,12,16 Nocardiosis primarily involves the lungs, 5,[19][20][21] but skin and soft tissue infections (SSTIs), [21][22][23][24][25][26][27][28][29] central nervous system (CNS) infection (brain abscesses, meningitis), 7,[30][31][32][33][34] and dissemination 4,11,12,21,35 may occur. Given the rarity of the disease, the diagnosis and initiation of appropriate antimicrobial therapy are often delayed.…”

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confidence: 99%

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Nocardia spp.: A Rare Cause of Pneumonia Globally

Lynch

Reid

Clark

2020

Semin Respir Crit Care Med

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AbstractMembers of the Nocardia genus are ubiquitous in the environment. These aerobic, gram-positive organisms can lead to life-threatening infection, typically in immunocompromised hosts such as solid organ transplant recipients or those receiving immunosuppressive medications for other reasons. This current review discusses the microbiology of nocardiosis, risk factors for infection, clinical manifestations, methods for diagnosis, and treatment. Nocardiosis primarily affects the lung but may also cause skin and soft tissue infection, cerebral abscess, bloodstream infection, or infection involving other organs. Although rare as a cause of community-acquired pneumonia, Nocardia can have severe morbidity and mortality, particularly in patients with comorbidities or compromised immunity. Early diagnosis and timely initiation of therapy are critical to optimizing patient outcomes. Species identification is important in determining treatment, as is in vitro susceptibility testing. Sulfonamide therapy is usually indicated, although a variety of other antimicrobials may be useful, depending on the species and susceptibility testing. Prolonged therapy is usually indicated, for 6 to 12 months, and in some cases surgical debridement may be required to resolve infection.

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Section: Risk Factorsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Nocardia spp.: A Rare Cause of Pneumonia Globally

Lynch

Reid

Clark

2020

Semin Respir Crit Care Med

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“…Nocardia species belongs to actinomycetes, which can be found in the environment, especially water, soil and decaying vegetation [1,2]. These pathogens are usually the opportunistic, but may cause infections in immunocompromised patients [3], or rarely in immunocompetent individuals [4].…”

Section: Introductionmentioning

confidence: 99%

Nocardia farcinica meningitis in a patient with high-grade astrocytoma

Nasri

Fakhim

Barać³

et al. 2019

J Infect Dev Ctries

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We describe a case of 91-year-old male with astrocytoma who developed meningitis caused by Nocardia farcinica. He had a past medical history of anaplastic astrocytoma grade III. Endocranial computed tomography (CT) scan revealed mass lesion in the left occipital region associated with perilesional edema, without evidence of midline shift issue. The analyses of cerebrospinal fluid (CSF) revealed neutrophilic pleocytosis, hyperproteinorrachia and hypoglycorrhachia. Combined antimicrobial therapy was initiated (vancomycin, meropenem, acyclovir). CSF culture revealed Nocardia farcinica. Susceptibility testing revealed intermediate sensitivity to meropenem and antibiotic treatment was switched to trimethoprim-sulfamethoxazole and imipenem. After 7 days of treatment the patient developed progressive dyspnea. The chest CT scan revealed bilateral pleural effusion and alveolar infiltrate mostly in the right lobe. Ceftriaxone was added to the therapy, but the outcome was lethal. Nocardia spp. should be considered as differential diagnosis in the patients with brain tumor or meningitis in the setting of immune suppression and corticosteroid use. CSF cultures should be incubated longer with aim to allow fastidious organisms to grow, such as Nocardia spp.

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“…Furthermore, cases of multi-drug resistance nocardiosis [9,10] and the epidemiology and drug susceptibility of less common Nocardia species have recently been described [11,12]. In HIV-positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3% [13], and it is not considered an AIDSdefining disease.…”

Section: Introductionmentioning

confidence: 99%

Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report

Rita¹

2018

IJIDT

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The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.

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Nocardiosis in the south of France over a 10-years period, 2004–2014

Abstract: The clinical presentation and outcome of nocardiosis depend on the patient's initial immune status and underlying pulmonary condition. Severe forms were all iatrogenic, occurring after treatments altering the immune system.

Cited by 58 publications

References 35 publications

Nocardia spp.: A Rare Cause of Pneumonia Globally

Nocardia spp.: A Rare Cause of Pneumonia Globally

Nocardia farcinica meningitis in a patient with high-grade astrocytoma

Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report

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