Nocardial Brain Abscesses in a Pregnant Woman

Braun, Todd I.; Kerson, Lawrence A.; Eisenberg, Floyd P.

doi:10.1093/clinids/13.4.630

Cited by 30 publications

(15 citation statements)

References 5 publications

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“…In humans, at least six basic forms of disease may be recognized following Nocardia infection: (i) pulmonary nocardiosis (2,7,32,38,134,190,237,287,350,356,393); (ii) systemic nocardiosis (involving two or more body sites) (15,22,36,51,165,166,202,220,319,330,357); (iii) CNS nocardiosis (43,44,50,52,133,138,142,153,184,194,198,219,309,310), (iv) extrapulmonary nocardiosis (3,23,48,137,147,180,216,234,259,317); (v) cutaneous, subcutaneous, and lymphocutaneous (sporotrichoid) nocardiosis (12, 47, 101, 123, 269, 293,…”

Section: Clinical Aspects Of Nocardl4 Infectionsmentioning

confidence: 99%

Nocardia species: host-parasite relationships

1994

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The nocardiae are bacteria belonging to the aerobic actinomycetes. They are an important part of the normal soil microflora worldwide. The type species, Nocardia asteroides, and N. brasiliensis, N. farcinica, N. otitidiscaviarum, N. nova, and N. transvalensis cause a variety of diseases in both normal and immunocompromised humans and animals. The mechanisms of pathogenesis are complex, not fully understood, and include the capacity to evade or neutralize the myriad microbicidal activities of the host. The relative virulence of N. asteroides correlates with the ability to inhibit phagosome-lysosome fusion in phagocytes; to neutralize phagosomal acidification; to detoxify the microbicidal products of oxidative metabolism; to modify phagocyte function; to grow within phagocytic cells; and to attach to, penetrate, and grow within host cells. Both activated macrophages and immunologically specific T lymphocytes constitute the major mechanisms for host resistance to nocardial infection, whereas B lymphocytes and humoral immunity do not appear to be as important in protecting the host. Thus, the nocardiae are facultative intracellular pathogens that can persist within the host, probably in a cryptic form (L-form), for life. Silent invasion of brain cells by some Nocardia strains can induce neurodegeneration in experimental animals; however, the role of nocardiae in neurodegenerative diseases in humans needs to be investigated.

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Section: Clinical Aspects Of Nocardl4 Infectionsmentioning

confidence: 99%

Nocardia species: host-parasite relationships

1994

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“…In particular, invasive pulmonary nocardiosis has been reported to occur in renal (16,28,33,97,249,257,328,355,424,641) (177,178,251,442,540,612). Pregnant women may also rarely develop nocardiosis (76,430 (124). Rarely, the disease may manifest itself as an acute fulminating infection, and diffuse, fulminant pneumonitis may occur in immunocompromised patients (229,413), patients with pulmonary alveolar proteinosis (456), and nonimmunocompromised patients (524).…”

Section: Epidemiologic Aspects Of Infection In Humansmentioning

confidence: 99%

“…As with pulmonary nocardiosis, the patients at highest risk for developing disseminated infections are severely immunocompromised patients (76). All of the previously listed underlying disorders and therapies that place patients at risk for developing invasive pulmonary nocardial infections may also predispose these patients to the development of disseminated infections.…”

Section: Epidemiologic Aspects Of Infection In Humansmentioning

confidence: 99%

The medically important aerobic actinomycetes: epidemiology and microbiology

1994

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The aerobic actinomycetes are soil-inhabiting microorganisms that occur worldwide. In 1888, Nocard first recognized the pathogenic potential of this group of microorganisms. Since then, several aerobic actinomycetes have been a major source of interest for the commercial drug industry and have proved to be extremely useful microorganisms for producing novel antimicrobial agents. They have also been well known as potential veterinary pathogens affecting many different animal species. The medically important aerobic actinomycetes may cause significant morbidity and mortality, in particular in highly susceptible severely immunocompromised patients, including transplant recipients and patients infected with human immunodeficiency virus. However, the diagnosis of these infections may be difficult, and effective antimicrobial therapy may be complicated by antimicrobial resistance. The taxonomy of these microorganisms has been problematic. In recent revisions of their classification, new pathogenic species have been recognized. The development of additional and more reliable diagnostic tests and of a standardized method for antimicrobial susceptibility testing and the application of molecular techniques for the diagnosis and subtyping of these microorganisms are needed to better diagnose and treat infected patients and to identify effective control measures for these unusual pathogens. We review the epidemiology and microbiology of the major medically important aerobic actinomycetes.

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“…12 It is believed that neutrophils initially inhibit the growth of Nocardia sp until macrophages can be fully activated. 11 These immune defenses are compromised in patients with neutropenia and also in patients whose macrophages are effected by corticosteroid therapy, as in our case.…”

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confidence: 99%

“…Overall, 50% of all Nocardia infections occur in patients with compromised cell-mediated immunity. 12 In a study by Wilson et al, 11 86% of cases that specified immunosuppressive agents reported the use of prednisone and azathioprine. They also noted that a frequent opportunistic coinfection associated with nocardiosis is cryptococcal meningitis, as well as bacterial infections, pneumocystis pneumonia, aspergillosis, and candidemia.…”

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confidence: 99%