Disseminated nocardiosis in an immunosuppressed patient with systemic lupus erythematosus and neuromyelitis optica spectrum disorder

Terebelo, Sima; Sharif, Sara; Chaudhry, Zeshan A.; Ginzler, Ellen M.

doi:10.1177/0961203320976928

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…In the diagnosis and treatment of Nocardia, the spread of Nocardia affects at least two adjacent organs, especially brain abscess, which is an important factor in the adverse outcome of patients. We searched relevant literature from 2017 to 2021 in PubMed and Web of Science using disseminated Nocardia infection and case reports as the keywords and included confirmed disseminated Nocardia infection involving 2 organs and the above, complete records of adult cases, a total of 126 cases of disseminated Nocardia infection were retrieved, a total of 23 cases were included in the study (13,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38), and the remaining 113 cases (58 cases involving less than 2 organs, 23 cases with disease course records incomplete, 12 cases with other infections, 11 cases with no confirmed Nocardia infection, 4 cases where the full text could not be found, and 5 cases reported non-human or adult cases) were excluded. A summary and review of the 23 cases are presented below (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Cryptogenic Organizing Pneumonia Complicated With Cutaneous Disseminated Nocardia Infection: A Case Report and Literature Review

Wei

Bao²,

Wang³

et al. 2022

Front. Med.

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Nocardia disease is a rare opportunistic infection that usually occurs in individuals with solid organ transplantation, malignant tumors, human immunodeficiency virus (HIV) infection, or chronic lung disease history. Here, we reported a rare case of cryptogenic organizing pneumonia (COP) combined with disseminated Nocardia infection. A 75-year-old man was admitted to the respiratory department due to weakness and poor appetite for 3 months. The chest CT scan showed dense patchy shadows in the dorsal lower lobe of both lungs. After the transbronchial lung biopsy, the histopathological findings supported the diagnosis of COP. During the period of glucocorticoid reduction (oral methylprednisolone tablets 24 mg one time a day), the patient presented with masses on the back and bilateral upper limbs and intermittent fever for 3 days. After admission, the patient underwent a series of examinations and an ultrasound puncture of the mass. The puncture fluid was caseous necrosis, which was confirmed to be Nocardia infection after bacterial culture, so the diagnosis was disseminated Nocardia infection. After 13 days of admission, the patient developed a headache, accompanied by decreased visual acuity and blurred vision. An imaging (enhanced brain CT) examination revealed intracranial space-occupying lesions. The neurosurgeon was consulted and performed transcranial abscess puncture and drainage, intravenous antibiotics (meropenem, etc.) for 2 months, and trimethoprim/sulfamethoxazole (TMP-SMX) for 6 months. The patient was followed up for 3 years and has remained relapse-free. The mortality rate of disseminated Nocardia infection is as high as 85%, especially when combined with brain abscesses. Therefore, timely diagnosis and correct treatment are crucial for the prevention of fatal consequences. The report of this case can enable more patients to receive early diagnosis and effective treatment, so as to obtain a satisfied prognosis.

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