Multidrug-resistant<i>Nocardia pseudobrasiliensis</i>presenting as multiple muscle abscesses

Kandasamy, Vimalkumar Veerappan; Nagabandi, Arun; Horowitz, Edward A.; Vivekanandan, Renuga

doi:10.1136/bcr-2014-205262

Cited by 12 publications

(10 citation statements)

References 13 publications

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“…Intramuscular nocardial abscesses are a rare manifestation with no well-described characteristic symptoms 5 . An extensive literature review yielded only 20 cases, with 9 abscesses in the thigh 4,5,21-24 , 6 in the iliopsoas muscle 5,7,9,21,25,26 , 2 in the calf muscles 27 , 1 in the gluteal muscles 5 , 1 in the lower abdominal wall musculature 21 , and 1 in the deltoid muscle 21 . Clearly, Nocardia has a predilection for lower extremity and hip flexor musculature.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Nocardiosis Masquerading as Soft-Tissue Malignancy

Wuthrich

Freeman

Lencioni

et al. 2021

JBJS Case Connector

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Case: A 59-year-old man, immunosuppressed after renal transplant, presented with a painful posterior thigh mass concerning for malignancy, as well as pulmonary and posterior chest wall nodules. Cultures and mass spectrometry identified Nocardia paucivorans. The patient underwent operative irrigation and debridement of the posterior thigh and chest wall, with 12 months of antibiotic therapy. Conclusion: A 2-week delay in appropriate treatment was due to low suspicion for infectious etiology. Since cultures generally take weeks for positive diagnosis, advanced molecular or biochemical methods should be used. This case demonstrates importance in maintaining a high index of suspicion for nocardiosis in immunocompromised patients with soft-tissue masses.

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Section: Discussionmentioning

confidence: 99%

Disseminated Nocardiosis Masquerading as Soft-Tissue Malignancy

Wuthrich

Freeman

Lencioni

et al. 2021

JBJS Case Connector

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“…We performed the literature review by searching the MEDLINE database using the key words "nocardia," "nocardiosis, "and "myasthenia gravis." We found that up until our search, only 7 case reports of MG patients with nocardiosis had been reported [3][4][5][6][7][8][9]. To improve understanding of the disease process, we summarized the clinical characteristics of these patients, and these are listed in table 1.…”

Section: Discussionmentioning

confidence: 99%

A case report of disseminated nocardiosis with ocular involvement in a myasthenia gravis patient and literature review

Wang

Jiang

et al. 2019

Preprint

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Background Nocardiosis is a rare and life-threatening opportunistic infection in immunocompromised patients. Myasthenia gravis (MG) patients are potentially at risk of nocardia infection because of the use of immunosuppressive agents. To date, only 7 patients with MG have been reported to have nocardiosis. Disseminated nocardiosis with ocular involvement has not been reported in MG patients. Case presentation A 66-year-old man with MG who was receiving treatment with methylprednisolone and azathioprine was found to have a respiratory infection. He also had heterogeneous symptoms with skin, brain and ocular manifestations. Nocardia bacteria verified by the culture of puncture fluid, and a diagnosis of disseminated nocardiosis was made. Except for left eye blindness, the patient completely recovered from the disease with combination antibiotic therapy. To further understand nocardiosis in patients with MG, we reviewed the previous relevant literature. According to the literature, this is the first report of disseminated nocardiosis with ocular involvement in an MG patient. Conclusions MG patients with immunosuppressant treatments are potentially at risk of a rare nocardia infection, and a favourable prognosis can be achieved through early diagnosis and appropriate antibiotic therapy.

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“…Five different species of Nocardia were identified, but N. farcinica was the most frequently isolated species. This heterogeneity likely explains why each patient was ultimately discharged on a different antimicrobial regimen (Table 2); Nocardia species have unique susceptibilities (2,3,14). Our patient's delayed clinical improvement until the addition of linezolid highlights the clinical importance of Nocardia species identification and susceptibilities.…”

Section: Case Reportmentioning

confidence: 94%

“…He would undergo repeat imaging of the chest with plans to transition to TMP/SMX monotherapy if the imaging shows significant improvement of the pulmonary nodules. (2)(3)(4). Most patients experienced nocardiosis 5-50 days after their SARS-CoV-2 diagnosis; average time to co-infection identification was 17 days.…”

Section: Case Reportmentioning

confidence: 99%

“…N ocardia pseudobrasiliensis are gram-positive aerobic actinomycetes; stains of N. pseudobrasiliensis are partially acid fast (1). As with other Nocardia species, N. pseudobrasiliensis can infect immunocompromised patients and may cause disseminated disease (2). Risk factors for nocardiosis include immunosuppression caused by solid organ or hematopoietic cell transplantation, glucocorticoid therapy, chronic lung disease, diabetes, AIDS, and malignancy (3,4).…”

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confidence: 99%

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Nocardia pseudobrasiliensis Co-infection in SARS-CoV-2 Patients

Stamos¹,

Barajas-Ochoa²,

Raybould³

2023

Emerg. Infect. Dis.

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Multidrug-resistantNocardia pseudobrasiliensispresenting as multiple muscle abscesses

Cited by 12 publications

References 13 publications

Disseminated Nocardiosis Masquerading as Soft-Tissue Malignancy

Disseminated Nocardiosis Masquerading as Soft-Tissue Malignancy

A case report of disseminated nocardiosis with ocular involvement in a myasthenia gravis patient and literature review

Nocardia pseudobrasiliensis Co-infection in SARS-CoV-2 Patients

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