Abstract:RESUMO
Nocardiose pulmonar é uma infecção grave e incomum causada pela
RELATO DE CASOPaciente do sexo masculino, 49 anos, apresentou-se com queixa de mal estar geral, perda de apetite, tosse seca, dor para deglutir e febre alta a três semanas da admissão. Era acompanhado no serviço de clinica médica do Hospital Heliópolis com diagnóstico de púrpura trombocitopênica idiopática há quatro anos e esplenectomizado há quatro meses. Quando procurou este serviço, estava em uso de prednisona 1mg/kg/dia. Ex-tabagista, 4… Show more
“…Nocardia farcinica is a Gram-positive branching filamentous bacillus causing localized and disseminated infections in humans, including pulmonary infections [2–9], subcutaneous [10] and brain abscesses [11–13], and bacteremia [14–19], especially in immunocompromised patients [20]. …”
Nocardia farcinica is a Gram-positive weakly acid-fast filamentous saprophytic bacterium, an uncommon cause of human infections, acquired usually through the respiratory tract, often life-threatening, and associated with different clinical presentations. Predisposing conditions for N. farcinica infections include hematologic malignancies, treatment with corticosteroids, and any other condition of immunosuppression. Clinical and microbiological diagnoses of N. farcinica infections are troublesome, and the isolation and identification of the etiologic agent are difficult and time-consuming processes. We describe a case of fatal disseminated infection in a patient with myelodysplastic syndrome, treated with corticosteroids, in which N. farcinica has been isolated from blood culture and identified by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry. The patient died after 18 days of hospitalization in spite of triple antimicrobial therapy. Nocardia farcinica infection should be suspected in patients with history of malignancy, under corticosteroid therapy, suffering from subacute pulmonary infection,and who do not respond to conventional antimicrobial therapy. Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry can be a valuable tool for rapid diagnosis of nocardiosis.
“…Nocardia farcinica is a Gram-positive branching filamentous bacillus causing localized and disseminated infections in humans, including pulmonary infections [2–9], subcutaneous [10] and brain abscesses [11–13], and bacteremia [14–19], especially in immunocompromised patients [20]. …”
Nocardia farcinica is a Gram-positive weakly acid-fast filamentous saprophytic bacterium, an uncommon cause of human infections, acquired usually through the respiratory tract, often life-threatening, and associated with different clinical presentations. Predisposing conditions for N. farcinica infections include hematologic malignancies, treatment with corticosteroids, and any other condition of immunosuppression. Clinical and microbiological diagnoses of N. farcinica infections are troublesome, and the isolation and identification of the etiologic agent are difficult and time-consuming processes. We describe a case of fatal disseminated infection in a patient with myelodysplastic syndrome, treated with corticosteroids, in which N. farcinica has been isolated from blood culture and identified by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry. The patient died after 18 days of hospitalization in spite of triple antimicrobial therapy. Nocardia farcinica infection should be suspected in patients with history of malignancy, under corticosteroid therapy, suffering from subacute pulmonary infection,and who do not respond to conventional antimicrobial therapy. Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry can be a valuable tool for rapid diagnosis of nocardiosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.