Nocardiose pulmonar em portador de doença pulmonar obstrutiva crônica e bronquiectasias

Aidê, Miguel Abidon; Lourenço, Sílvia; Marchiori, Edson; Zanetti, Gláucia; Mondino, Pedro Juan José

doi:10.1590/s1806-37132008001100016

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…Pulmonary nocardiosis is a rare thoracic infection predominantly affecting immunocompromised hosts 8 The traditional risk factors for PN include long-term steroid therapy, malignancy, chemotherapy and HIV infection 11 However, one-third of cases reportedly occur in immunocompetent patients 12 There is increasing recognition that COPD is a risk factor for PN 13 Data are mostly from case reports and small series, given the rarity of PN. 3,4,14–16 Notably, several of these cases have COPD associated with bronchiectasis and this is an important but under-recognized risk-factor for PN as well.3,13 In our series, bronchiectasis was the most common underlying CPD. No clustering of cases was noted and only five of the 22 cases were diagnosed and managed in the outpatient non-CF bronchiectasis clinic.…”

Section: Discussionmentioning

confidence: 57%

Pulmonary Nocardiosis Presenting as Exacerbation of Chronic Pulmonary Disease

Kancherla

Ramanathan

Appalaraju

et al. 2019

Indian Journal of Critical Care Medicine

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BackgroundPulmonary nocardiosis (PN) occurs in chronic pulmonary disease (CPD) in the absence of traditional risk factors. Clinical features that differentiate bacterial exacerbations (AE-CPDb) from PN-related exacerbations (AE-CPDPN) are not well described.ObjectivesTo describe a series of AE-CPDPN without traditional risk factors and compare clinical features, radiology and outcomes with age, gender and CLD-type matched AE-CPDb.Materials and methodsSingle-center retrospective review and case-control study.ResultsAE-CPDPN had longer duration of symptoms and more leukocytosis at hospitalization. AE-CPDb patients were sicker with more chronic respiratory failure (OR 33.3, p = 0.01), cardiac disease and pulmonary hypertension (OR 6.2, p = 0.008) at diagnosis. More patients with AE-CPDb were discharged on domiciliary oxygen (OR 5.27, p = 0.01). On logistic regression, AE-CPDPN was independently associated with mechanical ventilation (OR 22.3, p = 0.01), length of hospital stay (median difference, 4 days, p = 0.016) but not to hospital mortality. 22.7% of AE-CPDPN died. Respiratory failure requiring oxygen, NIPPV or mechanical ventilation was associated with mortality in AE-CPDPN.ConclusionPN is a rare cause of AE-CPD and can be suspected by longer symptom duration, more leukocytosis, consolidation and cavitation. AE-CPDPN is associated with longer hospital stay and mechanical ventilation. Respiratory failure is associated with mortality in AE-CPDPN.Key messagesPulmonary nocardiosis can present in advanced chronic lung disease as an exacerbation in the absence of traditional risk factors like immunosuppression.Bronchiectasis, followed by chronic obstructive pulmonary disease are the most common chronic lung disease risk factors.Pulmonary nocardiosis is a rare cause of acute exacerbation of chronic pulmonary disease (CPD).Compared to exacerbations of CPD due to bacterial infections, nocardiosis-related exacerbations (CPDPN) were independently related to need for mechanical ventilation and length of hospital stay.Respiratory failure requiring oxygen, noninvasive ventilation and mechanical ventilation are associated with mortality in AE-CPDPN.How to cite this articleKancherla R, Ramanathan RM PL, Appalaraju B, Srinivas R. Pulmonary Nocardiosis Presenting as Exacerbation of Chronic Pulmonary Disease. Indian J Crit Care Med 2019;23(10):467–474.

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Section: Discussionmentioning

confidence: 57%

Pulmonary Nocardiosis Presenting as Exacerbation of Chronic Pulmonary Disease

Kancherla

Ramanathan

Appalaraju

et al. 2019

Indian Journal of Critical Care Medicine

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“…Pulmonary nocardiosis is the most common manifestation of Nocardia infection. The estimated annual incidence of pulmonary nocardiosis in the United States is between 500 and 1000 cases [ 4 ]. The majority of patients have impaired cell-mediated immunity, including those with underlying malignancies and human immunodeficiency virus infection, solid-organ or hematopoietic stem cell transplant recipients, and those receiving long term corticosteroids and medications that suppress cell-mediated immunity [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Nocardiosis in the Immunocompetent Host: Case Series

Singh

West

Sanders

et al. 2015

Case Reports in Pulmonology

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“…The disease of pulmonary nocardiasis is rarely seen. It was reported that there is an approximate incidence of 500 to 1000 cases annually in the US [ 1 ]. The Nocardia is a Gram-positive filamentous bacteria and in a group of actinomycetes that can cause opportunistic infection in immune-compromised patients [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

Sukahri

Zainudin

Hadi

et al. 2020

Case Reports in Pulmonology

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Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.

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Nocardiose pulmonar em portador de doença pulmonar obstrutiva crônica e bronquiectasias

Cited by 8 publications

References 8 publications

Pulmonary Nocardiosis Presenting as Exacerbation of Chronic Pulmonary Disease

Pulmonary Nocardiosis Presenting as Exacerbation of Chronic Pulmonary Disease

Pulmonary Nocardiosis in the Immunocompetent Host: Case Series

Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

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