Fatal<i>Nocardia farcinica</i>Bacteremia Diagnosed by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry in a Patient with Myelodysplastic Syndrome Treated with Corticosteroids

Leli, Christian; Moretti, Amedeo; Guercini, F.; Cardaccia, Angela; Furbetta, Leone; Agnelli, Giancarlo; Bistoni, Francesco; Mencacci, Antonella

doi:10.1155/2013/368637

Cited by 10 publications

(6 citation statements)

References 24 publications

(24 reference statements)

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“…Because each Nocardia species shows a specific antimicrobial susceptibility pattern, reliable microbiological data is essential for selecting the initial antibiotic therapy. In our case, the results of species identification between MALDI-TOF mass spectrometry and molecular analysis were consistent with each other, indicating the usefulness of MALDI-TOF mass spectrometry [38] . A previous study demonstrated that N. farcinica species were relatively more resistant to multiple antimicrobial agents, including third-generation cephalosporins and aminoglycosides, except amikacin, clarithromycin, and minocycline, and susceptible to imipenem, linezolid, and amikacin [23] .…”

Section: Discussionsupporting

confidence: 88%

“…In our case, the results of species identification between MALDI-TOF mass spectrometry and molecular analysis were consistent with each other, indicating the usefulness of MALDI-TOF mass spectrometry. [38] A previous study demonstrated that N. farcinica species were relatively more resistant to multiple antimicrobial agents, including thirdgeneration cephalosporins and aminoglycosides, except amikacin, clarithromycin, and minocycline, and susceptible to imipenem, linezolid, and amikacin. [23] Notably, the resistance rate of this species to trimethoprim/sulfamethoxazole was also approximately 50%; hence, an antimicrobial susceptibility test for trimethoprim/sulfamethoxazole is required, [22,23] although it has been selected as the first choice for empirical treatment in patients with nocardiosis.…”

Section: Discussionmentioning

confidence: 99%

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Disseminated nocardiosis caused by Nocardia farcinica in a patient with colon cancer

et al. 2021

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Rationale: Nocardiosis is an uncommon and potentially life-threatening infection that usually affects immunocompromised hosts. No clinical guidelines have been established for managing this rare disease, and the optimal treatment modality remains unclear. Nocardia farcinica, a relatively infrequent pathogen of nocardiosis, causes a clinically aggressive infection. In addition to our patient data, our search of the literature for patients who presented with empyema caused by N. farcinica will provide fundamental information for optimal treatment modalities.Patient concerns: A 64-year-old man was diagnosed with empyema, 4 days following surgery for sigmoid colon cancer. Brain lesions were evaluated only after N. farcinica was isolated and identified as the causative pathogen through repeated culture tests.Diagnoses: N. farcinica was isolated from the pleural effusion and confirmed as the pathogen through 16S rRNA sequencing. Interventions:The patient was successfully treated with tube thoracotomy, neurosurgical evacuation, and a combination of trimethoprim/sulfamethoxazole plus imipenem. Long-term antibiotic therapy was required to prevent recurrence.Outcomes: Pyothorax showed a good clinical response to antimicrobial therapy and drainage of pleural effusion, whereas brain abscess did not respond to medical therapy and required surgery. The patient eventually recovered and continued chemotherapy as treatment for sigmoid colon cancer.Lessons: Although extremely rare, this report demonstrates the importance of considering Nocardia infection as the differential diagnosis in immunocompromised patients who present with empyema. In particular, because of the N. farcinica infection's tendency to spread and the resistance of the organism to antibiotics, aggressive evaluation of metastatic lesions and standardized support from microbiological laboratories are important. Surgery may be required in some patients with brain abscesses to improve the chance of survival.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Disseminated nocardiosis caused by Nocardia farcinica in a patient with colon cancer

et al. 2021

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“…Species of Nocardia involved in human pathogenesis include Nocardia brasiliensis, Guinea pig nocardia and Picrax nocardia . Nocardiosis is a life-threatening disease ( 5 ) usually found in immunocompromised patients, or populations where it occurs secondary to other diseases. The lung is the most common site of nocardiosis, accounting for about 70–80% ( 6 , 7 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Disseminated Nocardiosis Caused by Nocardia vulneris in a Patient With Macroglobulinemia

Zhong

Huang

et al. 2022

Front. Public Health

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This report describes a case of disseminated nocardiosis, caused by Nocardia vulneris, in a 61-year-old man with macroglobulinemia and presenting with repeated fever, cough, shortness of breath, and muscle pain. The isolated Nocardia strain was resistant to ciprofloxacin, but susceptible to amikacin, gentamicin, tobramycin, linezolid, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic, moxifloxacin, ceftriaxone, cefotaxim, and imipenem. The patient was started on combined meropenem and doxycycline treatment, followed by trimethoprim-sulfamethoxazole, which was subsequently switched to a combination treatment of linezolid, amikacin, and trimethoprim-sulfamethoxazole. The patient recovered, and his condition remained stable. Although infection by Nocardia vulneris is rare, and it is easy to miss detection in clinical practice, clinicians should be aware of the possibility of this infection. In addition, the MIC value of the drug sensitivity test should be ascertained when there is a wide choice of medicines. The current case was treated successfully with linezolid, amikacin, and trimethoprim-sulfamethoxazole. In cases of disseminated nocardiosis, the patient should be treated with antimicrobial therapy for at least 12 months. Furthermore, bacteriological examination and antimicrobial susceptibility testing should be performed regularly.

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“…As a soil saprophyte, Nocardia species invasion into human body through the respiratory tract, skin, or digestive tract. Nocardiosis usually prevalent in immunocompromised patients or affect the populations that secondary to other diseases, it is a life-threatening diseases to the infected patients [3] . Lung is the most commonly infective site of nocardiosis, accounting for about 70-80% [4,5] , Gsenkirchen nocca, Nocardia brasiliensis, Ginea pig ncardia and Picrax ncardia are the main pathogenic bacteria of Nocardia species frequently isolated from humans.…”

Section: Discussionmentioning

confidence: 99%

Disseminated nocardiosis caused by Nocardia vulneris in a macroglobulinemia patient

Qiu¹,

Ma²,

Zhong³

et al. 2021

Preprint

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Headings Background : This is a case of a human disseminated nocardiosis caused by Nocardia vulneris which made the patient presenting with fever, cough, shortness of breath, muscle pain and multiple tubercle. Methods: Bacterial culture the blood, sputum, lung rinses and scalp pus samples of the patient, Nocardia vulneris was isolated and identified using the 16s ribosomal RNA gene sequence sequence data. and determine the sensitivity of the isolated bacteria to antibiotics and analysis of the strain's antibiotic treatment. Results: The isolated was identified as Nocardia brasiliensis, which was resistant to ciprofloxacin, but susceptible to amikacin, gentamicin, tobramycin, linezolid, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic, moxifloxacin, ceftriaxone, cefotaxim, imipenem. The patient recovered and his condition remained stable by combinations with linezolid, amikacin and trimethoprim-sulfamethoxazole. Conclusions: This is the first case report of disseminated nocardiosis caused by Nocardia vulneris, and the current case was treated successfully with linezolid, amikacin and trimethoprim-sulfamethoxazole. Clinicians should be aware of its diagnostic, and the MIC value of the drug sensitivity test should be concerned when there is a wide choice of medicines, for the disseminated cases which are diagnosed definitely should be treated with at least 12 months of antimicrobial therapy, bacteriological examination and antimicrobial susceptibility testing should be performed repeatedly.

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FatalNocardia farcinicaBacteremia Diagnosed by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry in a Patient with Myelodysplastic Syndrome Treated with Corticosteroids

Cited by 10 publications

References 24 publications

Disseminated nocardiosis caused by Nocardia farcinica in a patient with colon cancer

Disseminated nocardiosis caused by Nocardia farcinica in a patient with colon cancer

Case Report: Disseminated Nocardiosis Caused by Nocardia vulneris in a Patient With Macroglobulinemia

Disseminated nocardiosis caused by Nocardia vulneris in a macroglobulinemia patient

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