Cervicofacial nocardiosis: Report of case

Seidel, J.; Younce, Dean C.; Hupp, James R.; Kaminski, Zigmund C.

doi:10.1016/0278-2391(94)90409-x

Cited by 9 publications

(11 citation statements)

References 14 publications

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“…Infection after direct percutaneous inoculation, penetration through the alimentary tract and rarely dental injury have been reported [8]. The diverse clinical manifestations and difficulty in culture make early diagnosis of the infection difficult.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Nodules Attributed to Nocardiosis in a Renal Transplant Recipient on Tacrolimus Therapy

et al. 2000

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We report a renal transplant patient who suffered from disseminated nocardiosis after empirical tacrolimus rescue therapy for chronic allograft rejection. The nocardiosis presented initially as only mildly tender subcutaneous calf nodules without any other signs of inflammation nor constitutional upset, which later spread to the lung and brain causing bronchopneumonia and brain abscesses. The risk factors for nocardial infection in our patient include the use of potent immunosuppressive agents such as tacrolimus, poorly controlled diabetes mellitus and kidney dysfunction. She responded well to combination antibiotic therapy comprising parenteral meropenem, cefotaxime and oral minocycline. We conclude that in transplant recipients, especially those receiving newer and more potent immunosuppressive agents like tacrolimus, nocardial infection can present as apparently ‘cold’ subcutaneous nodules without any systemic upset. An associated brain lesion should be excluded even in patients without neurological symptoms.

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Section: Discussionmentioning

confidence: 99%

Subcutaneous Nodules Attributed to Nocardiosis in a Renal Transplant Recipient on Tacrolimus Therapy

et al. 2000

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“…As with other forms of primary skin infection, extension of infection from the face to the surrounding soft tissue and bone has been described [28]. Seidel et al [30] reported severe disease from local spread of infection in a patient who presented with a nocardial dental abscess. This resulted in a submandibular abscess, which then extended into the anterior triangle of the neck and the carotid sheath [30].…”

Section: Clinical Manifestationsmentioning

confidence: 97%

“…Seidel et al [30] reported severe disease from local spread of infection in a patient who presented with a nocardial dental abscess. This resulted in a submandibular abscess, which then extended into the anterior triangle of the neck and the carotid sheath [30].…”

Section: Clinical Manifestationsmentioning

confidence: 98%

“…may also cause significant local face and neck infection in the immunocompromised patient, for example, in advanced HIV or in organ transplantation [26,30] (Table 1). Both disseminated infection and local infection have been described in patients with diabetes mellitus [35], and disseminated infection can also occur in immunocompetent individuals.…”

Section: Clinical Risk Factorsmentioning

confidence: 99%

“…Many patients with face and neck nocardiosis have required incision and drainage of the lesion or abscess [7,11,[27][28][29][30]; early drainage avoids unnecessary morbidity. Indications for aspiration, drainage, or excision of abscesses are similar to those for other chronic bacterial infections (ie, abscesses that are accessible and relatively large, or lesions that progress despite antimicrobial therapy).…”

Section: Surgical Managementmentioning

confidence: 99%

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Nocardia Infections of the Face and Neck

Outhred

Watts

Chen

et al. 2011

Curr Infect Dis Rep

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Involvement of the soft tissues of the face and neck by Nocardia spp. is uncommon. We review the epidemiology, clinical features, diagnosis, and management of such infections in the setting of primary cutaneous nocardiosis and disseminated disease. Although immune compromise is an important risk factor for these infections, they also occur in healthy individuals. Infection may arise through direct inoculation following injury or by hematogenous spread from a primary site, usually the lung. The rare variant of lymphocutaneous disease-cervicofacial nocardiosis-typically affects children, but can occur in adults. The diagnosis is made by conventional microscopy and culture, but radiological imaging is useful to delineate disease extent, and molecular methods are increasingly assisting the diagnosis by providing rapid detection and identification of the pathogen. Sulfonamides remain the preferred treatment for many cases and are an important component of the therapeutic armamentarium. Other therapeutic options include minocycline, the carbapenems, and linezolid.

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Oral Infection Involving Nocardia and Actinomyces: A Case Report

Arora

Gruwell

Cobb

2018

Clin Adv Periodontics

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Introduction: Both Actinomyces and Nocardia are Gram-positive microbes characterized by a filamentous morphology. Both can be causative agents in slowly progressive, localized, or disseminated infections that are rare and typically occur in immunocompromised patients. Oral infections involving both microorganisms are very rare. Case Presentation:A black male with a history of Type 2 diabetes was referred with a chief complaint of a persistent 3 mm × 3 mm swelling facial to the mandibular central incisors. The swelling was asymptomatic except for occasional discharge of purulent exudate. Examination revealed 5-to 6-mm mesio-lingual and mid-lingual probing depths. Radiographs revealed a well-defined radiolucency between the roots of teeth #24 and #25. A full-thickness gingival flap was reflected exposing an oval-shaped bony defect, which was debrided and the contents submitted for microscopic examination. The resulting defect was filled with demineralized freeze-dried bone allograft (DFDBA) and capped with calcium sulfate. The patient was prescribed amoxicillin and 0.12% chlorhexidine gluconate mouthrinse. Examination of the biopsied tissue revealed both Actinomyces and Nocardia microorganisms. The patient was followed for 24 months and remains symptom-free with noted radiographic evidence of bone fill in the lesion area. Conclusions:This may be the first published report of an oral infection featuring both Actinomyces and Nocardia.The case reinforces the importance of microscopic examination of biopsy material removed from unusual and persistent pathologic lesions that are destructive of bone. Clin Adv Periodontics 2018;8:167-172.

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Cervicofacial nocardiosis: Report of case

Cited by 9 publications

References 14 publications

Subcutaneous Nodules Attributed to Nocardiosis in a Renal Transplant Recipient on Tacrolimus Therapy

Subcutaneous Nodules Attributed to Nocardiosis in a Renal Transplant Recipient on Tacrolimus Therapy

Nocardia Infections of the Face and Neck

Oral Infection Involving Nocardia and Actinomyces: A Case Report

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