A post-transplant infection by Nocardia cyriacigeorgica

Gandham, Nageswari; Kannuri, Sriram; Gupta, Aryan; Mukhida, Sahjid; Das, Nikunja; Mirza, Shahzad

doi:10.1099/acmi.0.000569.v3

Cited by 2 publications

(2 citation statements)

References 20 publications

(27 reference statements)

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“…Nocardia farcinica, an aerobic, Gram-positive bacterium belonging to the genus Nocardia, is a challenging opportunistic pathogen, particularly impacting immunocompromised individuals [7]. The primary mode of acquiring pulmonary nocardiosis involves inhaling aerosolized organisms, while direct inoculation represents the second most common route, leading to cutaneous infections [8]. Individuals with compromised cell-mediated immunity face the highest risk of Nocardia infections, with additional risk factors encompassing systemic corticosteroid use, solid organ or hematopoietic stem cell transplantation, HIV infection, diabetes mellitus, and underlying malignancy treated with chemotherapy [9].…”

Section: Discussionmentioning

confidence: 99%

Disseminated Nocardia farcinica Infection in a Renal Transplant Patient: A Case Report

Mustafa Alhashimi,

Salim,

Iqbal

et al. 2024

Cureus

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Nocardia farcinica , an aerobic, Gram-positive bacterium belonging to the genus Nocardia , is a challenging opportunistic pathogen, particularly impacting immunocompromised individuals. The prevalence of human disease has witnessed a notable rise over the past two decades, correlating with an expanding population of immunocompromised individuals and advancements in the detection and identification of Nocardia spp. within clinical laboratories. This case is of a 59-year-old male with compromised immunity due to immunosuppressive medication use following a renal transplant who had an array of presentations before confirming a diagnosis of disseminated nocardiosis. The challenges faced in our case provide valuable insights into the complexities associated with diagnosing and managing Nocardia infections in immunocompromised populations, informing future clinical practice and research endeavors.

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Section: Discussionmentioning

confidence: 99%

Disseminated Nocardia farcinica Infection in a Renal Transplant Patient: A Case Report

Mustafa Alhashimi,

Salim,

Iqbal

et al. 2024

Cureus

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“…The bacteria detected by mNGS can directly provide accurate clinical drug guidance, achieve targeted treatment of infected bacteria, and optimize the treatment plan ( 27 ). Combination therapy can enhance the efficacy and should be used as the initial treatment ( 28 , 29 ). Common regimens include sulfamethoxazole combined with imipenem or amikacin, imipenem combined with cefotaxime or amikacin, and amikacin combined with cefotaxime.…”

Section: Discussionmentioning

confidence: 99%

Metagenome next-generation sequencing plays a key role in the diagnosis and selection of effective antibiotics on the treatment of Nocardia pneumonia: a case report

Fan,

Fang,

Huang

et al. 2024

Front. Med.

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Nocardia disease is an opportunistic infection, the occurrence is rare and mostly occurs in patients with immune deficiency. Even if the patient is immunocompetent, it can still be life-threatening. This case report describes a previously healthy 78-year-old male farmer with lung lesions discovered on a computerized tomography scan. Combined with the patient’s history of fever and the results of elevated laboratory markers associated with inflammation, the patient was diagnosed with a lung infection. After escalating empirical broad-spectrum antibiotics, antiviral and antifungal therapy, the patient continued to deteriorate to septic shock. In the meanwhile, the patient’s sputum was cultured repeatedly, and no obvious positive pathogenic bacteria were found. Considering the patient was elderly and that these lesions were solid with burr signs, as well as the progression after antimicrobial therapy cancer was considered in the differential diagnosis. Artificial intelligence (YITU, Hangzhou Yitu Medical Technology Limited Company) was also applied, and it also calculated that these lesions were cancerous. The patient received a puncture biopsy of the largest lung lesion. During the puncture pus was withdrawn from largest lung lesion. Culture and metagenome next-generation sequencing (mNGS) detection performed on pus indicated Nocardia otitidiscaviarum. The test report of the mNGS is also attached with a susceptibility report of commonly used clinical antibiotics to this Nocardia spp. Using this result, the patient’s disease was quickly controlled after selecting the targeted drug compound sulfamethoxazole and intravenous meropenem for treatment. In view of the high misdiagnosis rate and poor sensitivity of culture for Nocardia spp., this case emphasized mNGS playing a key role in the diagnosis and selection of effective antibiotics for the treatment of Nocardia spp. lung infections.

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A post-transplant infection by Nocardia cyriacigeorgica

Cited by 2 publications

References 20 publications

Disseminated Nocardia farcinica Infection in a Renal Transplant Patient: A Case Report

Disseminated Nocardia farcinica Infection in a Renal Transplant Patient: A Case Report

Metagenome next-generation sequencing plays a key role in the diagnosis and selection of effective antibiotics on the treatment of Nocardia pneumonia: a case report

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